Association of tooth loss with hypertension

Objective. Hypertension may result from changes in dietary quality and nutrient intake. We therefore sought to determine the epidemiological association between tooth loss and hypertension in South African adults. Methods. This is a secondary data analysis of a cross-sectional survey of a nationally representative sample of adults aged 25 - 70 years who participated in the South African Demographic and Health Survey during 1998 (N=9 098). The primary data were collected using a validated questionnaire, which included information on past experience of tooth loss (partial or complete), use of dental services, tobacco use and other known risk factors for hypertension. Hypertension was defined as having a measured average blood pressure (BP) ≥160/95 mmHg and/or taking antihypertensive medication. Results. The prevalences of hypertension, any tooth loss and complete edentulousness were 18.1%, 72.2% and 9.4% respectively. Tooth loss was more common among overweight/obese respondents than among those with a normal body mass index (76.7% v. 66.7%;

A reflection on leadership in academic dentistry

This reflection is perhaps most appropriate as Sefako Makgatho Health Sciences University (SMU), the youngest University in South Africa, crosses the 5-year mark of its existence. It is a privilege to have served as the first Head of the School of Oral Health Sciences and subsequently as its first Deputy Vice Chancellor for Research, Postgraduate Studies and Innovation. The fact that the school have been in existence for many more years under different institutional arrangements before its incorporation into the new university (SMU) brings unique opportunities and challenges that may not be characteristic of a new dental school nor an existing dental school. It is for this reason that it would require strong, effective leadership at all levels to navigate this uniqueness for the betterment of the school as it continues to offer one of the flagship programmes of the University. At the same time adapting to the ever-increasing demands in the higher education sector, such as ‘massification’ of higher education and demands from the society, at large

Epidemiological association between osteoporosis and combined smoking and use of snuff among South African women

Objectives: This study sought to explore the epidemiological association between the exclusive use and the combined use of snuff and smoking on the prevalence of osteoporosis in a national population sample of South African women who were 40 years and older.Materials and Methods: This study involved a nationally representative sample of South African women who were 40 years and older and took part in the 2003/2004 South African Demographic and Health Survey (n = 2050). Data on tobacco use patterns, dietary calcium intake and other relevant factors were obtained through an interviewer‑administered questionnaire. As part of the data collection procedure, participants were asked whether a doctor, a nurse or any other health professional had ever told them they had osteoporosis. Those who answered in the affirmative and/or presented medications for osteoporosis were regarded as having osteoporosis.Results: The prevalence of osteoporosis was higher among those who had ever used both snuff and smoked (17.2%) either in the past or currently than among those who had ever used snuff only (5%) or smokedonly (5.1%). Even after controlling for potential confounders in a multivariable‑adjusted logistic regression, the combined use of snuff and smoking remained positively associated with osteoporosis (odds ratio = 3.60, 95% confidence interval: 1.03‑12.61). However, higher dietary calcium intake was negatively associated with osteoporosis.Conclusions: Based on these findings, it can be concluded that the combined lifetime use of both snuff and cigarettes may increase the odds of developing osteoporosis among women who are 40 years and older.Key words: Cigarette, nicotine, osteoporosis, snuff, South Afric

Epidemiological profile of non-daily smokers in South Africa: implications for practice

Background: This study sought to provide an epidemiological profile of non-daily (ND) smokers in South Africa.Methods: Using data obtained from the 1998 South African demographic and health survey (SADHS) – the largest nationally representative datasetavailable – smokers were classified as non-daily (ND) smokers or daily smokers. NDS were defined as persons aged 18 and over who had eversmoked 100 cigarettes, but did not currently smoke daily.Results: In 1998, an estimated 10% of current smokers were ND smokers (n = 255). Of the ND smokers, 69.7% had smoked daily in the past andcurrently smoked significantly fewer cigarettes per day (CPD) than current daily smokers (5.4 vs. 9.8). ND smokers were also significantly morelikely to have made at least one attempt to quit smoking, live in smoke-free homes, have more than 12 years of schooling and live in urban areas. Compared to past daily ND smokers, those ND smokers who had never smoked daily smoked fewer CPD and were more likely to be younger than 25 years old.Conclusions: The findings of this study suggest that the majority of ND smokers in South Africa are those trying to quit smoking rather than thoseinitiating smoking. Smoking rates among ND smokers are still at a level that has been shown to pose significant health risks, therefore healthpractitioners should also prioritise non-daily smokers for interventions regarding smoking cessation

Factors associated with smoking cessation in South Africa

Objectives. To determine the factors associated with attempting to quit smoking and successfully doing so, among South Africans.Methods. Data from the 1998 South African Demographicand Health Survey (the largest nationally representative survey dataset available to date) were used. We compared the characteristics of those who attempted to quit, with those of the entire population of smokers, and compared successful quitters with those who only attempted to quit. The data analysis included logistic regression analysis.Results. Of those who ever smoked and who smoked .100 cigarettes, 68.1% (N=2 223) attempted to quit smoking, but only 14.1% succeeded of those who ever attempted to quit. Those who attempted to quit were significantly more likely to be female, white, .55 years old, have tertiary education, believe smoking is harmful, have been dependent on alcohol in the past, live in smoke-free homes, or smoke >20 cigarettes per day. Similar factors were associated with successfulquitting, except that race was not a determinant of success, and those with 1 - 7 yearsf schooling (compared with no education or higher education) were most likely to succeed, while those currently dependent on alcohol were least likely to succeed.Conclusions. Clinical interventions, programmes targeting alcohol-dependent smokers, and policies that will boost the number of smoke-free homes and increase knowledge about the adverse health effects of smoking, may increase the rate of smoking cessation in South Africa

Missed opportunities for tobacco use screening and brief cessation advice in South African primary health care: a cross-sectional study

BACKGROUND: Primary health care (PHC) settings offer opportunities for tobacco use screening and brief cessation advice, but data on such activities in South Africa are limited. The aim of this study was to determine the extent to which participants were screened for and advised against tobacco use during consultations. METHODS: This cross-sectional study involved 500 participants, 18 years and older, attended by doctors or PHC nurses. Using an exit-interview questionnaire, information was obtained on participants' tobacco use status, reason(s) for seeking medical care, whether participants had been screened for and advised about their tobacco use and patients' level of comfort about being asked about and advised to quit tobacco use. Main outcome measures included patients' self-reports on having been screened and advised about tobacco use during their current clinic visit and/or any other visit within the last year. Data analysis included the use of chi-square statistics, t-tests and multiple logistic regression analysis. RESULTS: Of the 500 participants, 14.9% were current smokers and 12.1% were smokeless tobacco users. Only 12.9% of the participants were screened for tobacco use during their current visit, indicating the vast majority were not screened. Among the 134 tobacco users, 11.9% reported being advised against tobacco use during the current visit and 35.1% during any other visit within the last year. Of the participants not screened, 88% indicated they would be 'very comfortable' with being screened. A pregnancy-related clinic visit was the single most significant predictor for being screened during the current clinic visit (OR = 4.59; 95%CI = 2.13-9.88). CONCLUSION: Opportunities for tobacco use screening and brief cessation advice were largely missed by clinicians. Incorporating tobacco use status into the clinical vital signs as is done for pregnant patients during antenatal care visits in South Africa has the potential to improve tobacco use screening rates and subsequent cessation