Smoking Induced Oral Melanin Pigmentation among Ashkenazi Jewish Population

The diagnosis of oral pigmentation is a common finding in dark skinned populations. In addition to genetic factors, tobacco smoking is also considered an etiologic factor for oral melanin pigmentation. Oral pigmentation among light skinned populations has been described particularly in Caucasian Europeans and ranged between 10% and 18%. A previous study performed in Israel reported an unexpected high prevalence (24.9%) of oral pigmentation in the European Jews ("Ashkenazi") who are considered originally light skinned. Objectives: to examine the effect of smoking habit on the finding of oral pigmentation, within the Jewish Ashkenazi population in Israel. Methods: The study group included 450 Ashkenazi Jews (both parents were Ashkenazi). Two hundreds and forty four (52%) were smokers and 206 (48%) non smokers. All participants were clinically examined for oral pigmentation. Results: Statistically significant association has been demonstrated between the prevalence of oral pigmentation and tobacco smoking (p<0.001) in the whole study group as well as in each gender. The prevalence of oral pigmentation among the non-smokers was 7.3%, compared to 40.2% among the smokers. The duration of tobacco use was a major factor in the likelihood of finding oral pigmentation. The second leading factor was the amount of cigarettes consumed daily. Statistically significant association was also found between declined prevalence of oral pigmentation and the duration of smoking cessation (p<0.005). Conclusions: The current findings further validate the significant effect of tobacco smoking on the induction of oral melanin pigmentation. The higher rate of oral pigmentation noted among Ashkenazi smokers compared to other European light skinned populations as reported in the literature might be explained by some different genetic factors shared by the Jewish population, a possibility of higher prevalence of smoking habits, or a combination of both. Those assumptions require further investigations.