Smokeless Forms Research Articles

Prevalence of oral mucosal lesions in tobacco users: An institutional study in south India

Use of tobacco in smoking and smokeless form is very prevalent in India. Various oral mucosal lesions are associated with use of tobacco products.To assess prevalence of various oral mucosal lesions associated with tobacco use. This cross‑sectional study was conducted in department of oral medicine and radiology in a dental college in South India. Study included 342 tobacco users. Status of tobacco usage was elicited from each participant. Each participant was examined for oral mucosal lesions. 256(74%) participants had habit of smoking and 58(17%) had habit of chewing betel quid and 28(8%) had habit of both.Oral mucosal lesions were detected 144 participants. Various oral mucosal lesions were found to be associated with tobacco usage. Participants were educated regarding harmful effects of tobacco usage.

Correlates of Using Medically-Authorized Cannabis in a Large Cohort of People Living with HIV Who Use Cannabis.

Many people living with HIV (PLWH) use cannabis to manage symptoms, but a large proportion do so without medical cannabis authorization and use cannabis obtained outside the medical stream. In jurisdictions where non-medical cannabis use is legal, PLWH who hold medical cannabis authorization may represent a unique subgroup; yet, research on the correlates of using medical cannabis (authorized by a healthcare provider) in the context of non-medical cannabis legalization is lacking. Thus, this study examined the cannabis- and health-related correlates of medical cannabis use among PLWH in Ontario, Canada, where non-medical cannabis is legal. PLWH (N = 868; 85.37% men, mean age 51.34years [SD = 12.25]) who were enrolled in the Ontario HIV Treatment Network Cohort Study in 2022 and who reported past-year cannabis use completed an assessment of sociodemographic characteristics, HIV-related variables, cannabis and other substance use, and health-related quality of life. Relatively few participants (n = 122; 14.06%) reported any medical cannabis use, with most (n = 746; 85.94%) reporting exclusive use of non-medical cannabis. Logistic regression analyses showed that greater HIV symptom distress, poorer physical-health-related quality of life, more frequent cannabis use, and using smokeless forms of cannabis were each uniquely associated with increased likelihood of using medical cannabis relative to exclusively using non-medical cannabis. Results suggest that even in jurisdictions where non-medical cannabis is legal, a subset of PLWH continue to access cannabis through the medical stream, and these individuals report distinct patterns of cannabis use and poorer physical health. Findings may inform cannabis policy and clinical care for PLWH who use cannabis.

Trend and determinants of tobacco use among Indian males over a 22-year period (1998-2021) using nationally representative data.

Tobacco consumption is associated with an increased risk of morbidity and mortality. India is one of the largest consumers of tobacco worldwide. We assessed the trend of tobacco use among Indian males over a period of 20 years using data obtained from four rounds of the National Family Health Survey (NFHS). Data on tobacco usage and relevant socioeconomic variables obtained from NFHS rounds 2 to 5 over the period 1998-2021, was used for analysis. Specifically, data were available for 138,951 males from NFHS-2, 74,369 males from NFHS-3, 112,222 males from NFHS-4, and 101,839 males from NFHS-5. Significance of association between various socio-economic factors and tobacco usage was ascertained using a multicategory logistic regression model. Among all the forms of tobacco, smokeless tobacco was predominantly used by Indian males. The proportion of smokers and those using both smoke and smokeless forms peaked during NFHS-3, followed by a consistent dip; however, the use of smokeless tobacco plateaued from NFHS-4 to NFHS-5. NFHS-5 shows that 19.2% of Indian males smoked, 27.0% used smokeless tobacco, and 6.3% used both. Tobacco use has declined significantly over the last two decades. Tobacco usage is noticeably higher among the elderly, Muslims, and those from the backward classes, while it was considerably lower for individuals belonging to the educated and wealthier segment. There has been a steady decline in tobacco use in India over the past 22 years, specifically in the smoke-form category. However, smokeless tobacco use remains nearly unaffected. The outcome of this study might aid policymakers in devising targeted tobacco control policies and improving existing ones.

Investigating the association between tobacco use and oral health among security guards at a tertiary healthcare centre in New Delhi: a cross-sectional study.

