Abstract Introduction: Smoking related with multiple unfavorable effect on oral tissue and ample sequelae of complexity. E-cigarette initially gained its acceptance as cessation device though American Dental Association (ADA) not advocated it as a tobacco substitute. This study enquires into the exert influence of smoking and vaping on dental health, emphasizing risks, significance, and the behavioral factors driving this practice. A few research directly compares the dental health significances of smoking and vaping, hindering efforts to inform public health policies and interventions tailored to both behaviors. Method: A mixed-methods study was conducted, recruiting daily and occasional smokers and vapers, as well as non-users as a control group. Quantitative data involved surveys on smoking/vaping habits, oral health status, and biopsychosocial factors, alongside dental assessments. Qualitative data were gathered via semi-structured interviews exploring participants' perceptions and experiences. Results: Quantitative analysis showed significant differences in oral health outcomes between smokers, vapers, and non-users, with smokers displaying the highest rates of inflammatory diseases. Though the vaper group showed marked acquaintance but they expressed smoking as a media of stress reliever or a safer way to withdraw smoking gradually. Qualitative themes revealed stress, social influence, marketing strategy and risk perception as key behavioral drivers in terms of awareness, threat perception and willingness to quit smoking. Conclusion: Smoking and vaping both pose stomatognathic system health problems, with notable differences in outcomes. Targeted prevention strategies addressing biopsychosocial factors are vital to lessen these risks. Clinical Implication: The findings underscore the needfulness for dental practitioners to inform patients on the oral health threat of smoking and vaping, supporting comprehensive preventive care and health policy. Download Full Article.PDF DOI: https://doi.org/10.5281/zenodo.14560350 Home About the Joural Journal Committe Instruction to Contributors Archives BJDRE 15(1) Bangladesh Journal of Dental Research & Education official publication of Bangladesh Academy of Dentistry International (BADI)® ISSN (Online): 2308-9733 ISSN (Print): 22259015 ORCiD@BJDRE,BADI® ZENODO@BJDRE,BADI® OpenAIRE | EXPLOR@BJDRE,BADI®