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Yamamoto Y, Nishida N et al. J Clin Periodontol 2005; 32: 1041–1046

Over more than 20 yrs, smoking has become well established as the major environmental risk factor for periodontitis. Recent studies have suggested that passive as well as active smoking may be causally involved in periodontitis. In this study, 273 workers in an Osaka factory were examined in respect of smoking exposure (salivary cotinine assessment) and periodontal condition. Passive smoking was defined by a cotinine level of 1-7 ng/ml, and active smoking by 8+ ng/ml.

There were 102 current active smokers with a mean cotinine level of 145 ng/ml, 118 passive smokers with a mean level of 3 ng/ml, and 53 non-smokers with no detectable cotinine. In these 3 groups, respective mean numbers of teeth with probing depth 4+mm were 6.2, 4.5 and 2.3; and with probing attachment level 4+mm, 1.9, 1.6 and 0.9. Significant adjusted odds ratios for the presence of periodontitis were 2.87 in passive smokers and 4.91 in active smokers.