Tobacco usage is a major global public health concern, contributing to millions of deaths annually. This study focuses on security guards, an occupational group facing unique challenges, to investigate tobacco prevalence, usage patterns, and associated oral health risks. A cross-sectional study was conducted among security guards at a Tertiary Health Care Centre, from October 2022 to February 2023. Data on demographics, tobacco habits, and comorbidities were collected via a structured questionnaire. Clinical oral examinations provisionally diagnosed Oral Potentially Malignant Disorders (OPMDs) based on clinical findings. Appropriate Statistical analyses were employed. Among 696 security guards, 40.1% used tobacco, including 15.0% smokers and 74.5% engaging in smokeless tobacco. Additionally, 10.3% reported using both smoking and smokeless forms. Non-tobacco users accounted for 59.9%. Tobacco users showed a higher prevalence of OPMDs (11.4%) compared to non-tobacco users (1.4%). Security guards demonstrated a higher tobacco prevalence, with smokeless tobacco being predominant. Gender disparities in tobacco use emphasize the need for gender-specific interventions. The study highlights the significant impact of tobacco on oral health, especially the risk of OPMDs. A high prevalence of tobacco usage (40.1%), particularly smokeless tobacco, among security guards, emphasizes the importance of targeted interventions within this occupational group. Oral Potentially Malignant Disorders (OPMDs) were significantly more prevalent (11.4%) in tobacco users. The association between tobacco usage and OPMDs reaffirms the well-established association between tobacco and adverse oral health outcomes.

The association between smoking and smokeless tobacco use with dental caries among Pakistani patients

BackgroundTobacco use is widely recognised as a significant risk factor for oral cancer and periodontal diseases. However, the relationship between various types of tobacco use and dental caries has been inconsistent. This study aimed to determine the association between smoking and smokeless tobacco and dental caries among patients in a tertiary care hospital in Quetta, Pakistan.MethodsThis cross-sectional study was conducted from November 2020 to March 2021 among patients in a tertiary care hospital in Quetta, Pakistan. Oral examinations and interviews were performed according to the WHO Oral Health Survey basic methods (5th edition) to determine dental caries status, tobacco use, and oral health behaviours. The odds ratio and binary logistic regression were analysed to assess the association between the types (smoking tobacco, smokeless tobacco, and use of both types), duration, and frequency of tobacco use and high caries level (DMFT ≥ 5).ResultsFour hundred participants aged 18–65 were included, and 67.8% were tobacco users. Use of both smoking and smokeless tobacco (aOR = 14.7, 95%CI = 1.87–115.96, p = 0.011), smokeless tobacco only (aOR = 5.90, 95%CI = 1.89–18.37, p = 0.002), and smoking only (aOR = 2.18, 95%CI = 1.23–3.88, p = 0.008) were associated with significantly increased risk of high caries. Using tobacco for longer periods and more frequently daily also significantly increases the risk of high caries.ConclusionSmoking and smokeless tobacco are significantly associated with high dental caries after adjusting for other factors. Due to the high severity of dental caries and the high prevalence of tobacco use among Pakistani patients in this study, it is highly recommended to strengthen policies aimed at reducing tobacco usage, including smokeless forms.

IJCM_141A: Determinants of Awareness on Pictorial Health Warnings on Tobacco Products in the Eastern State of India

