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Background: Periodontitis is a chronic inflammatory disease affecting the supporting structures (periodontium) of teeth and progress to tooth loss. Smoking is a well-established modifiable risk factor that influences periodontal disease through altered immune response and changes in the oral environment. Due to demographic and behavioral factors impact of smoking on periodontal health may vary among diverse patient group. Objective: This study aims to investigate the relationship between smoking and periodontitis in diverse patient groups, with special importance on salivary pH changes and breath analysis (Exhaled Carbon Monoxide) as an additional diagnostic indicators used in this study. Methodology: A cross-sectional analytical study was conducted among diverse patient groups from varied demographic backgrounds. Periodontal parameters such as probing depth, clinical attachment loss, bleeding on probing and mobility of tooth were recorded. Smoking status, duration were assessed using structured questionnaires. Unstimulated saliva samples were collected to measure salivary pH, and breath analysis was performed to assess carbon monoxide associated with and without periodontal disease. Comparative and statistical analyses were carried out between smokers and non-smokers across different patient groups. Results: Smokers demonstrated significantly increased periodontal destruction, altered salivary pH levels, and higher levels ofexhaled carbon monoxide compared to non-smokers. Periodontal health is compromised positively with smoking, among diverse patient groups. Conclusion: Smoking adversely affects periodontal health by altering both clinical parameters and oral biochemical markers. Incorporating salivary pH and breath analysis (Exhaled Carbon Monoxide) may enhance Early detection and management of smoking-related periodontitis can enhanced by salivary pH and breath analysis(Exhaled Carbon Monoxide).