Tobacco Habits Research Articles

Exploring Oral Cancer Patterns: A 5-year Retrospective Analysis of Incidence, Clinical Features, Patient Behaviour and Treatment Outcomes at the Dental Unit of a Private Medical College and Hospital in Varanasi, Uttar Pradesh

Abstract Introduction: Oral cancer is a global health challenge. In India, there is a huge burden on the healthcare system. The prevalence of oral cancer globally and in India, coupled with the specific risk factors associated with the Indian population, necessitates targeted research to improve early detection and treatment outcomes. The present study analysed 93 patients with oral cancer over 5 years to determine the incidence corresponding to different stages of the disease. Materials and Methods: This retrospective cross-sectional study reviewed medical records from the hospital database. The epidemiological data included age, gender, tobacco habit, duration of tobacco use, site of the lesions, stages of cancer and the treatment provided. We analysed the relationship of epidemiological characteristics with age by the Chi-square test. The statistical test significance level was set at P < 0.05. Results: The incidences of oral cancer each year range from 8% to 12%. A male patient over 40 years of age was most affected by oral cancer 42 (45.16%). The most affected sites were buccal mucosa 36 (38.70%) and alveolus 33 (35.48%) amongst patients over 40 years of age. The predominant stage for the majority of cancer cases was Stage IV, accounting for 49 cases (52.68%). Additionally, the largest lesions, exceeding 4 cm in size, were observed in 64 cases (68.81%), and these instances were predominantly found in patients aged 40 years or older. Chewing tobacco emerged as a significant contributing factor to cancer, affecting 41 cases (42.08%), particularly among those with a habit duration exceeding 10 years, representing 48 cases (51.61%) in patients aged 40 years or older. Conclusion: There is an urgent need to spread awareness of oral cancer, followed by extensive screening in India. Tobacco in India is not only used widely but also associated with cultural relevance, and it is the need of the hour to implement the tobacco policy to reach out evenly to all communities.

Clinicopathologic characteristics of HPV-associated head and neck squamous cell carcinoma in Southern China: long-term retrospective study of 400 cases.

Human papillomavirus (HPV)-associated head and neck squamous cell carcinoma (HNSCC) is an evolving and growing disease, especially in developing countries. However, the clinical characteristics of HPV-associated HNSCC in regard to HPV infection rates, patient features, and prognosis are under-reported in the Asian population. In this study, we retrospectively enrolled a 400-case cohort of HNSCC with p16 immunochemistry and analyzed with long-term follow-up. We investigate the current HPV prevalence of HNSCC, unique HPV-associated patient clinical characteristics, and patient prognosis in the southern China population. HPV infection exhibited a 15% prevalence in all HNSCC cases, notably higher in oropharyngeal cases (30.7%), followed by oral cavity (11.8%), laryngeal (10.1%), and hypopharyngeal (2.5%). HPV status, gender, old age, and location of tumor were significantly associated with the patient's survival. Tonsil invasion was found more frequent in HPV-positive oropharyngeal HNSCC than in HPV-negative cases. HPV-associated HNSCC patients tend to possess stronger tobacco and alcohol habits, which were correlated to poor survival. HPV status's correlation with gender, age, and anatomical location is associated intricately with patient survival. The secondary primary tumor rate was found higher within the HPV-negative group, compared to the HPV-positive group (9.12% versus 1.67%). Our study provided a current picture of HPV-associated HNSCC in the southern China population and elaborated the understanding of key factors that correlate to HNSCC prognosis. Our findings indicated a strong susceptibility of HPV-associated oropharyngeal HNSCC in the tonsil and the difference in secondary primary tumor rates associated with HPV status.

Impact of tobacco habits on poor oral health status among bone-factory workers in a low literacy city in India: A cross-sectional study.