Background: Pictorial health warnings (PHWs) are an effective strategy to deter or reduce tobacco use. Objective: This study was conducted to determine the level of awareness of PHWs on tobacco products and their correlates among adults attending the outpatient department (OPD) of a tertiary care facility in Eastern India Methodology: This cross-sectional study was conducted over a period of 3 months among 307 patients aged 18 to 65. A pre-tested, semi-structured questionnaire was used for the collection of data, and inferential statistics were performed using JAMOVI version 2.3.21. Results: About 84% (95% CI, 78.9 - 87.2) of the participants were aware of PHW on tobacco products [82.4% (95% CI, 77.8 - 86.3)] for smoked forms, 51.8% (95% CI, 46.2 - 57.3) for smokeless forms. More than half of the participants felt that the current PHW was ineffective. Male [AOR, 3.13; 95% CI, 1.33 - 7.37], being educated [AOR, 3.37; 95% CI, 1.29 - 8.76], employment [AOR, 5.65; 95% CI, 1.21 - 26.30] and ever-tobacco use [AOR, 3.23; 95% CI, 1.43 - 7.2] were found to be independent correlates of PHW awareness for smoked tobacco products, whereas as being male [AOR, 2.01; 95% CI, 1.02 - 3.95] and being young (18-30 years) [AOR, 2.51; 95% CI, 1.08 - 5.84] were found to be the independent predictors of PHW awareness for smokeless tobacco products (SLT). Conclusion: Four out of every five individuals were aware of pictorial health warnings (PHW) on tobacco products; however, it was much less for SLT compared to smoked tobacco products. Male, being educated, employment and ever-tobacco use were independent correlates of awareness for the smoked form of tobacco products, whereas being young (18-30 years) was an independent predictor of awareness for SLT.

Impact of Flaxseed Oil Supplementation on Tobacco Dependence, Craving, and Haematological Parameters in Tobacco-Dependent Subjects.

Background Tobacco is prevalently used in smoking or smokeless forms and remains a major public health concern worldwide, with its adverse effects on overall health. Omega-3 fatty acid (FA) has shown its promising effects in various health conditions. Objective The purpose of this study was to evaluate the effect of flaxseed oil (omega-3 supplementation) on tobacco dependence, craving, withdrawal symptoms, and haematological parameters in tobacco users. Methods In this randomised, single-blind, placebo-controlled study, 104 tobacco users (54 in the omega-3 group and 50 in the placebo group) were supplemented with 10 ml of food-grade flaxseed oil and 10 ml of placebo for six months, respectively. Their demographics, frequency of daily tobacco use, tobacco dependence, tobacco craving, tobacco withdrawal symptoms, and complete blood count (CBC) were assessed at baseline (before intervention) and after a six-month intervention. Results The demographic characteristics of the two groups were similar except for gender at baseline. There were 50 males and four females in the omega-3 group, while there were 42 males and eight females in the placebo group. After a six-month flaxseed oil intervention, BMI values showed a significant reduction (p = 0.0081) in the omega-3 group when compared to baseline; however, CBC parameters did not show any significant changes when comparing baseline to follow-up values. On the contrary, haemoglobin and red blood cells (RBCs) showed significant changes when comparing the follow-ups of the omega-3 group with the placebo group, indicating p = 0.0016 and p = 0.0163, respectively. Also, omega-3 effectively decreased daily tobacco use frequency (p<0.0001), tobacco dependence (p<0.0001), and craving (p<0.0001). Conclusion Supplementation of 10 ml of flaxseed oil per day (omega-3 FA) for six months significantly reduced tobacco dependence and cravings. Additionally, the flaxseed oil supplementation effectively reduced the frequency of daily tobacco intake and modulated tobacco withdrawal symptoms. Thus, our results suggest that flaxseed oil supplementation is a useful adjunct for tobacco users who intend to quit tobacco use.

Factors Influencing the Consumption of Tobacco amongst the Khasi Indigenous People in Northeast India.

Tobacco use in any form is a major public health concern. It accounts for nearly 1.35 million deaths every year. Many chronic illnesses occur due to the consumption of tobacco, either smoke or smokeless form. The study aims to explore how smoking and smokeless tobacco consumption are distributed across a range of demographic and socioeconomic markers among Khasi indigenous people in Northeast India. It is a case-control study conducted in adults over 31 years of age. The study was carried out between June 2020 and August 2021. An Independent t-test was performed to determine the significant difference in age between smoking/smokeless tobacco users and non-tobacco users. Univariate and Multivariate analyses were conducted to determine the significant predictors affecting the use of smoking/smokeless tobacco in the respondents. A total of 505 respondents were included in the present study. There was a high statistically significant difference in the income level of tobacco and non-tobacco users (P value- 0.002). In Univariate analysis, it was found that the odds of consuming both forms of tobacco were significantly lower in the respondents aged between 51-60 (OR = 0.61, P value = 0.0453). The participants who studied till graduation and above had lower odds of both using forms of tobacco as compared to respondents who were illiterate/primary educated only (OR = 0.85, P value = 0.046). In conclusion, smoking and smokeless tobacco consumption are still widely prevalent in this region and strongly associated with age, gender, level of education, and place of residence. There is a need for further detailed analysis to identify risk factors that are strongly associated with the use of smoke and smokeless tobacco so that the community will be conscious about the hazardous effects of tobacco use in any form.

