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Kumar S, Gawde N, Pednekar MS. Social Determinants and the Prevalence of Paan Masala Use among Adults in India: Results from Global Adult Tobacco Survey, 2016-17. Asian Pac J Cancer Prev 2023; 24:3773-3781. [PMID: 38019235 PMCID: PMC10772776 DOI: 10.31557/apjcp.2023.24.11.3773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 11/06/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Gutkha or Paan masala with tobacco is commonly used smokeless tobacco product in India. Given the restrictions on advertisement and promotion of Gutkha and the necessity of warning labels on tobacco products, the tobacco industry has popularised paan masala without tobacco as a surrogate product. Paan masala itself is harmful for health but remains beyond scope of current tobacco control policies. It was important to understand prevalence and determinants of its use (with or without tobacco). METHODS Data from the Global Adult Tobacco Survey (GATS)-2, India was used to estimate prevalence of paan masala use (with or without tobacco) in India. Multi-nominal regression and logistic regression were used to calculate risk ratios and odds ratios. RESULTS The prevalence of any form of paan masala was 12.1% among adults in India. Prevalence was higher among males (17.8%) than females (6.0%), aged 25-44 years (14.5%) than those aged 65 years or above (9.0%). Relative risk ratio (RRR) for Paan masala with tobacco was significantly high among those with no formal schooling (RRR:2.00) and among those in poorest wealth quintiles (RRR:1.26). While, RRR were lower for Paan masala use without tobacco among those with no formal schooling (RRR:0.95) and among poorest wealth quintiles (RRR:0.78). Region-wise AOR were highest for North-East (AOR:4.80) and Central regions (AOR:4.76) compared to South India. CONCLUSION The prevalence of paan masala use is high in India. Persons belonging to lower socioeconomic status or having no formal schooling have higher risk of consuming paan masala with tobacco. However, persons from higher wealth quintiles or having formal schooling had higher risk of use of paan masala without tobacco. These findings need careful attention of policy makers and law enforcers as it indicates different marketing strategies might have adopted by industry to target these two mutually exclusive population groups.
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Affiliation(s)
- Shailendra Kumar
- School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India
| | - Nilesh Gawde
- School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India
- Datta Meghe Institute of Higher Education and Research, Sawangi, Maharashtra, India
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Pratap Singh R, Kumari N, Gupta S, Jaiswal R, Mehrotra D, Singh S, Mukherjee S, Kumar R. Intratumoral Microbiota Changes with Tumor Stage and Influences the Immune Signature of Oral Squamous Cell Carcinoma. Microbiol Spectr 2023; 11:e0459622. [PMID: 37409975 PMCID: PMC10434029 DOI: 10.1128/spectrum.04596-22] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 06/11/2023] [Indexed: 07/07/2023] Open
Abstract
Characterization of the oral microbiota profile through various studies has shown an association between the microbiome and oral cancer; however, stage-specific determinants of dynamic changes in microbial communities of oral cancer remain elusive. Additionally, the influence of the intratumoral microbiota on the intratumoral immune system remains largely unexplored. Therefore, this study aims to stratify microbial abundance in the early-onset and subsequent stages of oral cancer and analyze their influence on clinical-pathological and immunological features. The microbiome composition of tissue biopsy samples was identified using 16S rRNA amplicon sequencing, while intratumoral and systemic immune profiling was done with flow cytometry and immunohistochemistry-based analysis. The bacterial composition differed significantly among precancer, early cancer, and late cancer stages with the enrichment of genera Capnocytophaga, Fusobacterium, and Treponema in the cancer group, while Streptococcus and Rothia were enriched in the precancer group. Late cancer stages were significantly associated with Capnocytophaga with high predicting accuracy, while Fusobacterium was associated with early stages of cancer. A dense intermicrobial and microbiome-immune network was observed in the precancer group. At the cellular level, intratumoral immune cell infiltration of B cells and T cells (CD4+ and CD8+) was observed with enrichment of the effector memory phenotype. Naive and effector subsets of tumor-infiltrating lymphocytes (TILs) and related gene expression were found to be distinctly associated with bacterial communities; most importantly, highly abundant bacterial genera of the tumor microenvironment were either negatively correlated or not associated with the effector lymphocytes, which led to the conclusion that the tumor microenvironment favors an immunosuppressive and nonimmunogenic microbiota. IMPORTANCE The gut microbiome has been explored extensively for its importance in the modulation of systemic inflammation and immune response; in contrast, the intratumoral microbiome is less studied for its influence on immunity in cancer. Given the established correlation between intratumoral lymphocyte infiltration and patient survival in cases of solid tumors, it was pertinent to explore the extrinsic factor influencing immune cell infiltration in the tumor. Modulation of intratumoral microbiota could have a beneficial effect on the antitumor immune response. This study stratifies the microbial profile of oral squamous cell carcinoma starting from precancer to late-stage cancer and provides evidence for their immunomodulatory role in the tumor microenvironment. Our results suggest combining microbiome study with immunological signatures of tumors for their prognostic and diagnostic application.