Oral health is a vital indicator of well-being that is influenced by various habits and lifestyles of individuals. Oral diseases are the bottleneck in the effective control of non-communicable diseases (NCDs) due to chronic in nature and reciprocal relationship as sharing the common risk factors and habits such as sugar, tobacco, and alcohol consumption that increase the risk of developing various inevitable diseases. However, there is a lack of literature highlighting the relationship between risk factors for oral diseases and general health among individuals. This cross-sectional study was carried out among 500 study participants aged 20 to 64 years who gave written informed consent and were recruited by Multistage Stratified Cluster Sampling technique among workers in five bone factories, working for at least one year since January 2001 to March 2022 in Sambhal city, Uttar Pradesh. WHO-Basic Oral Health Survey-1997 was used to record the data regarding sociodemographic and oral health status variables. We used the modified WHO-STEPWISE pre-structured questionnaire to record tobacco consumption habits and oral health-seeking behavior. We scheduled a clinical intra-oral examination to record the Decayed Missing Filled Teeth (DMFT) index and the interview on the premises of five bone factories. Among the 500 bone-factory workers, the total number of males was 342 (68.40%) and 158 (31.60%) were females. The mean age (Standard Deviation) was 33.18 (10), and the mean DMFT score of factory workers was 2.84 (3.12). Production workers had the highest mean DMFT score of 4.60 (3.25). More than half of the factory workers (53.2%) were tobacco users. Tobacco users were 3.52 times more likely to have a severe DMFT index. Most common pre-cancerous lesions were oral submucous fibrosis and leukoplakia. Compared to non-tobacco users, mild tobacco users have 6.80 folds higher odds of oral lesions. Tobacco consumption is not only harmful for oral health but also leads to several non-communicable and systemic diseases. NCDs and dental caries are chronic and preventable conditions with a bidirectional relationship implicated by modifiable major risk factors such as tobacco consumption. Decreasing the consumption of tobacco use may improve oral health and reduce the risk of the development of NCDs. Also, regular dental visits should be scheduled to monitor the oral health status of factory workers. Additionally, tailored intervention for tobacco cessation should be implicated to maintain the general and oral health of industrial workers.

Tobacco and marijuana use during the COVID-19 pandemic lockdown among American Indians residing in California and Oklahoma.

American Indian (AI) people experience a disproportionate tobacco and marijuana burden which may have been exacerbated by the COVID-19 pandemic. Little is known about the tobacco and marijuana habits of American Indian individuals during the COVID-19 pandemic. The objective of this study is to examine tobacco and marijuana use as well as change in use during the COVID-19 pandemic among the American Indian community. This cross-sectional study analyzes survey data from a convenience sample of American Indian individuals residing in California and Oklahoma and included adults with and without cancer that resided in both rural and urban areas (n=1068). During October 2020 - January 2021, 36.0% of participants reported current use of tobacco products, 9.9% reported current use of marijuana products, and 23.7% reported increased use of tobacco and/or marijuana in the past 30 days, with no difference between those with cancer and those without cancer. Tobacco use was associated with marital status, age, employment status, COVID-19 exposure, COVID-19 beliefs, and alcohol consumption. Marijuana use was associated with COVID-19 beliefs, alcohol consumption, and income level. Increased tobacco and/or marijuana use was associated with baseline use of those products. Nearly a quarter of participants reported increased use of tobacco and/or marijuana products during the COVID-19 pandemic. We observed high rates of tobacco use during the COVID-19 pandemic, consistent with other studies. Research is needed to examine whether tobacco and marijuana use will decrease to pre-pandemic levels post-pandemic or if these behaviors will persist post-pandemic. Given these findings, there is a pressing need to increase access to evidence-based tobacco and marijuana treatment services in the AI population post COVID-19 pandemic.

A prospective study of circulating estrogen in oral leukoplakia and oral squamous cell carcinoma.