Impact of nicotine dependence on self-efficacy and readiness to quit among tobacco consumers in rural areas.

The aim of the present study was to determine the impact or effect of nicotine dependence on self-efficacy and readiness to quit. The current study was performed using a cross-sectional descriptive questionnaire design among tobacco users visiting primary health care facilities in the rural Jaipur district. Jaipur district is divided into four directions: east, west, north, and south. From each direction, two PHCs were selected randomly based on suitable accessibility to patients. Sample size of study is 465. Out of 465 tobacco consumers, 238 were consuming a smoked form of tobacco, and 227 study participants were consuming a smokeless form of tobacco. It was observed that the majority of study participants (145 (31%)) need smoke/smokeless tobacco within 5 minutes of waking up. With regards to internal stimuli, the majority of study participants (179 (38%)) and (203 (44%)) were not very sure that they would refrain from smoking when they were nervous and depressed. It was determined that quitting tobacco products was not at all important for 159 (34%) study participants. In regards to confidence in tobacco product quitting, only 79 (16%) of tobacco consumers were extremely confident. It was concluded that nicotine dependence impacts both self-efficacy and readiness to quit. It was determined that the higher the nicotine dependence, the less self-efficacy and the less would be the readiness to quit.

Trends in prevalence and correlates of tobacco use among school-going adolescents in Bhutan: A secondary data analysis of the 2004-2019 Global Youth Tobacco Survey.

Tobacco use remains a major public health challenge globally. In Bhutan, despite the implementation of strict tobacco control measures, the tobacco uses among the students continue to be alarmingly high compared to neighboring countries. This study aims to analyze the trends and correlates of tobacco use among students in Bhutan, utilizing the nationally representative Global Youth Tobacco Survey (GYTS) data from multiple survey years. Secondary analyses of GYTS data collected during 2004-2019 with 12,594 students aged 11-18 years were employed. Use of tobacco was defined as either smoked or smokeless tobacco use in last 30 days of the survey. Prevalence was estimated over time and multivariable log-binomial regression was used to determine the correlates of current tobacco use. Overall tobacco use prevalence increased from 18.5% in 2004 to 27.3% in 2019. Males had higher prevalence (20.4% in 2019) than females (7.0% in 2019). Smokeless tobacco use increased substantially from 8.2% to 19.4% over the study period. Earlier age of initiation had adjusted odds ratio (aOR) of 9.2 for <11 years and 12.8 for 13-16 years vs. never smoking), betel quid use (aOR 3.3), peer pressure (aOR 3.6), and lower cost were significant correlates of adolescent tobacco use. Despite tobacco control policies, tobacco use among Bhutanese students is high and has been increasing over time, especially smokeless forms. Tobacco uses regulation, targeted interventions for high-risk junior high school students, and addressing social influences are urgently needed to curb this epidemic. Sustained tobacco use surveillance and public health action is imperative to protect students in Bhutan from this harmful habit.

Smokeless and combustible tobacco use among 148,944 South Asian adults: a cross-sectional study of South Asia Biobank

IntroductionTobacco use, in both smoking and smokeless forms, is highly prevalent among South Asian adults. The aims of the study were twofold: (1) describe patterns of SLT and combustible tobacco product use in four South Asian countries stratified by country and sex, and (2) assess the relationships between SLT and smoking intensity, smoking quit attempts, and smoking cessation among South Asian men.MethodsData were obtained from South Asia Biobank Study, collected between 2018 and 2022 from 148,944 men and women aged 18 years and above, living in Bangladesh, India, Pakistan, or Sri Lanka. Mixed effects multivariable logistic and linear regression were used to quantify the associations of SLT use with quit attempt, cessation, and intensity.ResultsAmong the four South Asian countries, Bangladesh has the highest rates of current smoking (39.9% for male, 0.4% for female) and current SLT use (24.7% for male and 23.4% for female). Among male adults, ever SLT use was associated with a higher odds of smoking cessation in Bangladesh (OR, 2.88; 95% CI, 2.65, 3.13), India (OR, 2.02; 95% CI, 1.63, 2.50), and Sri Lanka (OR, 1.36; 95% CI, 1.14, 1.62). Ever SLT use and current SLT use was associated with lower smoking intensity in all countries.ConclusionsIn this large population-based study of South Asian adults, rates of smoking and SLT use vary widely by country and gender. Men who use SLT products are more likely to abstain from smoking compared with those who do not.

