Policy on Tobacco Use

Policy statement

The AAPD opposes the use of all forms of tobacco including cigarettes, pipes, cigars, bidis, kreteks, and smokeless tobacco and alternative nicotine delivery systems, such as tobacco lozenges, nicotine water, nicotine lollipops, or heated tobaccocigarette substitutes (electronic cigarettes). The AAPD supports national, state, and local legislation that eliminates tobacco advertising and promotions that appeal to or influence children, adolescents, or special groups. The AAPD supports prevention efforts through merchant education and enforcement of state and local laws prohibiting tobacco sales to minors. As ETS is a known human carcinogen and there is no evidence to date of a safe exposure level to ETS,²⁹ the AAPD also supports the enactment and enforcement of state and local clean indoor air and/or smoke-free policies or ordinances prohibiting smoking in public places.

Furthermore, the AAPD encourages oral health professionals to:

• determine and document tobacco use by patients and the smoking status of their parents, guardians, and caregivers.
• provide anticipatory guidance and substance abuse counseling (e.g., smoking, smokeless tobacco) and referral to primary care providers or behavioral health/addiction specialists if indicated.
• routinely examine patients for oral signs of and changes associated with tobacco use.
• promote and establish policies that ensure dental offices, clinics, and/or health care facilities, including property grounds, are tobacco free.
• support tobacco-free school laws and policies and work with school boards to increase tobacco-free environments and events.
• serve as role models by not using tobacco and urging staff members who use tobacco to stop.
• educate patients, parents, guardians, and caregivers on the serious health consequences of tobacco use and exposure to ETS in the home.
• work to ensure all third-party payors include best practice tobacco cessation counseling and pharmacotherapeutic treatments as benefits in health packages.
• work with school boards to increase tobacco-free environments for all school facilities, property, vehicles, and school events.
• work on the national level and within their state and community to organize and support anti-tobacco campaigns and to prevent the initiation of tobacco use among children and adolescents, eliminate cigarette sales from vending machines, and increase excise tax on tobacco products to reduce demand.
• work with government organizations, legislators, community leaders, and health care organizations to ban tobacco advertising, promotion, and sponsorships.
• organize and support efforts to pass national, state, and local legislation prohibiting smoking in businesses such as daycare centers where children routinely visit and other establishments where adolescents frequently are employed.
• establish and support education/training activities and prevention/cessation services throughout the community.
• recognize the U.S. Public Health Service clinical practice guideline Treating Tobacco Use and Dependence ⁵⁸ and the American Academy of Pediatrics’ Policy Statement on Protecting Children and Adolescents from Tobacco and Nicotine⁵⁹ as valuable resources.