Reports suggested that hormone replacement therapy decreased the incidence of squamous cell carcinoma (SCC) of the oral cavity. The aim of this study was to analyze and quantify the serum 17β-estradiol (E2) level by chemiluminescence immunoassay in four groups, Group I (control group with no habit of tobacco and areca), Group II (control group with a habit of tobacco and areca), Group III (potentially malignant disorder-leukoplakia), and Group IV (oral squamous cell carcinoma (OSCC)). It was the first study to evaluate E2 in four study groups with and without the habit of tobacco. The serum analysis was carried out in Cobas e411 analyzer by electrochemiluminescence immunoassay analysis. As per the Kruskal--Wallis test, statistically significant rise in estradiol levels in Group IV as in comparison to Group III as compared with Groups II and I. This study proved that irrespective of the gender bias, the female sex hormone, estradiol levels were significantly raised in OSCC patients. This study suggests that E2 may play a vital role in determining the patient prognosis in OSCC with tobacco habit. The confounding results of this preliminary study opened up new advents emphasizing the role of E2 in OSCC. The role of E2 in estrogen receptor regulation can also be a subject of study for targeted therapies in improving the patient's prognosis.

Salivary Oxidative Stress Assessment in Tobacco Users with and without Potentially Malignant Disorders and Micronuclei Estimation using Fluorescent Microscopy

Abstract Background: Consumption of tobacco in either smoking or nonsmoking form produces free radicals, contributing to an increased risk of oral cancer as a result of oxidative stress. Biochemical changes in antioxidant enzymes are responsible for tobacco-associated oral carcinogenesis. Due to the production of reactive oxygen species and oxidative stress, the promotion of carcinogenesis occurs in the cells. Oral potentially malignant disorders (OPMDs) is an assembly of benign lesions with morphologically altered clinical or histopathological tissue that has a greater than normal risk of transforming into malignant lesions after diagnosis at a later date. Micronuclei are the goal site for early genotoxic events and are involved in carcinogenic events. Micronuclei in exfoliated cells are useful biomarkers in assessing cytogenetic damage. Early detection will help to devise appropriate treatment plans, thereby improving patient survival rates. Aim and Objectives: To estimate the salivary superoxide dismutase (SOD) levels and the expression of micronuclei in exfoliated buccal cells of tobacco users before the onset of tobacco-induced oral lesions and correlating the same with patients with OPMDs to determine if this can be useful in predicting early malignant potential in subjects with habitual tobacco usage. Materials and Methods: The study included three groups. Group I – Tobacco users with OPMD (n = 50), Group II – Tobacco users without OPMD (n = 50), and Group III – Healthy controls (n = 50). Sandwich enzyme-linked immunosorbent assay was done for saliva samples for quantification of salivary SOD. Exfoliated buccal cells were smeared and stained with acridine orange stain and viewed under a fluorescent microscope for micronuclei estimation. Results: The study showed a significant difference in salivary SOD levels and increased micronuclei expression among tobacco users than healthy controls. Conclusion: Our study results revealed a gradual and steady decrease of SOD levels and increased micronuclei expression from healthy control to tobacco users without lesions and tobacco users with lesion, and this can be used as an effective noninvasive early diagnostic biomarker in assessing malignant progression in tobacco users. Furthermore, the evaluation of micronuclei estimation can serve as a simple, quick, and noninvasive chair-side procedure for regular oral cancer screening in patients with tobacco usage.

Abstract B124: An assessment of awareness on oral cancer among smokeless tobacco users in the rural skirts of Tamil Nadu, India