Determinants of awareness on pictorial health warnings on tobacco products in an Eastern state of India.

Pictorial health warnings (PHW) are an effective strategy to deter or reduce tobacco use. This study was conducted to determine the level of awareness of PHWs on tobacco products and their correlates among adults attending the outpatient department (OPD) of a tertiary care facility in Eastern India. This cross-sectional study was conducted over a period of 3 months among 307 patients aged 18 years to 65 years. A pre-tested semi-structured questionnaire was used for the collection of data and inferential statistics were performed using JAMOVI version 2.3.21. About 84% (95% CI, 78.9-87.2) of the participants were aware of PHW on tobacco products, 82.4% (95% CI, 77.8-86.3) for smoked forms and 51.8% (95% CI, 46.2-57.3) for smokeless forms. More than half of the participants felt that the current PHW were ineffective. Male [AOR, 3.13; 95% CI, 1.33-7.37], being educated [AOR, 3.37; 95% CI, 1.29-8.76], employment [AOR, 5.65; 95% CI, 1.21-26.30] and ever-tobacco use [AOR, 3.23; 95% CI, 1.43-7.2] were found to be independent correlates of PHW awareness for smoked tobacco products, whereas as being male [AOR, 2.01; 95% CI, 1.02-3.95] and being young (18-30 years) [AOR, 2.51; 95% CI, 1.08-5.84] were found to be the independent predictors of PHW awareness for smokeless tobacco products (SLT). Four out of every five individuals were aware of pictorial health warnings (PHW) on tobacco products; however, it was much less for SLT compared to smoked tobacco products. Male, being educated, employment and ever-tobacco use were independent correlates of awareness for the smoked form of tobacco products, whereas being young (18-30 years) was an independent predictor of awareness for SLT.

Tobacco consumption and its relation to time taken to death among COVID-19 patients died in an intensive care unit. A retrospective and descriptive study from Mizoram, India

Background: The relationship between tobacco consumption and coronavirus disease 2019 (COVID-19) deaths among patients admitted in an intensive care unit (ICU) has not been studied in North-east parts of India. Aims and Objectives: The aims and objectives of the present study were to study the prevalence of smoke form and smokeless form of tobacco usage among the patients who had died of COVID-19 and to study the relationship of tobacco usage and number of duration of stay in ICU and number of days taken to death from the time of testing positive. Materials and Methods: This was a retrospective descriptive study of 279 COVID-19-positive patients who got admitted in ICU in Zoram Medical College. Mizoram from February 2020 to February 2022 and subsequently died because of COVID-19 in ICU. The data regarding age, sex, date of testing positive, date of admission in ICU, and date of death were collected from the patient case sheet. The details regarding tobacco consumption were collected from the patients close relatives. Descriptive analysis was carried out by mean and standard deviation along with range for quantitative variables, frequency, and proportion for categorical variables. Data were analyzed using IBM software version 22. P&lt;0.05 was considered as significant. Results: The mean age of the study population was 63.8 years. Majority were males 178 (63.80%). 198 (70.97%) had comorbidities. One hundred and twenty-nine (46.24%) were tobacco users. Mean stay in ICU in days was 7.75 days. Majority were using smokeless form of tobacco 73 (56.59%). The mean duration of survival in days from time tested positive to the death was 39.52 days among tobacco users when compared with non-tobacco users (47.48 days) (P=0.265). Mean duration of survival was 53.07 days among smoke form versus 31.3 days among smokeless form users. (P=0.031). Conclusion: There is no conclusive finding to say that there is a significant difference in time taken to death between tobacco users and non-tobacco users.

