Introduction:
Though cigarette smoking is associated with a variety of negative health care effects, tooth staining and halitosis are few reversible complications associated with the aesthetic perception of the users, making them an important motivational factor in tobacco cessation practices. Nicotine Replacement Therapy (NRT) gums has been traditionally used for moderately dependent smokers to facilitate the transition from smoking to abstinence.

Objectives:
The aim of this study was to assess whether quit rates were better with a tooth whitener based NRT gum compared to that of a plain NRT gum among a group of bus drivers who were moderately dependent to cigarette smoking.

Methods:
This interventional study was conducted among sixty bus drivers who were current cigarette smokers with a mean use of 5.3 cigarettes per day for a duration of 9.4 years. The study participants were divided into two arms, with the interventional group being administered a sodium bicarbonate based tooth whitener containing NRT gum, while the control group being administered plain NRT gum, after regular tobacco cessation advices. The outcome variable assessed were tooth staining based on the modified Lobene index and subjective assessment of smoking frequency, quit and relapse rate at baseline and 6 weeks after cessation therapy.

Results:
At the end of study duration, the mean tooth stain index was reduced significantly in the interventional group from 2.4 to 1.2 (p<0.05, Mann Whitney U Test), while there was no difference in the control group. Self reported complete abstinence was reported among 7 and 5 in the intervention and control groups respectively. Both quit and relapse rates were statistically insignificant between both the groups.

Conclusion(s):
Though the subjects of this study demonstrated a significant reduction in tooth staining with a tooth whitener based NRT gum, its relevance as an additional motivating factor for smoking cessation is questionable.