Abstract Background In India, the number of newly diagnosed tobacco related cancers has been estimated at approximately 250 000 out of a total of 700 000–900 000 new cancers diagnosed each year. Smokeless tobacco (ST) is tobacco consumed orally, not smoked. It has been in use for as long as other forms of tobacco consumption and its use have increased. The deleterious effects of smokeless tobacco use are perhaps not as well-known as those produced by smoking. Smokeless tobacco use has been recognized as a cause of cancer. In developing countries, tobacco is mostly chewed with other ingredients. The aim of this study is to assess the awareness of health hazards of tobacco among smokeless tobacco users in Kancheepuram District, Tamil Nadu, India. METHODOLOGY The inhabitants of the villages in Kancheepuram district were recruited after ethical clearance from the institutional ethical board, permission from the Village panchayat leader and informed consent from the participants to conduct the study. Inhabitants of the villages aged 18 to 75 years and present on the day data collection and who were willing to participate in the study were included.Random sampling method was used and data was collected from a cross-sectional survey, using a pretested Questionnaire, which included Demographic data, tobacco habits, its frequency and form.Anti-tobacco counselling was given on the spot and followed.The data collected was analysed using SPSS version21. RESULT: The study population consisted of total 800 individuals, male 400 and females 400. From the results it is observed that more than 70% were unaware of the harmful effects of using tobacco products. Majority of the females use smokeless tobacco and smoking tobacco was common among males. Most common cause of tobacco use was pleasure 32.5% and inducing factor were friends 43.7%. High prevalence of potentially malignant lesion were found among this population. Effectiveness of anti-tobacco counselling is greater among the females compared to males. CONCLUSION: The dangers from smoking and chewing tobacco are well documented within the literature but the public’s lack of knowledge of the risks is a concern. Health professionals are encouraged to disseminate information on the subject as widely as possible and improve existing screening programmes to ensure that the public is made aware of these risks, especially those within high-risk groups. Citation Format: Delfin Lovelina Francis, Saravanan SP. An assessment of awareness on oral cancer among smokeless tobacco users in the rural skirts of Tamil Nadu, India [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B124.

A Study on the Effects of Smoking among Public Smokers of Tamil Nadu

Tobacco usage is one of the biggest problems of the public health and environment in the World. Tobacco use constitutes a global epidemic that results in five million deaths each year. Cigarette contains a mix of over 7,000 chemicals. Nicotine is a highly addictive chemical present in the tobacco plant. According to the World Health Organization (WHO), India is home to 12% of the world’s smokers. The Smoking habits of tobacco have become a usual thing to all groups of people in India as well as all Countries. The smoking is not only hazards to smokers, but also to the common people and it leads to some diseases like Cancer, constricted blood vessels, Smelly Hair, Yellow Fingers, Unhealth teeth, Heart disease, Immune System, Blood Clotting, Poor Vision, Dull sense of smell and taste. Non-Smokers health also get affected by smokers and there is a possibility of getting the following ailments like Lung cancer, Breathing problems, Heart disease like heart attack, Stroke, Die early, Cardiovascular diseases, Hair Loss, Wheezing, Infant death, Blindness. Some natural disasters like Global Warming, Deforestation, Toxic Waste, Air Pollution, Water Pollution, Effects on Livestock, Biodiversity loss, Fertility of the soil and the Health impacts on home and wild animals affect the environment due to these smokers. Against this background, this study is focused on the effects of smoking among public smokers of Tamil Nadu.

Assessing the prevalence and predictors of anemia among pregnant women in India: findings from the India National Family Health Survey 2019–2021

Background Anemia is more prevalent in low- and middle-income countries including India. Anemia in pregnancy is associated with increased risk of maternal health problems and adverse birth outcomes. This study estimates the prevalence and associated risk factors of anemia among pregnant women in India. Methods This cross-sectional study is based on secondary data from the India National Family Health Survey-V (NFHS-5) conducted during 2019–2021. We extracted data of 27,317 currently pregnant women to estimate the prevalence and contributory factors associated with anemia using descriptive statistics and logistic regression analysis. Results The prevalence of anemia among pregnant women in India was 52.2%. Anemia was higher among adolescent women (61.5%), those with no education (59.2%), those belonging to poorest wealth index (61.9%), scheduled tribes (59.3%), and those from the eastern region of India (62.1%). Further, it was more prevalent among women with a habit of smoking, tobacco, or alcohol (63.0%), and women with shorter birth intervals (59.7%). Among Indian states, anemia prevalence was higher in the state of Bihar (63.1%) and the union territory of Ladakh (71.4%). Logistic regression models show that women with no education (aOR = 1.41, 95% CI = 1.27–1.57), belonging to a poorest wealth quintile (aOR = 1.69, 95% CI = 1.51–1.90), and those with a habit of smoking, tobacco, or alcohol (aOR = 1.39, 95% CI = 1.18–1.63) were more anemic than their counterparts. Additionally, women with no education showed a four-times higher risk of severe anemia (aOR = 4.79, 95% CI = 2.75–8.36) than their highly educated counterparts. Conclusion Anemia affects half of all pregnant women in India. Anemia prevalence is higher among adolescents, illiterate, poor, and tribal communities. Social norm-based interventions and strengthening the community health facilitators should be implemented to reduce the high burden of anemia in India.