Behavioural interventions for tobacco cessation in India: A systematic review and meta-analysis.

Tobacco consumption is an area of public health concern in India. One of the unmet needs of many low-resource countries is to provide cost-effective tobacco cessation interventions for reducing tobacco-related mortality. This article reviews studies on non-pharmacological interventions for tobacco cessation in India. A systematic review by PICO (population, intervention, comparison, outcome) of behavioural intervention-based tobacco cessation studies that met the inclusion criteria, with a minimum 1-month follow-up, reporting outcomes in terms of frequencies or percentages published between 2010 and 2020 was performed. Following the review stages, 16 studies comprising 9,613 participants were included in the review. A pooled estimate was derived using both fixed-effects and random-effects models. The intervention showed good overall efficacy for any tobacco user (relative risk [RR] = 1.73 [95% confidence interval [CI]: 1.58-1.90) (fixed-effect model)] and (RR = 2.02 [95% CI: 1.64-2.48] [random-effects model]). Behavioural intervention studies targeted towards only smokers (RR of 1.81 [95% CI: 1.55-2.11] and 1.96 [95% CI: 1.52-2.53]) and combined smoking and smokeless tobacco users (RR of 1.69 [95% CI: 1.50-1.90] and 2.12 [95% CI: 1.49-3.01]) were equally efficacious. The review provides the effectiveness of behavioural interventions in quitting tobacco among users of both smoking and smokeless forms of tobacco. The review findings are of particular significance to inform health policy decisions on the integration of cost-effective brief behavioural intervention into existing health care services in resource-constrained countries.

An Assessment of the Effectiveness of an Intervention to Quit Tobacco Use in Patients Seek Treatment from the Institute of Oral Health, Maharagama, Sri Lanka

Background: Tobacco is consumed in both smoked and smokeless forms. STEP Survey Sri Lanka 2015 showed that 29.4% males and 0.1% females were current smokers, Smokeless Tobacco (SLT) use was found in 26% of males and 5% of females. Dental setting could be considered as a suitable venue to provide brief health education message to persuade quit from tobacco. The aim of this study was to assess the effectiveness of brief intervention among tobacco users attending the Institute of Oral Health, Maharagama, Sri Lanka. Methods: Dental Surgeons provide routine care for the patients at the OPD and assess the use of tobacco at the beginning and help patients to quit tobacco which takes only 3-5 minutes. Method of intervention of this study is to provide brief messages to quit tobacco based on oral health effects due to tobacco use: staining teeth, status of periodontal health, halitosis, smoker’s keratosis, whiteness (burning) of the mucosa and palate and chewer’s mucosa. Tobacco quit rate and attempts were assessed through the telephone conversation in 3 months, 6 months intervals. Results: One hundred and twenty eighty subjects were recruited for the study, 45 (35%) failed to contact after 6 months interval which yielded the total sample of 83. Among 73 betel chewers, 46 (63%) subjects were completely quit the habit after 6 months. Eight out of 10 subjects who chew betel quid more than 5 quid per day quit. Among 22 smokers, 7 (32%) completely quit smoking with brief intervention at dental setting. Conclusion: Brief intervention at dental setting immensely helps to quit habit of daily betel chewers. This is an ongoing study relatively larger sample is needed for confirmation of the findings.&#x0D;

The Predominance of Tobacco Propensities and Tobacco-Related Oral Lesions in Textile Mill Workers of Bhopal: A Cross-Sectional Study.