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Affiliation(s)
- Raghwendra Pratap Singh
- Immunology Laboratory, Council for Scientific and Industrial Research-Institute of Microbial Technology, Chandigarh, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Naina Kumari
- Human Microbiome Research Laboratory, National Institute of Biomedical Genomics, Kalyani, West-Bengal, India
| | - Sameer Gupta
- Department of Surgical Oncology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Riddhi Jaiswal
- Department of Pathology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Divya Mehrotra
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Sudhir Singh
- Department of Radiology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Souvik Mukherjee
- Human Microbiome Research Laboratory, National Institute of Biomedical Genomics, Kalyani, West-Bengal, India
| | - Rashmi Kumar
- Immunology Laboratory, Council for Scientific and Industrial Research-Institute of Microbial Technology, Chandigarh, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
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Dangore-Khasbage S, Bhowate RR, Khubchandani M. Chemical Composition of Areca Nut and Its Adverse Effects on Human Health. Cureus 2023; 15:e43739. [PMID: 37731445 PMCID: PMC10507371 DOI: 10.7759/cureus.43739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/18/2023] [Indexed: 09/22/2023] Open
Abstract
Areca nut (AN) is one of the addictive substances consumed widely in the world. The composition of AN is very complex, and each component has variable properties. This study aims to review the composition of AN and its adverse effects on humans. For this review, the literature search was performed by an electronic search of the Pubmed/Medline, Scopus, and Google Scholar databases using proper MESH headings and retrieved the articles published from 1997 to 2022. The eligibility criteria included human studies, a form of AN, the composition of AN, harmful effects of AN, the effect of AN on the oral cavity, the effect of AN on vital organs, and articles published in English. Data were extracted regarding the composition of AN, forms of AN, and harmful effects of AN on the oral cavity and on other systems. A total of 449 articles were identified from various databases, and 36 studies were selected that met the inclusion criteria. The active components of AN, which produce harmful effects, are primarily alkaloids, polyphenols, tannins, and certain trace elements. AN is consumed in different forms, and based on the form, its composition also varies. AN is known to cause deleterious effects on the oral cavity as well as various body organs. The most dangerous and widely reported impacts of AN on the oral cavity are the development of oral submucous fibrosis, a premalignant condition, and oral malignancy. However, during the chewing process, excretory products of AN are released and circulate in the body of "chronic habitual" and affect the other body parts. Thus, AN consumption may contribute to cardiac, liver, endocrinal, metabolic, respiratory, and reproductive system disorders also. AN composition is complex, and its consumption is harmful to human health. In regard to controlling the issue of the harmful effects of this habit, preventive measures should be established.
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Affiliation(s)
- Suwarna Dangore-Khasbage
- Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Rahul R Bhowate
- Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Monika Khubchandani
- Pediatric Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Shaashi Uday H, Pethagounder Thangavelu R, Rajaram Mohan K, Fenn SM, Appusamy K. Evaluation of Nicotine Dependence Among Smokeless Tobacco Users Using the Fagerstrom Nicotine Dependence Scale for Smokeless Tobacco. Cureus 2023; 15:e38639. [PMID: 37288236 PMCID: PMC10243400 DOI: 10.7759/cureus.38639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2022] [Indexed: 06/09/2023] Open
Abstract
Nicotine dependence is a current indwelling and challenging health burden among smokeless tobacco users as it involves the compulsive use of a substance despite its known harmful effects. The evaluation of nicotine dependence is challenging as it involves physical and psychological dependence due to nicotine in smokeless tobacco. AIM AND OBJECTIVE The primary aim is to assess the nicotine dependence in a group of smokeless tobacco by using a six-question Fagerstrom Test for Nicotine Dependence for Smokeless Tobacco (FTND-ST) and to assess the nicotine dependence among three groups, namely Group - 1, who were exclusively pan masala, gutka chewers, Group - 2, who were exclusively Hans users, and Group - 3, who were exclusively betel quid with smokeless tobacco chewers. MATERIALS AND METHODS Only those who use smokeless tobacco in the age groups between 21 to 70 years were randomly selected. The total sample size is 100 patients. The age groups were divided into 21-28, 29-35, 36-42, 43-49, 50-56, 57-63, and 64-70. Informed consent was obtained from the participants of the study. RESULTS The Hans chewers are predominantly females. Pan masala and gutka chewers are predominantly males. CONCLUSION Smokeless tobacco chewers like pan masala were found to have high mean nicotine dependence Fagerstrom score than Hans and betel quid with smokeless tobacco chewers.