Oral Cancer Hazards Related to Tobacco Use and a Transtheoretical Model Assessment of Preparedness of Individuals With Oral Potentially Malignant Disorders to Quit Tobacco Use.

Objectives There is a lack of knowledge on oral cancer and oral potentially malignant disorders (OPMDs) among the local communities of Northeast India. Since the habit of tobacco is linked to the culture and oral cancer is a widespread epidemic here, it is pertinent to assess the knowledge about risk factors and readiness to quit the habit among the study population. Methods The present research was done in the Tobacco Cessation Centre (TCC), Department of Public Health Dentistry (PHD) of Regional Dental College (RDC), Guwahati, Assam, from Jan 2023 to June 2023. This cross-sectional research was done among 200 patients aged 15-65 years. We have utilised the transtheoretical model (TTM) for assessing behaviour change. Oral inspection using a mouth mirror and explorer with adequate illumination was used to visualise the lesions. Data was collected through a self-administered questionnaire. Chi-square and odds ratio (OR) tests were used to see the association among the variables. The data was analysed with Microsoft Excel (Microsoft Corporation, Redmond, Washington) and IBMSPSSStatistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York, United States).A p-value less than 0.5 is considered to be statistically significant. Results Of the 200 participants, 64(32%) had some oral lesions linked to tobacco use. A significant correlation was observed between the oral lesions and TTM stages (OR=2.81, p<0.05). Among the participants, most were aware only of tobacco (68%) and quid chewing (58%) practices as risk reasons for developing oral cancer. Conclusion The study participants' awareness of OPMDs, their health risks, and clinical signs and symptoms could be higher. A significant relationship was seen between OPMDs and TTM behavioural stages.

Overexpression of XRCC1 is Associated with Poor Survival in Patients with Head and Neck Squamous Carcinoma and Has Potential to Be Used as Targeted Therapy by Synthetic Lethality.

Background: Head neck squamous cell carcinoma (HNSC) is globally prevalent cancer attributed to tobacco habit. Despite the significant advances in early diagnosis and treatment of HNSC chemo-radio resistance are routinely observed in patients. Aberrant DNA repair mechanisms mainly microhomology mediated DNA end joining (MMEJ) pathway causing deleterious mutations and is implicated in treatment resistance. X-ray cross complimenting group 1 (XRCC1) has recently been shown to play an essential role in MMEJ making XRCC1 a potential therapeutic target to render tumors chemo-radiosensitive. This study analyzes the correlation between the expression level of XRCC1 gene with survival, regulation by miRNA and synthetic lethality partners in HNSCC. Materials and Methods: XRCC1 gene expression was evaluated in 520 HNSC patients and 44 of normal tissues using the UALCAN (TCGA) database and its correlation with survival outcome of HNSC patients was analyzed by Kaplan-Meier plot. Infiltration of immune cells in tumors was analyzed by “Tumor-Infiltrating Immune Estimation Resource (TIMER) and promoter methylation status of XRCC1 in samples was analysed by UALCAN. STRING was used to find gene interacting partners of XRCC1. Results: XRCC1 was significantly overexpressed in primary tumor of HNSCC and significantly increased with tumor stages and grade and associated with poor survival rate. High XRCC1 expression in HNSC was positively correlated with infiltration level of B cells naïsve, CD4+ and macrophages. Conclusion: These results indicate that XRCC1 is a prognostic marker for predicting survival in HNSC patients. Understanding how XRCC1 leads to treatment resistance and modulate immune response can lead to development of targeted therapy.

