Objectives

The aim of the study was to estimate the prevalence of smoking and the disparities in the smoking practices of three regions in Caribbean: Jamaica, the Dominican Republic, and Puerto Rico. The secondary objective was to assess the prevalence and severity of gingivitis in relation to the smoking practices of the participating three regions.

Method

The study population comprised 1,847 (weighted N = 1,830) individuals (18 years old and above) who were volunteer participants from the capitals of Jamaica, the Dominican Republic, and Puerto Rico. A structured interview was used to assess the participants’ smoking behaviors. The participants were classified as current smokers, past smokers, or never-smokers. Oral examinations were conducted to evaluate the status of the participants’ gingival health. The gingival index (GI) was used to determine the extent of gingival inflammation. Polytomous regression was used to estimate the adjusted odds ratios (aOR) for smoking status (current, past or never), according to risk factors (sex, age group, education, marital status, tooth-brushing frequency, and city of residence). Logistic regression models were used to assess the associations between different smoking-status variables and mild to gingivitis.

Results

The majority of the participants were never-smokers, with current smokers being found most commonly in Kingston (33.22%), followed by San Juan (12.76%) and Santo Domingo (8.8%). Both current (aOR = 2.22, 95% CI: 1.45–3.40) and past (aOR = 1.87, 95% CI: 1.19–2.93) smoking (vs. never smoking) was strongly associated with severe gingivitis.

Conclusion

The results indicate that there is a high prevalence of light smokers in the participating Caribbean countries. Smoking was the most prevalent in Jamaicans and the least prevalent in Dominicans. Study population of current smokers were found to have a four-fold increased risk of severe gingivitis and a two-fold increased risk of moderate gingivitis