Low wages, long work hours, and stressful working conditions predominantly affect the oral and general health of industrial workers, which in turn resultin their tobacco consumption. This cross-sectional study examined the prevalence of tobacco use and its associated oral lesions among textile mill workers in Bhopal, India. Oral cancer and premalignant lesions are significantly increased by smoking and chewing tobacco. The study's objective was to assess and record the prevalence of oral mucosal lesions linked to tobacco use in different age groups among Bhopal textile industry workers. A cross-sectional study was conducted among 583 textile mill workers. Data were collected using a questionnaire and the WHO Oral Health Assessment Form 2013. IBM SPSS Statistics for Windows, Version 29 (Released 2022; IBM Corp., Armonk, New York, United States) was used for the statistical analysis. Variables were compared using the mean, percentage, and standard deviation. The chi-square test and Fisher's exact test were used to compare the distribution of gender, tobacco habits, and oral mucosal lesions in different age groups. Males made up 69.1% of the workforce. A clear male preference was noted (P ≤ 0.001). About 64.7% of the workers did not have any tobacco-related habits, 20.8% used smokeless tobacco, 7.9% used a smoking form of tobacco, and 6.7% used both. Older age groups, 31-45 and >46 years old, had a higher proportion of users of smokeless tobacco (P ≤ 0.001). The most commonly reported oral mucosal lesions were ulcerative conditions in 6.9%, followed by oral submucous fibrosis (OSMF), keratotic lesions, and leukoplakia in 5.0%, 4.1%, and 3.6% of the study population, respectively. Leukoplakia and OSMF were prevalent in the 31-45-yearage group, while ulcerative lesions were more prevalent in the 18-30-yearage group (P ≤ 0.001). Workers at textile mills were more likely to use a smokeless form of tobacco. Older age groups had higher rates of smokeless tobacco use as compared to smoking, which was more prevalent in the younger age group. Oral mucosal lesions in older age groups frequently include OSMF and leukoplakia. The main reasons for engaging in the tobacco use habit were stress and a lack of awareness. Oral hygiene was a neglected entity among workers.

Abstract 8: Assessment of Oesophageal Cancer Risk Factor in Age Sex Matched Case Control Study by Using Conditional Logistic Regression in the State of Assam, North East, India

Abstract Purpose: Oesophageal cancer is one of the major type of neoplasm which have high rate incidence and mortality around the world, especially in the State of Assam of India it is major cause of concern, as the region witness increases of cases over the years, the region is known for its diversity as there are more than 100 ethnic group present which linked to different social, cultural habits and consumption pattern, previous reports found that the region has the habits of consumption of different variety of tobacco product,self prepared tobacco variety along with commercial one have widespread used in this communities. Methods: The study is a Hospital based case control study, total 200 samples with 100 cases and 100 control subjects are selected for the study. Deviation of up to 5 years is adjusted in the control subject to construct age sex matched model. The questionnaire is self administrated in nature. Results: The study found that the average age of the oesophageal cancer patient was 51.8 years (95% CI 50.52-58.20) .The factors which have found to be significantly impacted on the Incidence of oesophageal cancer are as Smoked form of tobacco (OR 2.344,CI 1.0234-5.567,P-value 0.038) while breakdown between above 40 Age group and below 40 age group,the population above 40 groups are have higher risk of Incidence to cancer among the tobacco user,Chilli (OR 1.870,CI 0.687-3.569,P-value 0.023), Spicy level (OR 1.435,CI 0.0.323-4.568,P-value 0.047), Betel Nut (OR 3.256,CI 1.235-5.567,P-value 0.015), when comparison is done on this risk factor between above 40 Age group and below it the consumption pattern of Betel Nut (61%),number of Tooth lose(73%) and Hot tea use (66%) are observed higher among the above 40 year age group. the synergistic index of Smoking habits with Alcohol use, Betel nut consumption and Consumption of Smokeless form of Tobacco is seen an increase in odd risk from 3 - 17%. Conclusion: Oesophageal cancer have great burden in the health care sector and have consequence on economic sector as more resource need to divert to care of the people, it is better to have a well-developed and well equipped infrastructure for the ease of treatment, and possibly mass screening camp and awareness mainly focus towards Tobacco consumption behavior and knowledge regarding various act to make people aware general consensus regarding its harmful effect. Citation Format: Biraj Kalita, Ksh Singh Anand. Assessment of Oesophageal Cancer Risk Factor in Age Sex Matched Case Control Study by Using Conditional Logistic Regression in the State of Assam, North East, India [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 8.