O.2.3-6 Free-living patterns of physical activity and sedentary behaviour of workers from the manufacturing industry of micro, small and medium enterprises: the Happy-OPA project

Abstract Background Occupational physical activity (OPA) may not report the same health benefits as leisure time physical activity (LTPA). While LTPA is beneficial for all workers, OPA can be detrimental for health. Most importantly, LTPA might have different health effects for different occupational groups (low versus high OPA jobs). It is also unclear the influence LTPA or leisure time sedentary behaviour (LTSB) might have on the health, wellbeing and productivity of workers with high OPA jobs. This project will (i) study the free-living patterns of (occupational and leisure time) physical activity (PA) and sedentary behaviour (SB) in workers from the manufacturing industry. Then, we will (ii) investigate associations between free-living patterns of PA and SB with mental health, happiness, absenteeism and work-related injuries of manufacturer workers. Methods Cross-sectional study. Employers and occupational risk prevention services will randomly invite workers (aged 18 to 65) from manufacturing industries of micro, small and medium enterprises in Central Catalonia to participate (n = 220). Participants will wear an ActivPAL device for 7 days and will complete a questionnaire on general health, life balance between work and family life, mental well-being, mental health, work-related happiness and absenteeism. Variables (1) physical activity pattern (activPAL3TM), (2) demographic data and lifestyles (food, tobacco and alcohol habits (ESCA 2022), (3) impact of work on employees' health, absence for illness (5th and 6th European Survey of Working Conditions), (4) well-being (Health Questionnaire, SF-36), (5) Work Health Balance (WHB Questionnaire), (6) Mental Health (Patient Health Questionnaire, PHQ-9), (7) Happiness (Pemberton Happiness Index). The group will be analysed on the average value of the variables. Discussion Identifying the free-living patterns of physical activity and sedentary behaviour of workers with high OPA and its associations with health, will provide preliminary data to develop tailored PA (occupational and non-occupational) interventions to this occupational group. Support / Funding Source Grants for the recruitment of research staff (Agency for the Management of University and Research Grants, co-financed by the European Union).

Salivaomics to decode non-coding RNAs in oral cancer. A narrative review.

Oral cancer is the most debilitating disease which affects the orderly life of a human. With so much advancement in research and technology, the average life expectancy of an individual with oral cancer appears to be about 5 years. The changing trend in incidence of oral cancer among young individuals and women without tobacco habits are ascending. Non habit related oral cancer are taking centre stage and multiple factors which induce complex biology are associated in such scenarios. To decipher the aetiology and to understand the process, these cancerous conditions are to be studied at molecular level. Saliva, the most non-invasively obtained body fluid are assessed for biomarkers exclusively in liquid biopsy. This fluid gives a huge platform to study number of molecules associated with oral cancer. Non coding RNAs are transcripts with no protein coding function. They are gaining more importance in recent times. Long noncoding RNA, microRNA are major types of noncoding transcriptome that influences in progression of oral cancer. They seem to play an important role in health and disease. Apart from these, circulating tumour cells, exosomes, extracellular vesicles, antigens and other proteins can be studied from saliva. This review is aimed to update the knowledge on current biomarkers in saliva associated with oral cancer and their epigenetic role in disease progression as well recent advances in detecting these markers to identify the stage of the disease, which will help in deciding the treatment protocol.

Training on Risk Factor Identification of Dental Diseases for PKK Group in Margodadi Village, Seyegan

Several oral diseases that often occur are influenced by various risk factors that can increase the severity of the disease. Indicators included in behavioral risk factors related to non-communicable diseases include health risk, food consumption behavior, lack of vegetables and fruit, smoking and tobacco habits, lack of physical activity, and consumption of alcoholic beverages. The presence of health cadres has recently become an alternative for the world of health to overcome its human resource crisis in providing health services at the local level by recruiting them from the local community. The purpose of this activity was that it is hoped that the health cadres will be able to play an active role in exploring various kinds of risk factors for dental disease in the people of the Margodadi Village area and can become decision-makers for community members regarding the right time to see a dentist. This community service activity was carried out at PKK Groups in Margodadi Village for 76 health cadres using visual media for education. The analysis showed increased health cadres’ knowledge and awareness about risk factors of dental disease. At the end of the community service activity, educational media such as posters and leaflets were donated to PKK Groups with the hope that the cadres can convey this material to the community and apply the identification of risk factors for dental health in the community

Analyzing the Frequency of Premalignant Lesions and Oral Malignancy in Indian Subjects Attending Outpatient Department From the Low Socioeconomic Group.