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Affiliation(s)
- Hiremath Shaashi Uday
- Department of Oral Medicine and Radiology, Vinayaka Mission's Sankarachariyar Dental College, Vinayaka Mission's Research Foundation, Salem, IND
| | - Ravikumar Pethagounder Thangavelu
- Department of Oral Medicine and Radiology, Vinayaka Mission's Sankarachariyar Dental College, Vinayaka Mission's Research Foundation, Salem, IND
| | - Karthik Rajaram Mohan
- Department of Oral Medicine and Radiology, Vinayaka Mission's Sankarachariyar Dental College, Vinayaka Mission's Research Foundation, Salem, IND
| | - Saramma Mathew Fenn
- Department of Oral Medicine and Radiology, Vinayaka Mission's Sankarachariyar Dental College, Vinayaka Mission's Research Foundation, Salem, IND
| | - Kumar Appusamy
- Department of Oral Medicine and Radiology, Vinayaka Mission's Sankarachariyar Dental College, Vinayaka Mission's Research Foundation, Salem, IND
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Chavan SS, Pagar VS, Borde A, Patil SP, Kinge AD. An Epidemiological Study of Addictive Behavior Pattern Among Adolescent Tobacco Users. Int J Prev Med 2023; 14:17. [PMID: 37033287 PMCID: PMC10080569 DOI: 10.4103/ijpvm.ijpvm_659_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 05/19/2021] [Indexed: 04/11/2023] Open
Abstract
Background The risk of developing tobacco-related cancer and chronic heart and lung disease is greater if addiction starts in adolescence. Even experimental use of tobacco in adolescents significantly increases the risk of addiction in adulthood. This study intends to collect valuable data regarding sociodemographic characteristic of tobacco use, pattern of dependence among adolescent tobacco users, which will be essential for formulating recommendations, and their possible intervention aimed at reducing the problem of tobacco use. Methods A community-based cross-sectional study was done where 400 subjects were enrolled. Nonprobability Snowball sampling technique was used to locate adolescents aged 12-18 years, who were practicing tobacco use. Face-to-face interviews were taken for data collection. Fragerstorm dependency test for tobacco was used to classify dependency of tobacco product into high and low dependency. Data was analyzed using Chi-square test and proportions using SPSS software version 21. Results Majority of the subjects were in the age group of 16-18 years; mean age for initiation of tobacco was 15.6 years. Gutkha was the predominant form of tobacco product being used. Peer pressure 192 (48.0%) was the major reason for initiation of tobacco use. A significant association was found between dependency on tobacco and age, literacy, and socioeconomic status. Conclusions Tobacco use starting from early age has many health implications. There is a need for stringent laws against the selling of tobacco to adolescents and targeted health awareness program against tobacco.
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Affiliation(s)
- Sushant S. Chavan
- Department of Commmunity Medicine, Shri Bhausaheb Hire Government Medical College, Dhule, Maharashtra, India
| | - Vikrant S. Pagar
- Department of Commmunity Medicine, Shri Bhausaheb Hire Government Medical College, Dhule, Maharashtra, India
- Address for correspondence: Dr. Vikrant S. Pagarm, Flat No. 12, Triveni Apartment, Balappa Colony, Near 100 Futi Road, Dhule - 424 001, Maharashtra, India. E-mail:
| | - Anant Borde
- Department of Commmunity Medicine, Shri Bhausaheb Hire Government Medical College, Dhule, Maharashtra, India
| | - Sarika P. Patil
- Department of Commmunity Medicine, Shri Bhausaheb Hire Government Medical College, Dhule, Maharashtra, India
| | - Amol D. Kinge
- Department of Commmunity Medicine, Shri Bhausaheb Hire Government Medical College, Dhule, Maharashtra, India
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Shah R, Shah H, Thakkar K, Parikh N. Conventional Therapies of Oral Cancers: Highlights on Chemotherapeutic Agents and Radiotherapy, Their Adverse Effects, and the Cost Burden of Conventional Therapies. Crit Rev Oncog 2023; 28:1-10. [PMID: 37830213 DOI: 10.1615/critrevoncog.2023046835] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
Oral cancer (OC) is increasing worldwide, and it is mostly present to clinic in the late-stage of disease. Cancer of the lips, tongue, hard palate, upper and lower gingiva, buccal mucosa, and retromolar trigone are all included in the category of oral cavity cancer. Disease symptomatology and pathological grading decides the course of treatment. Several treatment modalities either alone in combinations may be utilized for oral squamous cell carcinoma (OSCC), including surgery, radiotherapy (external beam radiotherapy/brachytherapy), and adjuvant systemic therapy (chemotherapy or immunotherapy). Cancer patients also face a greater risk of oral side effects from chemotherapy, such as slowed tissue healing, bone, and salivary gland damage and disintegration, and disruption of the normal bacterial balance in the mouth. Consequently, the economic burden of the salivary gland, oral cavity, and oropharyngeal cancers must be also known for budget allocation, designing different programs and management strategies targeting oral cancers by any healthcare institutes. This article provides a summary of the most recent research that supports the use of chemotherapy for patients with advanced illness both alone and in conjunction with radiation including its adverse events and cost burden for oral cancers.