COMPARISON OF GLOBAL YOUTH TOBACCO SURVEY (GYTS) – 4 TAMIL NADU WITH INDIA

The Global Youth Tobacco Survey (GYTS) is a worldwide survey of students in grades 13 through 15 that is conducted in schools and is nationally representative. The worldwide youth tobacco survey is a component of the global tobacco surveillance system.This paper evaluates the gender disparities in tobacco use across the populations of Tamil Nadu and India using data from the GYTS 2019 survey.The 2019 GYTS objectives were determining the level of tobacco usage, indicated age, exposure to secondhand smoke, and tobacco advertising. A total of 34 schools from Tamil Nadu were chosen for the survey among the 987 schools in India.The questionnaire included details about tobacco use prevalence, quitting, secondhand smoke, the media's influence on tobacco use, the availability of tobacco to young people, and knowledge and attitudes about smoking in paper products among girls and boys between the ages of 13 and 15. Prevalence of ever tobacco users and current tobacco users (both smoking and smokeless form) in Tamil Nadu is lower than Indian average.This Youth Tobacco Survey data is used by health and education professionals to improve national and state programs aimed at preventing and reducing youth tobacco use

Prevalence and determinants of oral potentially malignant disorders in rural areas of South India.

Oral potentially malignant disorders are associated with a risk of undergoing malignant transformation and a concomitant increase in morbidity and mortality. Moreover, epidemiological studies, especially from rural areas, are important in assessing their prevalence and the identification of determinants of these disorders so that preventive strategies can be employed in tackling them. Cross-sectional descriptive study was conducted based on guidelines of the World Health Organization's Guide Epidemiology and Diagnosis of Oral Mucosal Disease and Conditions 1995 in rural areas of south India. Prevalence of oral potentially malignant disorders (OPMDs) in the studied population was 13.28%, with oral submucous fibrosis (OSMF) accounting to 6.21% and erythroplakia at 1.3%. Regression analysis revealed, age 40-54 years (odds ratio [OR] = 3.8, confidence interval [CI] at 95%-1.5-4.0, P < 0.05), lower socioeconomic groups (OR = 2.1, CI at 95%-1.4-3.1, P < 0.05), habits (OR = 3.2, CI at 95%-1.9-3.8, P < 0.05), smoke form of tobacco-beedi (OR = 2.5, CI at 95%-1.6-2.8, P < 0.05), smokeless form of tobacco-areca nut lime and leaf and tobacco (OR = 3.1, CI at 95%-1.9-3.4, P < 0.05) to be the possible determinants for OPMDs. The overall prevalence of OPMDs in the studied population was 13.28%. The most common OPMDs were OSMF. Identified determinants were age, socioeconomic group, ethnicity, diet, body mass index, and associated harmful habits.

Urinary Metabolomics Identified Metabolic Perturbations Associated with Gutka, a Smokeless Form of Tobacco.

Gutka, a form of smokeless tobacco, is widely used in the Indian subcontinent and in other regions of South Asia. Smokeless tobacco exposure is most likely to increase the incidence of oral cancer in the Indian population, and metabolic changes are a hallmark of cancer. The development of biomarkers for early detection and better prevention measures for smokeless tobacco users at risk of oral cancer can be aided by studying urinary metabolomics and offering insight into altered metabolic profiles. This study aimed to investigate urine metabolic alterations among smokeless tobacco users using targeted LC-ESI-MS/MS metabolomics approaches to better understand the effects of smokeless tobacco on human metabolism. Smokeless tobacco users' specific urinary metabolomics signatures were extracted using univariate, multivariate analysis and machine learning methods. Statistical analysis identified 30 urine metabolites significantly associated with metabolomic alterations in humans who chew smokeless tobacco. Receiver operator characteristic (ROC) curve analysis evidenced the 5 most discriminatory metabolites from each approach that could differentiate between smokeless tobacco users and controls with higher sensitivity and specificity. An analysis of multiple-metabolite machine learning models and single-metabolite ROC curves revealed discriminatory metabolites capable of distinguishing smokeless tobacco users from nonusers more effectively with higher sensitivity and specificity. Furthermore, metabolic pathway analysis depicted several dysregulated pathways in smokeless tobacco users, including arginine biosynthesis, beta-alanine metabolism, TCA cycle, etc. This study devised a novel strategy to identify exposure biomarkers among smokeless tobacco users by combining metabolomics and machine learning algorithms.