Effects of Oral pH Changes on Smoking Desire.

Background: Nicotine addiction is associated with nicotine absorption from buccal mucosa and it is stated that the main factor that determines the nicotine absorption is saliva pH. In the literature, the effects of changes in saliva pH values after eating and drinking on smoking desire in the smokers were not questioned.

Aim: The main purpose of this study was to show the effect of saliva pH changes on smoking desire. The secondary aims were to show the effects of coffee and water drinking on saliva pH and the effects of smoking on oral-dental health (oral hygiene, gingival bleeding).

Study Design: Case-control.

Methods: A questionnaire was administered that included "Sociodemographic Data Form" and smoking history and Fagerström Test for Nicotine Dependence (FTND). Oral and dental examinations were performed with mirror sonds and using oral hygiene standard Silness and Leöe plaque index and DMFT Index (Index of Decayed Missing or Filled Teeth). Untreated saliva samples were taken and baseline saliva flow rate and pH values were measured. To assess pH changes, saliva pH was remeasured after sugar-free instant coffee and water consumption. Smoking desire was evaluated with Visual Analog Scale (VAS).

Results: There were 24 (55.8%) female and 19 (44.2%) male among the 43 smoking and 39 nonsmoking cases. Smoking was significantly associated with poor oral hygiene (in smokers 4.71 (←1.40), in nonsmokers 2.30 (←1.59); p<0.01). DMFT Index was higher in smokers than in nonsmokers (in smokers 6.45 (←3.69), in nonsmokers 3.87 (←2.67); p<0.01). Gingival bleeding was more prevalent in smokers (0.68 (←0.76)), than nonsmokers (1.20 (←0.90); p=0.009). Salivary flow rates were lower in smokers (in smokers 2.56 (←1.34), in nonsmokers 3.00 (←1.22), p=0.06). In both groups, pH values increased after coffee consumption and decreased after water; in smokers basal:6.67 (±0.41), pHcoffee: 6.93 (±0.36), pHwater: 6.85 (±0.33); in nonsmokers pHbasal: 6.84 (±0.37), pHcoffee: 7.02 (±0.37), pHwater: 6.97 (±0.31), p<0.01. The VAS values of smokers at basal 4.73 (±3.21); p<0.01, after coffee consumption 4.91 (±3.08); p<0.01 and after water 3.15 (±2.72); p<0.01.

Conclusion: The saliva pH increased after coffee consumption and decreased after drinking water. Besides VAS values decreased significantly after drinking water. The results suggest that a simple behavior such as drinking water may be used in conjunction with behavioral and cognitive therapies in the pursuit of smoking cessation.