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Affiliation(s)
- Rima Shah
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Rajkot, Gujarat, India
| | - Heeya Shah
- H. Lee Moffitt Cancer Centre and Research Institute, Tampa, FL, USA
| | - Keval Thakkar
- H. Lee Moffitt Cancer Centre and Research Institute, Tampa, FL, USA
| | - Nisarg Parikh
- Attending Radiologist, Bassett Health Care Network, Cooperstown, NY, USA
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Chen L, Yuan F, Chen S, Li X, Kong L, Zhang W. Potential Role of Host Microbiome in Areca Nut-Associated Carcinogenesis and Addiction. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27238171. [PMID: 36500264 PMCID: PMC9739811 DOI: 10.3390/molecules27238171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/21/2022] [Accepted: 08/30/2022] [Indexed: 11/25/2022]
Abstract
Areca nut (AN) is widely consumed all over the world, bringing great harm to human health and economy. Individuals with AN chewing are at high risk of cardiovascular disease and impaired immune system and metabolic system. Despite a growing number of studies having reported on the adverse effects brought by AN chewing, the exact mechanism of it is limited and the need for additional exploration remains. In recent years, the interaction between microorganisms, especially intestinal microorganism and host, has been extensively studied. AN chewing might disrupt the oral and intestinal microbiota communities through direct connect with the microbes it contains, altering PH, oxygen of oral and intestinal microenvironment, and disturbing the immune homeostasis. These mechanisms provide insights into the interplay between areca nut and host microbiota. Emerging studies have proposed that bidirectional interaction between polyphenols and intestinal microbes might play a potential role in the divergence of polyphenol, extracted from AN, among individuals with or without AN-induced cancer development and progression. Although some AN chewers have been aware of the harmful effects brought by AN, they cannot abolish this habit because of the addiction of AN. Increasing studies have tried to revealed that gut microbiota might influence the onset/development of addictive behaviors. Altogether, this review summarizes the possible reasons for the disturbance of host microbiota caused by areca nut chewing and clarifies the complex interaction between human microbiome and major constituents and the addiction and carcinogenicity of AN, tempting to provide novel insights into the development and utilization of it, and to control the adverse consequences caused by AN chewing.
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Affiliation(s)
- Lihui Chen
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha 410078, China
- Institute of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, Central South University, 110 Xiangya Road, Changsha 410078, China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha 410078, China
- National Clinical Research Center for Geriatric Disorders, 87 Xiangya Road, Changsha 410008, China
| | - Fulai Yuan
- Health Management Center, Xiangya Hospital, Central South University, Changsha 410078, China
| | - Sifang Chen
- Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, Xiamen 361000, China
| | - Xiong Li
- The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510060, China
| | - Lingyu Kong
- Department of Radiology, Xiangya Hospital, Central South University, Changsha 410008, China
- Correspondence: (L.K.); (W.Z.)
| | - Wei Zhang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha 410078, China
- Institute of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, Central South University, 110 Xiangya Road, Changsha 410078, China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha 410078, China
- National Clinical Research Center for Geriatric Disorders, 87 Xiangya Road, Changsha 410008, China
- Correspondence: (L.K.); (W.Z.)
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Ali SW, Rehman Usmani SU, Zia A. Seed bezoars as a rare cause of fecal impaction in pediatric patients: A report of two cases from Pakistan. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2022. [DOI: 10.1016/j.epsc.2022.102457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Gutka consumption and dietary partialities explaining anemia in women of a coastal slum of Karachi, Pakistan: A mixed-method study. PLoS One 2022; 17:e0276893. [PMID: 36315485 PMCID: PMC9621450 DOI: 10.1371/journal.pone.0276893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 10/15/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Limited literature is available on the dietary pattern and its consequences on health of women living in coastal slums of Karachi, Pakistan. MATERIAL AND METHODS The study employed a mixed-method approach where concurrent quantitative and qualitative assessments were carried out. An analytical cross-sectional survey was conducted to collect information on demographic, household, obstetrics characteristics, and dietary pattern of married women of reproductive age (MWRA). Blood samples were collected to identify the hemoglobin level to determine anemia. For the qualitative component, focus group discussions were carried out with women and in-depth interviews with shopkeepers to understand the availability of food items at household level and in local markets respectively. In addition, observational visits were carried out at different points in time to the local market to document the availability of iron-rich foods for the community. RESULTS The overall prevalence of anemia in sample population was 68.0%. Women with no formal education (AOR: 2.93 95% CI: 1.90-4.52), who consumed gutka (AOR: 2.84 95% CI: 1.81-4.46), did not eat red meat (AOR: 1.68 95% CI: 1.06-2.65), and only had seafood (AOR: 4.56 95% CI: 1.38-15.02) were more likely to be anemic as compared to their counterparts. Qualitative data revealed that any kind of meat and fruits were beyond the reach of community people due to non-affordable cost. A high percentage of women used a locally produced recreational substance known as gutka which gives them a feeling of wellbeing and suppresses hunger. CONCLUSION In our study population, lack of access to diversity of food items, illiteracy, and use of gutka are the statistically significant factors which are associated with anemia in married women of this coastal slum area. The lack of demand for diversity in food is related to poverty and preference of spending money on gutka.
