Integrating Community-Based Interventions and Medical Education to Reduce Tobacco-Related Oral Diseases: A Public Health Approach in Community Dentistry and Medicine

Authors

  • Ghazala Yasmin Kabir Medical College , Gandhara University Peshawar
  • Ayesha Zafar Akhtar Saeed Medical College, Lahore
  • Anjum Younus Liaquat College of Medicine and Dentistry, Karachi, Pakistan 
  • Kainat Zafar Akhtar Saeed Medical College, Lahore

DOI:

https://doi.org/10.36283/ziun-pjmd14-4/088

Keywords:

Tobacco Use Disorder, Oral health, Community Health Services, Primary Health Care

Abstract

Background: Tobacco consumption is a major preventable cause of oral cancer, leukoplakia, and periodontal disease. This study assessed the twofold effect of community-based interventions and medical education on the reduction of oral health risks that are caused by tobacco.

Methods: A community-based comparative interventional study was carried out in March-August 2024. There were 320 participants who were randomized into the Community Intervention Arm (n = 160) and the Educational Integration Arm (n = 160). Demographic factors, tobacco and oral lesions were measured at baseline. Also, 80 medical and dental students were enrolled in a teaching pilot module. Measurement of outcomes was done at baseline, 1 month and 3 months. Chi-square and t-tests were used to analyze the data with p < 0.05 being significant.

Results: There were no significant differences in age, gender, education, tobacco use, or oral lesions between groups (all p > 0.05) at baseline. The awareness of oral risks increased from 68 (42.5%) to 125 (78.1%) participants (p = 0.002), willingness to quit increased from 51 (31.8%) to 102 (63.7%) participants (p = 0.01), and attempts of quitting improved from 12 (7.5%) to 45 (28.1%) (p = 0.03) in the area of community arm. The knowledge scores rose to 86.2% ± 8.7 (p < 0.0001) among students (n = 80), whereas counseling competency rose to 52(65.0%) (p = 0.03) compared to 28 (35.0%) initially.

Conclusion: Community-based interventions integrated with educational training were very effective in increasing awareness of tobacco cessation, quit behavior and student counseling competency.

Author Biographies

  • Ghazala Yasmin, Kabir Medical College , Gandhara University Peshawar

    Department of Community Medicine

  • Ayesha Zafar, Akhtar Saeed Medical College, Lahore

    Department of Pathology

  • Anjum Younus, Liaquat College of Medicine and Dentistry, Karachi, Pakistan 

    Department of Community Dentistry

  • Kainat Zafar, Akhtar Saeed Medical College, Lahore

    Department of Pathology

References

1. Khan ZR, Zaidi SJA, Riaz S, Mahboob U, Mirza S, Khalid F, et al. Rural Pakistan's smokeless tobacco epidemic: a need for tailored interventions. BMC Oral Health. 2025 May 28;25(1):818. doi: 10.1186/s12903-025-06244-3.

2. Mungia R, Gelfond JAL, Valenzuela EJ, Sangdahl CE, Taverna M, Farokhi MR. Understanding dental practitioners' knowledge and practices of smokeless tobacco: South Texas Oral Health Network study. Patient Educ Couns. 2025 Jan;130:108448. doi: 10.1016/j.pec.2024.108448.

3. Rasool S, Holliday R, Khan Z, Dobbie F, Bauld L. Behavior Change Intervention for Smokeless Tobacco Cessation Delivered Through Dentists in Dental Settings: A Pragmatic Pilot Trial. Nicotine Tob Res. 2024 Jun 21;26(7):878-887. doi: 10.1093/ntr/ntad243.

4. Fisher ND, Kirtane AJ. Renal denervation for hypertension. Nat Rev Cardiol. 2025 Sep;22(9):664-674. doi: 10.1038/s41569-024-01104-z.

5. Hammad A, Ahmad A, Khraisat O, Kumar V, Munshi H, Khalid N, et al. Patent foramen ovale closure vs medical therapy in secondary prevention of stroke and TIA: A systemic review and meta-analysis. Cardiovasc Revasc Med. 2025 Jul 2:S1553-8389(25)00351-3. doi:

10.1016/j.carrev.2025.06.037.

6. Rasool S, Dobbie F, Khan Z, Holliday R, Khalid F, Khan T, et al. Process evaluation of a pragmatic feasibility trial on smokeless tobacco cessation intervention delivered in dental hospitals. BMC Publ Health. 2024 May 16;24(1):1327. doi: 10.1186/s12889-024-18821-2.

7. Rasool S, Dobbie F, Ahmad F, Khan Z, Holliday R, Bauld L. Smokeless Tobacco Cessation Support in Dental Hospitals in Pakistan: Dentists and Dental Patients' Perspectives on Current Practices, Support Needed, and Opportunities Available. Nicotine Tob Res. 2024 Jan 1;26(1):63-71. doi: 10.1093/ntr/ntad125.

8.Khan MA, Vichayanrat T, Ngoenwiwatkul Y. The association between smoking and smokeless tobacco use with dental caries among Pakistani patients. BMC Oral Health. 2024 Jun 24;24(1):723. doi: 10.1186/s12903-024-04508-y.

9. Yasmin G, Zafar A, Younus A, Zafar K. Integrating community-based interventions and medical education to reduce tobacco-related oral diseases: a public health approach in community dentistry and medicine. Pak J Med Dent. 2025 Sep 29;14(4). doi: 10.36283/ziunpjmd14-4/088.

10. B R C, Khanum N, Kulkarni P, Basavegowda M, M K, S S. E-learning module on tobacco counselling for students of medicine and dentistry in India: a needs analysis using mixed methods research. BMJ Publ Health. 2024 Dec 12;2(2):e001031. doi: 10.1136/bmjph-2024-001031.

