The relationship between smoking-related awareness including periodontal disease and heated tobacco products vs. the Kano test for social nicotine dependence for youth in 5th and 6th grade elementary school students

Abstract

Objective: Heated tobacco products (HTPs), which have become rapidly prevalent in Japan since 2015, contain new chemicals that are not present in conventional tobacco, but their risks haven’t been adequately researched. The purpose of this study is to assess awareness of the impact of not only conventional tobacco, but also the harmful damage on periodontal tissue and HTPs on overall health as well as the effect of antismoking lectures to elementary school students.
Method: In this cross-sectional school-based study, students (aged 11-12 years) in 6 elementary schools from 2017 to 2018 completed a questionnaire on smoking-related awareness and were then given the Kano test for social nicotine dependence for youth (KTSND-youth). The KTSND-youth was reevaluated following an anti-smoking lecture.
Results: The sample consisted of 496 students (227 boys, 269 girls) among whom more than 95% recognized the harmful impact of smoking and second-hand smoke. However, the student’s awareness of harmful damage on periodontal tissue and the impact of HTPs on overall health were only 76% and 56%, respectively. The median KTSND-youth score of students significantly decreased from 3.0 before lecture to 1.0 after lecture. Furthermore, the median KTSND-youth score of students who had more knowledge about periodontal disease or HTPs was significantly lower than those without knowledge both before and after the anti-smoking lecture.
Discussion: The median KTSND-youth score in this study was lower than those in previous studies.
Conclusions: Anti-smoking lectures in elementary schools that also address the negative effects of periodontal tissue and HTPs/conventional tobacco on overall health are important for discouraging students from becoming smokers or users of HTPs in the future.