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Shaikh SB, Tung WC, Pang C, Lucas J, Li D, Rahman I. Flavor Classification/Categorization and Differential Toxicity of Oral Nicotine Pouches (ONPs) in Oral Gingival Epithelial Cells and Bronchial Epithelial Cells. TOXICS 2022; 10:660. [PMID: 36355951 PMCID: PMC9696007 DOI: 10.3390/toxics10110660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/21/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
Abstract
Oral nicotine pouches (ONPs) are a modern form of smokeless tobacco products sold by several brands in the U.S., which comprise a significant portion of non-combustible nicotine-containing product (NCNP) sales to date. ONPs are available in various flavors and may contain either tobacco-derived nicotine (TDN) or tobacco-free nicotine (TFN). The growth in popularity of these products has raised concerns that flavored ONPs may cause adverse oral health effects and promote systemic toxic effects due to nicotine and other ONP by-products being absorbed into the circulatory system through oral mucosa. We hypothesized that flavored ONPs are unsafe and likely to cause oral and pulmonary inflammation in oral and respiratory epithelial cells. Before analyzing the effects of ONPs, we first classified ONPs sold in the U.S. based on their flavor and the flavor category to which they belonged using a wheel diagram. Human gingival epithelial cells (HGEP) were treated with flavored ONP extracts of tobacco (original, smooth), menthol (wintergreen and cool cider), and fruit flavor (americana and citrus), each from the TDN and TFN groups. The levels of ONP-induced inflammatory cytokine release (TNF-α, IL-6, and IL-8) by ELISA, cellular reactive oxygen species (ROS) production by CellRox Green, and cytotoxicity by lactate dehydrogenase (LDH) release assay in HGEP cells were assessed. Flavored ONP extracts elicited differential toxicities in a dose- and extract-dependent manner in HGEP cells 24 h post-treatment. Both fruit TDN and TFN extracts resulted in the greatest cytotoxicity. Tobacco- and fruit-flavored, but not menthol-flavored, ONPs resulted in increased ROS production 4 h post-treatment. Flavored ONPs led to differential cytokine release (TNF-α, IL-6, and IL-8) which varied by flavor (menthol, tobacco, or fruit) and nicotine (TDN vs. TFN) 24 h post-treatment. Menthol-flavored ONPs led to the most significant TNF-α release; fruit TFN resulted in the most significant IL-6 release; and fruit TDN and tobacco TFN led to the highest release of IL-8. Subsequently, human bronchial epithelial cells (16-HBE and BEAS-2B) were also treated with flavored ONP extracts, and similar assays were evaluated. Here, the lowest concentration treatments displayed increased cytotoxicity. The most striking response was observed among cells treated with spearmint and tobacco flavored ONPs. Our data suggest that flavored ONPs are unsafe and likely to cause systemic and local toxicological responses during chronic usage.
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Affiliation(s)
- Sadiya Bi Shaikh
- Department of Environmental Medicine, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Wai Cheung Tung
- Department of Environmental Medicine, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Cortney Pang
- Department of Environmental Medicine, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Joseph Lucas
- Department of Environmental Medicine, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Dongmei Li
- Department of Clinical and Translational Science Institute, School of Medicine and Dentistry, University of Rochester, Rochester, NY 14642, USA
| | - Irfan Rahman
- Department of Environmental Medicine, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY 14642, USA
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Rajput N, Gholap D, Mhatre S, Dikshit R. Epidemiological Review: Esophagus Squamous Cell Carcinoma in India. Indian J Med Paediatr Oncol 2022. [DOI: 10.1055/s-0042-1755445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AbstractWorldwide the incidence of esophagus squamous cell carcinoma (ESCC), remains one of the most common causes of cancer death. ESCC is one of the leading types of cancer in the North and Northeast regions of India among both genders. Risk factors of ESCC include tobacco, alcohol, areca nut, hot beverages, low fruit diet, poor oral hygiene, unpiped water, and human papillomavirus infection. This review tries to elaborate on various modifiable risk factors for ESCC, which have been studied worldwide and need to be studied in India. PubMed was used as a search platform using keywords, such as “esophagus cancer,” “esophagus squamous cell carcinoma,” “epidemiology,” “India,” “incidence,” “mortality,” “risk factors,” “treatment,” “survival,” “prevention” and their corresponding Medical Subject Heading terms, were used in combination with Boolean operators “OR” and “AND.” Studies from India are mostly hospital-based case-control studies from the North region. Further research is required in India to understand the etiology, to design large-scale screening and prevention strategies.
