Objective:
To improve their performance and alertness, bus drivers are known to abuse alcohol, cigarette, kola nut, and other substances which have substantial independent and combined deleterious effects on oral tissues. The study aimed to characterize risk associations between aggregates of alcohol/tobacco use and oral health outcomes among a group of road transport workers in the Ojota and Berger bus terminals in Lagos State.

Methods:
Data was obtained from a probability sample of 150 commercial drivers from two bus terminals (Ojota and Berger) in Lagos State via face-to-face interviews and oral examination using a validated structured questionnaire. Past and present tobacco and alcohol use were evaluated evocatively. Multivariate regression analysis measured the relationship between the outcomes [potentially malignant lesions (Leukoplakia, Erythroplakia, Smokers palate, Lichen planus), periodontal disease (CPITN Scores 3,4) and OHRQoL (OHIP-14)] and exposures, controlling for covariates -age, marital status, education status, income level, oral hygiene, dental caries, functional tooth units and previous treatment.

Results:
All the respondents were male. The prevalence of ever-use alcohol was 82%, 35% were moderate or heavy drinkers (2-4 drinks). Prevalence of ever-use of tobacco was 71%; 32% were heavy smokers (>11 cigarettes per day); 64% had a history of kola nut chewing habit while 53% ate at least 2 kola nuts daily. Heavy smokers/ moderate to heavy drinkers had more potentially malignant lesions (OR=1.89, 95% CI: 1.33–3.27); significantly worse periodontal destruction(OR=3.12, 95% CI: 2.28–5.17); and significantly worse OHRQoL (OR=2.35, 95% CI: 1.42–4.54)[pain (p = 0.002), discomfort (p = 0.007), speech (P = 0.005), diet (P = 0.014), social embarrassment (P = 0.017), self-consciousness (P = 0.012)] than Non/light smokers and Non/light drinkers, after adjusting for clinical and socioeconomic covariates.

Conclusions:
This study highlights the role of tobacco and alcohol as modifiable risk factors for periodontal disease and potentially malignant lesions which can impact negatively on OHRQoL. Bus drivers in this part of Lagos State in Nigeria, are an important target group in controlling tobacco and alcohol use in Nigeria and they should receive adequate attention for oral health promotion and other preventive initiatives.