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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