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Affiliation(s)
- Nikita Rajput
- Department of Molecular Epidemiology and Population Genetics, Centre for Cancer Epidemiology, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Devyani Gholap
- Department of Molecular Epidemiology and Population Genetics, Centre for Cancer Epidemiology, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Sharayu Mhatre
- Department of Molecular Epidemiology and Population Genetics, Centre for Cancer Epidemiology, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
| | - Rajesh Dikshit
- Department of Molecular Epidemiology and Population Genetics, Centre for Cancer Epidemiology, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
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Bhattacharjee T, Gangopadhyay S. Cancer causing chewing habits and related oral lesions - A comparative study among females of socio-culturally different areas of West Bengal. J Oral Maxillofac Pathol 2022; 26:599. [PMID: 37082086 PMCID: PMC10112115 DOI: 10.4103/jomfp.jomfp_220_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 04/03/2022] [Accepted: 04/04/2022] [Indexed: 04/22/2023] Open
Abstract
Background Smokeless tobacco, as well as areca-nut both, causes cancerous and precancerous lesions of the oral cavity. The traditional value of India, as well as West Bengal do not allow females for smoking, but there is no such disapproval for using smokeless tobacco or areca nut. Geographically and socio-culturally, the Northern part of West Bengal differs from its Southern part. Aims This study aimed to assess the prevalence of different chewing habits, habit products, and habit-related different oral lesions among females in two socio-culturally different areas of West Bengal. Methods A total of 222 women from areas of North Bengal and 173 women from areas of South Bengal aged 15 years and above were selected. A face-to-face interview was conducted using a structured questionnaire. An oral cavity examination was done to rule out any oral mucosal alterations caused by cancer-causing habits. Statistical Analysis Chi-square test or Fischer's exact tests were used to compare unpaired proportions as appropriate. Results In areas of the northern part of Bengal, 42.34% of females were chewers, and in areas of the southern part of Bengal 18.50% of females were chewers. Younger female chewers were more from areas of the northern part of Bengal. Women, residing in different areas of the northern part of Bengal had more habit-related oral lesions, compared to the southern part of Bengal. Conclusion Special attention should be given to increasing awareness regarding chewing habit-related health hazards among females, especially in areas of North Bengal.
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Affiliation(s)
- Tathagata Bhattacharjee
- Department of Oral Pathology and Microbiology, North Bengal Dental College and Hospital, Darjeeling, West Bengal, India
| | - Somnath Gangopadhyay
- Professor and Former Head and In-Charge of Occupational Ergonomics Laboratory, Department of Physiology, University of Calcutta, Kolkata, West Bengal, India
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13
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Gupte HA, Chatterjee N, Mandal G. Using the Theory of Planned Behavior to Explain and Predict Areca Nut Use Among Adolescents in India: An Exploratory Study. Subst Abuse Rehabil 2022; 13:47-55. [PMID: 36097584 PMCID: PMC9464035 DOI: 10.2147/sar.s377606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/31/2022] [Indexed: 11/26/2022] Open
Abstract
Context Areca nut, used alone or in combination with tobacco, contributes to the high oral cancer burden in India. Used widely by adolescents, who perceive it as a harmless substance, areca nut is addictive and considered a precursor to tobacco use. Given its serious implications for addictiveness and physical health, urgent preventive interventions for areca nut use are required in India and South-East Asia. Studies examining the role of health behavior theory in explaining and predicting areca nut use and for development of its prevention among adolescents are scarce. Aim This study explored the role of the components of Theory of Planned Behavior (TPB) such as attitudes, subjective norms, perceived behavioral control, and intention in predicting areca nut use among adolescents. Settings and Design Observational study with cross-sectional design conducted with 1884 male and female adolescents attending low-income schools in Mumbai, India. Methods and Material Self-administered surveys were used to gather data on age, gender, behavioral factors and areca nut use. Statistical Analysis Used Chi-square and Mann Whitney test for bivariate and logistic regression for multivariate analysis. Results Around 27.2% of 1884 participants were areca nut users. The mean age of users was 13.75 years. Intention-to-use and perceived behavioral control were statistically significant predictors of actual areca nut use (p<0.001). The components of TPB such as attitude, perceived subjective social norms, and perceived behavioral control had a statistically significant effect on the intention-to-use areca nut (p<0.05). Conclusion This exploratory study indicates that constructs from TPB could help us understand and predict areca nut use. However, more rigorous future research is required to generate insights that help craft effective theory-based behavioral interventions for areca nut prevention and cessation in adolescents.
