Missed Opportunities for Detecting Alternative Nicotine Product Use in Youth: Data From the National Dental Practice-Based Research Network

J Adolesc Health. 2018 Nov;63(5):587-593. doi: 10.1016/j.jadohealth.2018.06.007.


Purpose: With growing rates of youth e-cigarette and hookah use, and the fact that use of these products is difficult to detect, surveillance and early detection efforts need to be reassessed. Physicians and pediatricians both report that their level of knowledge about these products is low. Given that over 80% of youth have had dental visits in the past year and that the effects of nicotine use are visible early in routine dental examinations, it is likely that dental professionals are well positioned to play a critical role in detection. Currently, the knowledge about alternative nicotine among practicing dental clinicians is unknown.

Methods: One thousand seven hundred and twenty-two dental professionals in community practice in the United States National Dental Practice-Based Research Network responded to a survey in the summer/fall of 2016. These data were supplemented with network membership enrollment data, and the American Community Survey, and were analyzed using descriptive statistics, measures of association, and logistic regression.

Results: Only 25%-36% of dental professionals feel knowledgeable about the most common types of alternative nicotine products, including e-cigarettes and hookahs. Thirty-eight percent of respondents reported not screening at all for e-cigarettes.

Conclusions: A substantial percentage of dental professionals do not have a working understanding of alternative nicotine products, nor are aware of their patients' use rates. Better access to information and training on alternative nicotine products could provide an opportunity to improve surveillance for early use of these products in youth populations.

Keywords: Dentistry; E-cigarettes; Hookah; Nicotine addiction; Prevention.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Dental Care
  • Dentists / education
  • Dentists / statistics & numerical data*
  • Electronic Nicotine Delivery Systems*
  • Female
  • Humans
  • Male
  • Nicotine / adverse effects*
  • Risk Factors
  • Surveys and Questionnaires
  • Vaping / adverse effects*


  • Nicotine