Chronic disease and smoking cessation intention: associations with oral health status, behaviors, and care in Korea.

BACKGROUND

Oral conditions are immediately perceptible in daily life and may act as proximal factors associated with smokers' intention to quit, yet it is unclear whether these associations differ by chronic disease status.

METHODS

We analyzed nationally representative Korea Community Health Survey data (2010-2024) for current smokers aged ≥30 years (N = 522,377). The outcome was cessation intention (yes/no). Oral factors included self-rated oral health, masticatory discomfort, periodontal symptoms, oral-hygiene behaviors (post-lunch toothbrushing; dental flossing/interdental brushes), and dental service utilization (checkups, scaling, unmet dental care). Survey-weighted hierarchical logistic regression estimated associations in the total sample; models were repeated within strata defined by physician-diagnosed hypertension or diabetes. In the full sample, interaction terms (oral factor × chronic disease) were tested with Holm-Bonferroni adjustment.

RESULTS

Approximately 27% had chronic diseases; the survey-weighted prevalence of cessation intention was 62.6 vs. 66.0% in chronic-disease and non-chronic groups, respectively. After full adjustment, chronic disease was associated with higher odds of intention (OR = 1.19; 95% CI: 1.11-1.26). Oral status and oral-hygiene behaviors were positively associated with intention. Dental scaling remained positively associated (OR = 1.11; 95% CI: 1.04-1.17), whereas routine checkups were borderline/non-significant (OR = 1.06; 95% CI: 1.00-1.12). Reporting unmet dental care was also associated with higher intention (OR = 1.21; 95% CI: 1.14-1.29). No statistically significant heterogeneity across chronic-disease strata was observed; formal interaction tests were not significant after Holm-Bonferroni adjustment, and marginal predicted probabilities showed only small absolute differences.

CONCLUSION

In this nationally representative sample, oral health status, hygiene behaviors, and dental care utilization showed modest yet consistent associations with smokers' intention to quit, without meaningful modification by chronic disease status. These findings support embedding evidence-based cessation support within routine dental and chronic-disease care and using observable oral health cues as conversation starters to motivate quitting.