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Impact of Reduced-Exposure Nicotine Product Use on Oral Health Conditions among the High-Risk Population

Award Number: R03DE036072
ORGANIZATION: NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 07/08/2026
PERIOD OF PERFORMANCE END DATE: 07/07/2028

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Impact of Reduced-Exposure Nicotine Product Use on Oral Health Conditions among the High-Risk Population - PROJECT SUMMARY/ABSTRACT The goal of this project is to determine at the population level the extent to which the use of reduced-exposure nicotine products impacts oral health among adults at high risk of oral health conditions in the United States (U.S.). Oral health conditions are common, expensive to treat, and have major impacts on quality of life. Tobacco use (combustible tobacco smoking, smokeless tobacco use) is a leading risk factor for oral health conditions. Quitting tobacco confers reduced risk of oral health conditions relative to continued use, and this reduction in risk increases with greater time since quitting. As of 2023, the U.S. population of adults who formerly smoked tobacco/used smokeless tobacco is estimated to be >60 million people. Two new types of tobacco-free reduced- exposure nicotine products have emerged on the U.S. market and have grown in popularity: electronic nicotine products (ENPs) and oral nicotine pouches. These products expose consumers to fewer harmful or potentially harmful constituents (HPHCs) compared to combustible tobacco smoking. Use of these products has been increasing among former tobacco users; among the 58 million adults who formerly smoked tobacco, 6.8 million were using ENPs or nicotine pouches in 2023; among the 7.7 million adults who formerly used smokeless tobacco, 1.7 million were using ENPs or nicotine pouches. With market trends suggesting these population sizes will continue to grow, it is important to determine the extent to which use of these products impacts oral health. We will conduct a large-scale population-based study of adults who formerly used combusted/smokeless tobacco. We will use an empirically-driven conceptual model to guide evaluation of the extent to which the use of reduced-exposure nicotine products impacts oral health when also considering exposure to other risk factors, protective factors, and other potential confounding factors such as socioeconomic status. We will analyze data from the long-standing, longitudinal, nationally representative Population Assessment of Tobacco and Health (PATH) Study of adults (interviewed in 2013-2023+ [ongoing], current subset N~6,500). The design of the PATH Study enables us to determine cumulative lifetime exposures to tobacco products and to identify disease onset prospectively. Further, we will use biomarker data to objectively quantify and compare exposure to nicotine and carcinogens between those who do and do not use reduced-exposure nicotine products. We will conduct survival analyses to address two specific aims: Aim 1 will determine the extent to which the use of ENPs and use of nicotine pouches impacts oral health (periodontal disease-related conditions, overall oral health and symptoms) among adults who have quit smoked tobacco use. Aim 2 will determine the extent to which the use of ENPs and use of nicotine pouches impacts oral health among those who have quit smokeless tobacco use. For each aim, we will evaluate whether time to onset of each oral health outcome differs between those who do and do not use each reduced-exposure product, net of potential confounding factors.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $347,000 )
2026	2026	HEALTH RESEARCH, INC.	665 ELM ST	BUFFALO	NY	14203	ERIE	USA	Oral Diseases and Disorders Research	000	1	7/10/2026	NEW	$347,000
														Subtotal = $347,000

Grand Total All Awards = $347,000

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Impact of Reduced-Exposure Nicotine Product Use on Oral Health Conditions among the High-Risk Population

Award Number: R03DE036072

ORGANIZATION: NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 07/08/2026

PERIOD OF PERFORMANCE END DATE: 07/07/2028

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