While the precise mechanisms whereby cigarette
smoking can exert an effect on periodontal tissues are
not completely understood it is clear that it is still the
most significant preventable risk factor for periodontitis.
Its effects are related to the duration and number of
cigarettes consumed. The smoking status of the family
members may also be relevant both in regard to behavioral
influences and the potential consequence of passive
smoking. This latter area is in need of further research.
Besides having a range of systemic effects
which can alter the host response cigarette smoking
would also appear to have considerable local effects
which may account for the premature establishment of
the disease process in susceptible young adults.