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Affiliation(s)
| | | | - Gauri Mandal
- Salaam Bombay Foundation, Mumbai, Maharashtra, India
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14
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Ali A, Manzoor MF, Ahmad N, Aadil RM, Qin H, Siddique R, Riaz S, Ahmad A, Korma SA, Khalid W, Aizhong L. The Burden of Cancer, Government Strategic Policies, and Challenges in Pakistan: A Comprehensive Review. Front Nutr 2022; 9:940514. [PMID: 35938114 PMCID: PMC9355152 DOI: 10.3389/fnut.2022.940514] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/23/2022] [Indexed: 01/09/2023] Open
Abstract
Cancer is a severe condition characterized by uncontrolled cell division and increasing reported mortality and diagnostic cases. In 2040, an estimated 28.4 million cancer cases are expected to happen globally. In 2020, an estimated 19.3 million new cancer cases (18.1 million excluding non-melanoma skin cancer) had been diagnosed worldwide, with around 10.0 million cancer deaths. Breast cancer cases have increased by 2.26 million, lung cancer by 2.21 million, stomach by 1.089 million, liver by 0.96 million, and colon cancer by 1.93 million. Cancer is becoming more prevalent in Pakistan, with 19 million new cancer cases recorded in 2020. Food adulteration, gutkha, paan, and nutritional deficiencies are major cancer risk factors that interplay with cancer pathogenesis in this country. Government policies and legislation, cancer treatment challenges, and prevention must be revised seriously. This review presents the current cancer epidemiology in Pakistan to better understand cancer basis. It summarizes current cancer risk factors, causes, and the strategies and policies of the country against cancer.
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Affiliation(s)
- Anwar Ali
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, China
- Food and Nutrition Society, Gilgit Baltistan, Pakistan
| | | | - Nazir Ahmad
- Department of Nutritional Science, Government College University Faisalabad, Faisalabad, Pakistan
| | - Rana Muhammad Aadil
- National Institute of Food Science and Technology, University of Agriculture, Faisalabad, Pakistan
| | - Hong Qin
- School of Nutrition and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha, China
| | - Rabia Siddique
- Department of Chemistry, Government College University Faisalabad, Faisalabad, Pakistan
| | - Sakhawat Riaz
- Department of Home Economics, Government College University Faisalabad, Faisalabad, Pakistan
| | - Arslan Ahmad
- Department of Home Economics, Government College University Faisalabad, Faisalabad, Pakistan
| | - Sameh A. Korma
- Department of Food Science, Faculty of Agriculture, Zagazig, Egypt
| | - Waseem Khalid
- Department of Food Sciences, Government College University, Faisalabad, Pakistan
| | - Liu Aizhong
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, China
- *Correspondence: Liu Aizhong
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15
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Cirillo N, Duong PH, Er WT, Do CTN, De Silva MEH, Dong Y, Cheong SC, Sari EF, McCullough MJ, Zhang P, Prime SS. Are There Betel Quid Mixtures Less Harmful than Others? A Scoping Review of the Association between Different Betel Quid Ingredients and the Risk of Oral Submucous Fibrosis. Biomolecules 2022; 12:664. [PMID: 35625592 PMCID: PMC9138976 DOI: 10.3390/biom12050664] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 02/06/2023] Open
Abstract
Oral submucous fibrosis (OSF) is a potentially malignant condition of the oral cavity characterized by progressive fibrosis of the submucosal tissues. OSF is typically associated with the use of betel quid (BQ), a chewing package made of natural products (e.g., areca nut, betel leaves), with or without smokeless tobacco. BQ ingredients contain pro-carcinogenic bioactive compounds, but also potentially protective biomolecules, and we have shown recently that the chemical properties of different BQ recipes vary, which may explain the unequal prevalence of OSF and oral cancer in BQ users in different geographical regions. Hence, this scoping review was aimed at evaluating the existing literature regarding different BQ compounds and their association with OSF. The repository of the National Library of Medicine (MEDLINE/PubMed), medRxiv databases, Google scholar, Baidu scholar, CNKI, and EBSCO were used to search for publications that investigated the association between BQ chewing and OSF up to November 2021. The search terminology was constructed using the keywords "betel quid" and "oral submucous fibrosis", and their associated terms, with the use of Boolean operators. The search was conducted under Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, together with clear inclusion and exclusion criteria. The review showed that the risk of developing OSF varied between different BQ recipes, and that chewing BQ mixtures containing betel inflorescence (BI) significantly increased the risk of OSF, as did the addition of tobacco. Conversely, the use of betel leaf in the mixture was likely to be protective, which may be due to the presence of polyphenols. Although further research is needed to determine the effect of individual BQ ingredients in the development of OSF, our pilot results provide the scope and rationale for informing future chemopreventive strategies for OSF and oral cancer in BQ chewers.
