Cranio : the journal of craniomandibular practice · 2026
Early smoking onset and temporomandibular disorder symptoms later in life.
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Machado Oliveira Leandro, Machado Oliveira José Pedro, Regina Pelissari Thayná
Аннотация
OBJECTIVES: To investigate the association between early smoking onset (SO) and TMD symptoms among adults, and assess whether smoking intensity mediates this association.
METHODS: This secondary analysis used data from the Brazilian Longitudinal Study of Ageing (ELSI-Brazil). TMD symptoms were assessed using the Fonseca Anamnestic Index. Inverse probability weighting balanced early-life confounders and estimated risk differences (RD) and risk ratios (RR). Robustness was evaluated using positive (POC) and negative (NOC) outcome controls outcomes and E-values. Mediation analysis was conducted among smokers.
RESULTS: 7,103 individuals were assessed. The RD comparing initiation before age 15 with never smoking was 0.06 (95% CI: 0.01, 0.11), corresponding to an RR of 1.37 (95% CI: 1.08, 1.72). POC, NOC, and E-values suggested residual confounding was unlikely to explain findings. No mediation via smoking intensity was observed.
CONCLUSION: Early SO is associated with higher TMD risk overall. Preventing early initiation, especially before age 15, may reduce TMD burden.
METHODS: This secondary analysis used data from the Brazilian Longitudinal Study of Ageing (ELSI-Brazil). TMD symptoms were assessed using the Fonseca Anamnestic Index. Inverse probability weighting balanced early-life confounders and estimated risk differences (RD) and risk ratios (RR). Robustness was evaluated using positive (POC) and negative (NOC) outcome controls outcomes and E-values. Mediation analysis was conducted among smokers.
RESULTS: 7,103 individuals were assessed. The RD comparing initiation before age 15 with never smoking was 0.06 (95% CI: 0.01, 0.11), corresponding to an RR of 1.37 (95% CI: 1.08, 1.72). POC, NOC, and E-values suggested residual confounding was unlikely to explain findings. No mediation via smoking intensity was observed.
CONCLUSION: Early SO is associated with higher TMD risk overall. Preventing early initiation, especially before age 15, may reduce TMD burden.