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Table 2 Details of US studies considered.

From: Systematic review of the relation between smokeless tobacco and non-neoplastic oral diseases in Europe and the United States

First author, year of publication

Location

Study Perioda

Sex

Age

Population

Further details of study design

Endpointsb

Experimental studies

Grasser 1997 [21]

North Carolina

10 days

M+F

18 to 47

214 soldiers

4 ST users with oral leukoplakia advised to stop

ML

Payne 1998 [22]

Nebraska, Iowa

7 days

M

Mean 25

16 snuff users with oral lesions at habitual sites only

Site of snuff placement changed

ML

Martin 1999 [23]

Texas

6 weeks

M

17 to 34

3051 air force trainees

119 ST users with oral leukoplakia ordered to stop

ML

Prospective studies

Beck 1995 [24]

North Carolina

1988 to 1991

M+F

65+

818 dentate adults (50% black, 50% white)

Selected from Piedmont study. Reexamined at 18 and 36 months

PD, OP

Dietrich 2007 [25]

National

1986 to 2002

M

40–75

43112 health professionals dentate and cancer free at baseline

Data on tooth loss recorded every 2 years

DC

Case-control studies

Fisher 2005A [26]

West Virginia

2001 to 2002

M+F

18+

90 cases of oral leukoplakia, 78 controls with periapical cysts and no oral leukoplakia

Subjects identified from biopsy of hyperkeratosis

ML

Cross-sectional studies of populations unselected by ST use

Greer 1983 [27]

Colorado

Not given

M+F

14 to 19

1119 high school students

-

ML, PD, DC

Poulson 1984 [28]

Colorado

Not given

M+F

14 to 19 Mean 16.7

445 high school students

-

ML, PD, DC

Offenbacher 1985 [29]

Georgia

Not given

M

10 to 17 Mean 13.8

565 grammar and high school students

-

ML, PD, DC

Wolfe 1987 [30]

New Mexico

Not given

M+F

14 to 19 Mean 16.0

226 Native American children at boarding school

-

ML, PD

Cummings 1989 [31]

New York

1985

M

22 to 44 Mean 29

25 baseball players and coaches

-

ML, PD

Creath 1988 [32]

Alabama

Not given

M

11 to 18

995 adolescent football players

-

ML, PD

Stewart 1989 [33]

Florida

Not given

M

10 to 18

114 middle and high school students

5588 M+F interviewed, 182 examined orally, no results for 68F

ML

Ernster 1990 [34]c

Arizona

1988

M+F

20 to 29 (77%)

1109 professional baseball players

-

ML, PD, DC

Greene 1992 [35]

Arizona

1989 to 1990

M

20 to 29 (76%)

894 professional baseball players

-

ML

Sinusas 1992 [36]

Pennsylvania

1990

M

17 to 58 Mean 25

206 baseball players and managers

-

ML, PD, DC

Daughety 1994 [37]

Iowa

Not given

M

16 to 17

821 11th and 12th grade school students

-

ML

Robertson 1997 [38]

Arizona

1988 to 1990

M

20 to 29 (77%)

1846 professional baseball players

Includes subjects in Ernster 1990 [34] and Greene 1992 [35]

ML, PD, DC

Tomar 1997 [39]d

National

1986 to 1987

M+F

12 to 17

17027 school students

NIDR National Survey of Oral Health

ML

Tomar 1999 [40]

National

1988 to 1994

M+F

18+

14087 dentate adults

Third National Health and Nutrition Examination Survey (NHANES III)

DC

Riley 2004 [41]

Florida

1993 to 2000

M+F

45+

873 adults

Reinterviews occurred over a 48 month period but analyses are all cross-sectional

OP

Shulman 2004 [42]

National

1988 to 1994

M+F

18+

17235 adults

NHANES III, but different endpoints from Tomar 1999 [40]

ML

Fisher 2005B [43]

National

1988 to 1994

M+F

18+

12932 adults

NHANES III, but different endpoints from Tomar 1999 [40] and Shulman 2004 [42]

PD

Sinusas 2006 [44]

Pennsylvania

1991 to 2000

M

Mean 26

190 to 259 baseball players and coaches examined each year

Men attending spring training. Some men may attend on multiple occasions

ML

Cross-sectional studies of populations selected by ST use and/or presence of oral lesions

Smith 1970 [45]

Tennessee

Not given

M+F

Mean 55

15000 long-term snuff users

-

ML

Christen 1979 [46]

Texas

Not given

M

18 to 22 Mean 20

14 college athletes who used ST

-

ML, PD

Kaugars 1992 [47]

Virginia

Not given

M

14 to 77 Mean 29

347 ST users recruited by advertisinge

-

ML

Little 1992 [48]

Oregon, Washington

Not given

M

15 to 77

245 ST users in Kaiser Permanente Dental Care Program

Also 223 age-matched non ST users

ML

Roberts 1997 [49]

Indiana

1994 to 1995

M+F

Not given

22 snuff users and 19 non users

Oral lesions not recorded in non users

ML

  1. a Length of follow-up period for experimental studies, period of follow-up for prospective studies, and time study conducted otherwise
  2. b DC = dental caries, ML = mucosal lesion, OP = oral pain, PD = periodontal or gingival diseases
  3. c Similar results are reported by Grady et al [83], Robertson et al [84] and Daniels et al [85]
  4. d Results from this study are also reported by Kleinman et al [86]
  5. e An additional group of 91 non users of ST with no oral lesions provides no useful information and has been ignored