Smokeless tobacco use. A dangerous nicotine habit

Carcinoma of buccal mucosa in smokeless tobacco users: a preliminary study of the use of cytology for early detection

A type of smokeless tobacco, known as Maras powder, is widely used in lieu of cigarettes in the south-eastern region of Turkey. In the present study, we evaluated cytological smears obtained from the lesion of lower lip mucosa of 80 smokeless tobacco users. There were severe epithelial abnormalities in seven out of the 80 subjects. Punch biopsies from these cases disclosed dysplasia in three cases, carcinoma in situ in two, and carcinoma in the other two cases. There was mild dysplasia in two punch biopsies of the remaining 73 cases. Oral cancer in tobacco powder users appeared to be related to the length of use, as it was observed only in subjects with 15 or more years of exposure.

Sister-chromatid exchange inducing effect of smokeless tobacco using on T-lymphocyte chromosomes

A kind of a smokeless tobacco (Maras powder) is widely used instead of cigarettes in the South Eastern region of Turkey. In this study we investigated the sister-chromatid exchange (SCE) inducing effect of this powder on the chromosomes of its users compared with smokers and nonsmokers using standard cell culture methods and SCE staining techniques. Average SCE per metaphase and total SCEs increased significantly among both smokeless tobacco users and smokers compared to nonsmokers (p < 0.01). However, the effect is significantly lower in smokeless tobacco users than in smokers (p < 0.05).

Use of smokeless tobacco: blood pressure elevation and other health hazards found in a large-scale population survey

Health hazards associated with the use of smokeless tobacco were evaluated in a cross-sectional study of 97,586 Swedish construction workers undergoing health examinations in 1971-74. All users of smokeless tobacco only (5014 subjects) and all exclusive smokers of > or = 15 cigarettes daily (8823 subjects) were compared with all non-users of any tobacco (23,885). Both smokeless tobacco users and smokers showed higher prevalences of circulatory and respiratory disorders. Hypertension was most common in smokeless tobacco users. In the 45- to 56-years age group, the odds ratio for a diastolic blood pressure of > 90 mmHg was 1.8 (95% CI, 1.5-2.1), and for a systolic blood pressure > 160 mmHg, 1.7 (95% CI, 1.3-2.1). Smokers showed the lowest prevalence of hypertension. Disability pensions due to cardiovascular disease were nearly 50% more frequent in both smokeless tobacco users and smokers. These findings indicate that an increased cardiovascular risk is also associated with the use of smokeless tobacco.

Oral leukoplakia and adolescent smokeless tobacco use

The recent increase in smokeless tobacco (ST) use has prompted investigators to assess the health effects of ST use. This study attempted to evaluate the prevalence of oral leukoplakia among adolescent users and to determine factors associated with its presence. During their annual physical examination, 1116 teenaged football players (567 black, 546 white) answered a 34-question survey and received an oral screening examination. Results indicated that 0.5% of nonusers, 1.5% of previous users, and 13% of current users had clinically evident oral leukoplakia. Factors statistically associated with higher leukoplakia rates included history of ST use, regular ST use, years of ST use, and the weekly quantity consumed. Factors not associated included use of alcohol, use of cigarettes, type of ST used, and hours of ST use. One brand of snuff was found to be associated with a relative risk of leukoplakia higher than that of another brand of snuff. Overall, in ST users oral leukoplakia was six times more likely to develop than in nonusers. Earlier ages of ST use may lead to greater periods of use (in years) and to possible increases in deleterious long-term health effects in current adolescents.

Prevention, detection, and diagnosis of head and neck cancers

Head and neck cancers are a complex group of diseases that result in significantly visible alterations of several vital functions. Ironically, 90% of these tumors are preventable; however, implementing the primary and secondary levels of prevention will require a personal commitment from the patient, in addition to commitments from the community and professionals, such as nurses, physicians, and other members of the health care team.