11. Bhardwaj R, Agrawal U, Vashist P, Manna S. Determination of sample size for various study designs in medical research: A practical primer. J Family Med Prim Care. 2024 Jul;13(7):2555-2561. doi: 10.4103/jfmpc.jfmpc_1675_23.

12. Adekola AD, Alli OI, Mbata AO, Ogbeta CP. Integrating multisectoral strategies for tobacco control: Evidence-based approaches and public health outcomes. Int J Med All Body Health Res.. 2023 Jan;4(1):60-69. doi: 10.54660/IJMBHR.2024.4.1.60-69

13. Zeven K. Pregnancy-associated spontaneous coronary artery dissection in women: a literature review. Curr Ther Res. 2023 Jan;98:100697. doi: 10.1016/j.curtheres.2023.100697.

14. Tognola C, Maloberti A, Varrenti M, Mazzone P, Giannattasio C, Guarracini F, et al. Myocardial infarction with nonobstructive coronary arteries (MINOCA): current insights into pathophysiology, diagnosis, and management. Diagnostics. 2025 Apr 7;15(7):942. doi: 10.3390/diagnostics15070942.

15. Santoro F, Mallardi A, Leopizzi A, Vitale E, Stiermaier T, Trambaiolo P, et al. Stepwise approach for diagnosis and management of Takotsubo syndrome with cardiac imaging tools. Heart Fail Rev. 2022 Mar;27(2):545-558. doi: 10.1007/s10741- 021-10205-7.

16. Avraham R, Simon-Tuval T, Van Dijk D. Determinants of physical activity habit formation: a theory-based qualitative study among young adults. Int J Qual Stud Health Well-being. 2024 Dec;19(1):2341984. doi: 10.1080/17482631.2024.2341984.

17. Alsoghier A, Alnutaifi A, Alotaibi O, Alotaibi A, Alharbi A, Almubarak N, et al. Barriers and facilitators for oral health screening among tobacco users: a mixed-methods study. BMC Oral Health. 2024 Mar 5;24(1):306. doi: 10.1186/s12903-024-04084-1.

18. Cheng HG, Noggle B, Vansickel AR, Largo EG, Magnani P. Tobacco Use, Risk Perceptions, Yasmin et al., 2025 ISSN (Print): 2313-7371 ISSN (Online): 2308-2593 and Characteristics of Adults Who Used a Heated Tobacco Product (IQOS) in the United States: Cross-Sectional Survey Study. JMIR Form Res. 2025 Feb 7;9:e57398. doi: 10.2196/57398.

19. El Hajj MS, Awaisu A, Nik Mohamed MH, Saleh RA, Al Hamad NM, Kheir N, et al. Assessment of an intensive education program for pharmacists on treatment of tobacco use disorder using an objective structured clinical examination: a randomized controlled trial. BMC Med Educ. 2022 Apr 18;22(1):289. doi: 10.1186/s12909-022-03331-9.

20. Bhatt G, Goel S, Grover S, Medhi B, Singh G, Gill SS, et al. Development of a multicomponent tobacco cessation training package utilizing multiple approaches of intervention development for health care providers and patients attending non-communicable disease clinics of Punjab, India. Front Publ Health. 2022 Dec 2;10:1053428. doi: 10.3389/fpubh.2022.1053428.

21. Bhatt G, Goel S, Grover S, Medhi B, Jaswal N, Gill SS, et al. Feasibility of tobacco cessation intervention at non-communicable diseases clinics: A qualitative study from a North Indian State. PLoS One. 2023 May 4;18(5):e0284920. doi: 10.1371/journal.pone.0284920.

22. Bhatt G, Goel S, Kiran T, Grover S, Medhi B, Singh G, et al. Estimating the Cost of Delivering Tobacco Cessation Intervention Package at Noncommunicable Disease Clinics in Two Districts of North India. Nicotine Tob Res. 2023 Sep 4;25(11):1727-1735. doi: 10.1093/ntr/ntad105.

23. Naseeb U, Alam MT, Pervez F, Mustafa MS, Azam U, Laila S, et al. Knowledge, Attitude, and Perception of Passive Smoking Among Medical and Dental Students of Karachi: A Survey-Based Study. Tob Use Insights. 2024 May 23;17:1179173X241258347. doi: 10.1177/1179173X241258347.

24. Mišković I, Kuiš D, Špalj S, Pupovac A, Prpić J. Periodontal Health Status in Adults Exposed to Tobacco Heating System Aerosol and Cigarette Smoke vs. Non-Smokers: A CrossSectional Study. Dent J (Basel). 2024 Jan 29;12(2):26. doi: 10.3390/dj12020026.

25. Pouly S, Ng WT, Benzimra M, Soulan A, Blanc N, Zanetti F, et al. Effect of Switching to the Tobacco Heating System Versus Continued Cigarette Smoking on Chronic Generalized Periodontitis Treatment Outcome: Protocol for a Randomized Controlled Multicenter Study. JMIR Res Protoc. 2021 Jan 18;10(1):e15350. doi: 10.2196/15350.

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Published

2025-09-29

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How to Cite

1.
Yasmin G, Zafar A, Younus A, Zafar K. Integrating Community-Based Interventions and Medical Education to Reduce Tobacco-Related Oral Diseases: A Public Health Approach in Community Dentistry and Medicine. PJMD [Internet]. 2025 Sep. 29 [cited 2026 Jun. 3];14(4). Available from: https://ojs.zu.edu.pk/pjmd/article/view/4246

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