Association of Oral Pre-Malignant Lesions with the Consumption of Tobacco: A Cross-sectional Observational Study


Background: Tobacco usage is a global public health issue. It can be ingested in a variety of methods, including chewing and/or smoking. It can induce a range of oral pre-malignant lesions in addition to different malignancies (OPML). Oral submucous fibrosis (OSMF), tobacco pouch keratosis (TPK), leukoplakia, erythroplakia, and smoker’s palate are examples of these conditions. The major goal of this study was to establish the prevalence of tobacco use among workers who were at high risk of tobacco use and addiction, as well as the relationship between tobacco use and oral pre-malignant lesions.
From March to October 2014, a cross-sectional observational study of workers in four distinct sectors in Ahmedabad and Gandhinagar was conducted. Females made up 28 (3 percent) of the 909 workers polled on their present or previous cigarette use. The purpose of the oral examination was to discover pre-malignant lesions. The findings in the oral cavity were assessed based on tobacco use, and statistical analysis was used to determine the significance of the found links between tobacco use and lesions.
Males accounted for 881 of the 909 participants. Only one of the 28 females had previously chewed tobacco. Only males were included in additional analyses to eliminate gender bias. 537 (60.9 percent) of the 881 male workers used tobacco, with 360 (40.9 percent) using smokeless tobacco (SLT) and 141 (16 percent) smoking. OPML were found in 52 percent of those who had been exposed to tobacco by smoking or chewing, compared to 2.6 percent of those who had not been exposed. [40.58 (20.37 – 80.87) odds ratio] Even after quitting for 6 months, the chances of having OPML remained high. [17.70 (8.25-38.01)]; [17.70 (8.25-38.01); [17.70 (8. However, in these former customers, the danger was lowered by 56 percent [Odds ratio 0.44 (0.28-0.67)]. Oral lesions were found in 43 percent of the 360 tobacco chewers, compared to only 2.6 percent of individuals without an addiction. [Ratio of odds: 28.14 (14.05 – 56.34)]. Smoker’s palate was found in 23 percent of current smokers, but not in non-addicted workers.
Conclusion: Tobacco usage, in any form, is harmful and leads to a variety of oral premalignant lesions. Exposure to betel quid has a more detrimental effect that goes unreported. Even though tobacco use has a long-term effect, quitting can reduce the risk of developing OPML significantly. Different types of lesions should be made more aware of, and specific efforts should be followed for early identification and treatment.

Author (S) Details

Chinmay Jani
Department of Internal Medicine, Mount Auburn Hospital, Cambridge, MA, USA and Harvard Medical School, Boston, MA, USA.

Arpita Joshi
Department of Internal Medicine, Mount- Sinai Elmhurst, New York City, USA.

Kushboo Jain
Department of Radiation Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India.

Kanisha Mittal
School of Public Health, Boston University, Boston, MA, USA.

Harshal Jadav
Department of Radiology, M P Shah Medical College, Jamnagar, India.

Divyesh Jetpariya
Department of Orthopedics, C U Shah Medical College, Surendranagar, India.

Omar Al Omari
Department of Internal Medicine, Mount Auburn Hospital, Cambridge, MA, USA and Harvard Medical School, Boston, MA, USA.

Harpreet Singh
Department of Pulmonary and Critical Care, Medical College of Wisconsin, Milwaukee, WI, USA.

Umit Tapan
Department of Hematology Oncology, Boston University Medical Center, Boston, MA, USA

D. V. Bala
Department of Community Medicine, Smt NHL Municipal Medical College, Ahmedabad, India.

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