Oral cancer is a rapidly growing disease among Indian subjects mainly in the low socioeconomic group. Socially and economically marginalized subjects are at high risk for oral cancer because of smoke and smokeless tobacco consumption. To evaluate the prevalence of precancerous lesions and oral cancerand evaluate tobacco as a causative factor in Indian subjects visiting the outpatient department of the institute. Around 658 subjects were analyzed forfrequency of premalignant lesions and oral malignancy in Indian subjects from the low socioeconomic group. Patientsvisited for pain, burning, or ulceration in the oral cavity were clinically assessed for any tissue growths, leathery alterations, ulcerative changes,and white or red lesions in the oral cavity. Results:The overall prevalence of smokeless and smoking tobacco was 78.8% (n=518) and 65.2% (n=429) respectively in the present study. Around 39.8% (n=262) of samples were stained positive for precancerous and cancerous lesions of the oral cavity. The highest number of positive samples were from buccal mucosa with 36.2% (n=238) subjects and 6.1% (n=40) for labial mucosa. Oral cancer is highly prevalent in Indian subjects owing to high tobacco consumption rates and habits warranting the cessation center a priority. Also, early detection and screening are vital to attaining better outcomes. More tobacco cessation centers areneededto stop the habit and early diagnosis will prevent dysplastic changes.

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.

The Smell of Opium in Minangkabau: Tradition of Betel Chewing and Smoking Tobacco in the 19th Century

One of the historical themes of the Padri movement in Minangkabau in the 19th century was about eradicating the habit of smoking madat that occurred in Minangkabau society. The habit of smoking opium cannot be read at face value without investigating how opium-derived opium is used in the daily habits of the Minangkabau people. For example, in the habit of chewing betel nut and smoking tobacco. Therefore, using a social history approach, this paper will describe how opium is involved in the habit of chewing betel nut and smoking tobacco in the Minangkabau community. Thus, this paper will help explain how to understand the social context of the Padri in eradicating habits that they consider to be behavior that is not in accordance with Islamic teachings.

Abstract 65: Oral Health Inequalities Among Tobacco Users in the Tea Plantation Workers, Nilgiri Hills, Tamilnadu, India

Abstract Purpose: Tea is an important agro-industry of India, which contributes immensely to the countries economy. Poor socio-economic conditions, ignorance due to illiteracy, over-crowded and unhygienic living conditions in the residential colonies make tea garden population vulnerable. Hence this study was contemplated with an aim to assess the oral health status, tobacco use and cancer awareness among tea plantation workers, Nilgiri Hills, Tamil Nadu, India. Methods: A cross-sectional descriptive study was conducted to assess the prevalence of head and neck cancers among tobacco use and cancer awareness among tea plantation workers, Nilgiri Hills. Data was collected using a pretested Questionnaire, which included Demographic data, tobacco habits, its frequency and form. Oral examination for potentially malignant and cancerous lesions was done by the examiner. The data collected was analysed using SPSS version 21. Results: Results showed that among 900 study population, 57% had no formal education, 64.5% had indigenous brushing habits. Of those who had the habit of smoking, 26% smoked beedi, 10.9% smoked cigarette, 65% chewed raw tobacco, 18% chewed Hans and 28% had a combination of smoking and smokeless tobacco usage. 52% of oral mucosal and potentially malignant lesions, 6% oral cancers were observed. Prevalence of oral mucosal lesions in the study population was due to tobacco usage and lack of awareness regarding the deleterious effects of the products used. Conclusion: The dangers from smoking and chewing tobacco are well documented within the literature but the public’s lack of knowledge of the risks is a concern. Health professionals are encouraged to ensure that the public is made aware of these risks, especially those within high-risk groups. Citation Format: Delfin Lovelina Francis. Oral Health Inequalities Among Tobacco Users in the Tea Plantation Workers, Nilgiri Hills, Tamilnadu, 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 65.

