Mass. Dental Society Weighs In on Brookline Tobacco Restrictions

In advance of Brookline's 2019 Town Meeting, the Massachusetts Dental Society (MDS) joined fellow members of the Tobacco Free Mass Coalition in urging Town Meeting members to vote in favor of Article 19 to tighten the town’s flavored tobacco product sales restriction policy. Removing the exemption for mint, menthol, and wintergreen products, as well as the exemption for retail tobacco stores, will help reduce tobacco use and nicotine addiction—especially among youth—which will improve health, save lives, and reduce health care costs.

The MDS represents approximately 5,000, or 80 percent, of dentists in the Commonwealth through initiatives in education, advocacy, and promotion of the highest professional standards. As the leading authority on oral health care in Massachusetts, we take great pride in championing oral health and lending the voice of dentistry to worthy initiatives that can make a difference in the lives of residents across the Bay State.

Reducing tobacco use is a priority issue for the MDS due to the oral health complications caused by smoking and tobacco products. In addition to heart disease, lung disease, and other health problems, tobacco use has been associated with serious oral health impacts including gum disease and oral cancer.

Menthol cigarettes make up more than a quarter of the cigarette market in the United States. Because of the cooling properties and reduced throat irritability of menthol cigarettes, they are associated with increased initiation and greater addiction. In fact, the U.S. Food and Drug Administration (FDA) found that it is "likely that menthol cigarettes pose a public health risk above that seen with nonmenthol cigarettes."

According to the FDA’s Tobacco Products Scientific Advisory Committee:

• Menthol cigarettes increase the number of children who experiment with cigarettes and the number of children who become regular smokers, increasing overall youth smoking.
• Youth smokers are more likely to use menthol cigarettes than any other age group. Over half (54 percent) of youth smokers ages 12-17 use menthol cigarettes, compared to less than one-third of smokers ages 35 and older.
• Prevalence of menthol use is even higher among African American youth: seven out of 10 African-American youth smokers smoke menthol cigarettes.
• Menthol cigarettes are associated with increased nicotine dependence and reduced success in smoking cessation. While smoking rates have declined overall in recent years, use of menthol cigarettes has increased significantly. Overall, nearly 40 percent (38.8%) of smokers use menthol cigarettes. Menthol smoking rates have increased among young adults and remained constant among youth and adults, while non-menthol smoking has decreased in all three age groups.

Despite recent gains, tobacco use remains the leading cause of preventable illness and premature death in Massachusetts, and the tobacco problem is far from solved:

• Tobacco use costs Massachusetts and our residents more than $4 billion annually in health care costs.
• At least 2,100 Massachusetts kids (under age 18) become new daily smokers each year.
• In Massachusetts, 9,300 adults die each year from their own smoking.
• Approximately 103,000 Massachusetts kids alive now will ultimately die prematurely from smoking.

A 2019 report from the U.S. Centers for Disease Control and Prevention (CDC)indicated that overall tobacco use among youth is rising, driven by a spike in e-cigarette use. In 2018, there were 1.5 million more current youth e-cigarette users than in 2017. In Massachusetts, almost half of high school students reported having vaped at least once, according to the 2015 Massachusetts Youth Risk Behavior Survey. This surge in youth vaping prompted the U.S. Surgeon General to issue an advisory declaring it an epidemic. He warned of the dangers of e-cigarette use among teens and stressed the need to protect children from a lifetime of nicotine addiction and associated health risks.

While smoking e-cigarettes may pose fewer health risks than smoking regular tobacco cigarettes—the leading cause of preventable death in the United States—it is by no means harmless. E-cigarettes still contain nicotine—the addictive drug in regular cigarettes, cigars, and other tobacco products—which increases the risk of high blood pressure and diabetes. Many also include flavoring agents that may cause a chronic lung disease called bronchiolitis obliterans.

E-cigarettes also can have a significant impact on oral health. A study supported by the American Dental Association Foundation determined that vaping sweet e-cigarettes, including popular mint varieties, can increase the risk of dental cavities. Scientists evaluated e-cigarette aerosols and found that they have similar properties to high-sucrose, gelatinous candies and acidic drinks.

The Massachusetts Dental Society’s Word of Mouth publication includes more information on the dangers of e-cigarettes featured in the Winter/Spring 2019 cover story, “The Youth Vaping Epidemic.” Learn more at massdental.org/vaping.