EVALUATION OF CYTOGENIC DAMAGE IN ORAL EXFOLIATED BUCCAL CELLS OF TOBACCO USERS AND PATIENTS WITH POTENTIALLY MALIGNANT DISORDERS USING MICRONUCLEUS ASSAY - A PROSPECTIVE STUDY

Background: Cytogenic methods acts with complex type mutations, known as structural mutations (aberrations)and a special type of chromosomal damage, known as micronucleus. So, micronucleus (MN) assay has been used as a biomarker of genetic damage in buccal mucosa cells. Aim and Objectives: To evaluate micronucleus in the exfoliated cells of buccal mucosa of individuals with potentially malignant disorders and different tobacco related habits and in control group. To observe the incidence of micronucleus count based on duration, frequency and type of tobacco usage and also auto immune condition of Lichen planus. Materials and Method: The study population is divided into 3 groups. Group I : 15 healthy subjects (control), Group II : 15 smokers or chewers with habits andno evidence of lesion Group III : 30 Patients clinically diagnosed as having PMD of the oral cavity. Smears stained with DNA specific Feulgen stain. Association of micronucleus between all groups and its mean and standard deviation was assessed with ANOVA with p&lt;0.05 was considered as significant level. Results: The mean MN revealed that individuals with potentially malignant disorders had 26.8±5.1, individuals with tobacco habit (smokers/chewers) had 11.0±5.5 and controls had 0.2±0.5. The ANOVA test for association and mean frequency of micronucleus between all groups revealed significant value of &lt;0.001. Conclusion: Hence, MN assay in oral exfoliated buccal cells can be conveniently used as a biomarker for screening of potentially malignant disorders of oral cavity. And also provides an insight into the importance of early detection and prevention of OPMDs.

Inflammatory cytokines in alcohol use disorder patients are lower in smokers and users of smokeless tobacco.

Smoking and alcohol use often cooccur, and the use of nicotine-containing products is particularly common among persons with alcohol use disorder (AUD). Recent evidence shows that chronic alcohol use leads to inflammation through increased gut permeability and dysregulated cytokine levels. While cigarette smoking also has detrimental health effects, nicotine is indicated to exert immune dampening effects in some settings. Preclinical evidence demonstrates that nicotine may dampen alcohol induced inflammation, but inflammatory responses after use of nicotine has not yet been studied in persons with AUD. The current study compared the level of circulating cytokines in non-tobacco users, smokers, users of Swedish snus and dual tobacco users among abstinent AUD inpatients. We collected blood samples and information about somatic and mental health, and tobacco habits from 111 patients in residential treatment for AUD and 69 healthy controls. Levels of interferon (IFN)-γ, interleukin (IL)-10, tumor necrosis factor (TNF)-α, IL-17a, IL-1β, IL-6, IL-8, IL-1 receptor antagonist (ra), and monocyte chemoattractant protein (MCP)-1 were examined using a multiplex assay. Patients with AUD had higher levels of seven cytokines compared to healthy controls. Among the AUD patients, nicotine users had lower levels of IL-10, TNF-α, IL-17a, IL-1β, IL-8, and MCP-1 (all p<0.05). Our findings may indicate that nicotine has anti-inflammatory effects in patients with AUD. Still nicotine use cannot be recommended as a viable therapeutic option to reduce alcohol-induced inflammation because it may cause other adverse effects. Future studies of cytokine patterns in relation to mental or somatic health conditions are warranted to carefully investigate the effect of nicotine, by monitoring the use of any tobacco or nicotine product.