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Affiliation(s)
- Nicola Cirillo
- Melbourne Dental School, The University of Melbourne, Carlton, VIC 3053, Australia; (P.H.D.); (W.T.E.); (C.T.N.D.); (M.E.H.D.S.); (Y.D.); (M.J.M.)
| | - Peter Hung Duong
- Melbourne Dental School, The University of Melbourne, Carlton, VIC 3053, Australia; (P.H.D.); (W.T.E.); (C.T.N.D.); (M.E.H.D.S.); (Y.D.); (M.J.M.)
| | - Wee Teng Er
- Melbourne Dental School, The University of Melbourne, Carlton, VIC 3053, Australia; (P.H.D.); (W.T.E.); (C.T.N.D.); (M.E.H.D.S.); (Y.D.); (M.J.M.)
| | - Casey Thao Nhi Do
- Melbourne Dental School, The University of Melbourne, Carlton, VIC 3053, Australia; (P.H.D.); (W.T.E.); (C.T.N.D.); (M.E.H.D.S.); (Y.D.); (M.J.M.)
| | | | - Yining Dong
- Melbourne Dental School, The University of Melbourne, Carlton, VIC 3053, Australia; (P.H.D.); (W.T.E.); (C.T.N.D.); (M.E.H.D.S.); (Y.D.); (M.J.M.)
| | - Sok Ching Cheong
- Translational Cancer Biology, Cancer Research Malaysia, 1 Jalan SS12/1A, Subang Jaya 47500, Selangor, Malaysia;
| | - Elizabeth Fitriana Sari
- Dentistry and Oral Health, La Trobe Rural Health School, La Trobe University, Bendigo, VIC 3550, Australia;
| | - Michael J. McCullough
- Melbourne Dental School, The University of Melbourne, Carlton, VIC 3053, Australia; (P.H.D.); (W.T.E.); (C.T.N.D.); (M.E.H.D.S.); (Y.D.); (M.J.M.)
| | - Pangzhen Zhang
- School of Agriculture and Food, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC 3052, Australia;
| | - Stephen S. Prime
- Centre for Immunology and Regenerative Medicine, Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 4NS, UK;
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Khasbage SBD, Bhowate RR, Khatib N. Risk of liver disease in areca nut habitual: A systematic review. J Oral Maxillofac Pathol 2022; 26:128-129. [PMID: 35571298 PMCID: PMC9106242 DOI: 10.4103/jomfp.jomfp_345_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/31/2021] [Accepted: 01/24/2022] [Indexed: 12/03/2022] Open
Abstract
Background: Areca nut (AN) is one of the addictive substances known to cause deleterious effects on oral cavity as well as on various body organs including liver. But, scanty information is available reporting the adverse effects of AN chewing on the liver. Aim: To study the risk of liver disease in AN habitual based on the relevant published data. Methods: The literature search was performed by an electronic search of the PubMed/Medline, Scopus and Google Scholar databases using proper MESH headings and retrieved the articles published from 1998 to 2021. The eligibility criteria included: Human studies, AN habitual as study participants, use of controls and articles published in English. Data were extracted regarding characteristics of studies, characteristics of AN exposure, effect estimate and outcome of the studies. Results: Total 253 articles were identified from various databases and 15 studies were selected that met the inclusion criteria. Among these, thirteen studies showed an association between AN habit and attenuation of risk of liver disease as determined by relative risk/odds ratio/hazard ratio. Eleven studies described additive effect of AN and HBsAg and/or Anti hepatitis C virus status on development of liver disease. However, two of the studies showed opposite results. The heterogeneity in the study designs, exposure characteristics, outcomes and confounders precluded further meta-analysis. Conclusion: The association between AN chewing and an increased risk of developing liver disease is noted which necessitates the need for AN cessation campaign.
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Affiliation(s)
- Suwarna B Dangore Khasbage
- Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (M), Maharashtra, India
| | - Rahul R Bhowate
- Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (M), Maharashtra, India
| | - Nazli Khatib
- Human Physiology, JNMC, Wardha, Maharashtra, India
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Sawant S, Dugad J, Parikh D, Srinivasan S, Singh H. Identification & correlation of bacterial diversity in oral cancer and long-term tobacco chewers- A case-control pilot study. J Med Microbiol 2021; 70. [PMID: 34553683 DOI: 10.1099/jmm.0.001417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction. Squamous cell carcinoma is a highly aggressive type of oral cancer (OC). It is the most common cancer among men, and accounts for almost 90 % of all oral cancers in India. Consumption of tobacco is a leading factor contributing to maximum oral cancer incidences as per the WHO.Hypothesis/Gap statement. Researchers reported a direct association of microorganisms with dysbiosis in various oral lesions including oral cancer. However, there is a dearth of information related to compositional changes in the oral microbiome in long-term tobacco chewers and the Indian oral cancer population.Aim. The aim of this study was to identify and correlate the bacterial diversity in the oral cavity of tobacco chewers, patients with oral cancer and healthy subjects in the Indian population.Methods. Oral rinse samples were collected for ten subjects in each group followed by DNA extraction. The variable regions of the bacterial 16S rRNA gene (V6-V8) were amplified, sequenced, processed, and analysed using QIIME2 platform to assess alpha and beta diversity between the study groups.Results. This pilot study showed genus Streptococcus dominated the control group (18.54 %), and the abundance decreased in tobacco and OC group (9.63 and 5.45% respectively); whereas genus Prevotella dominated the tobacco and OC group (21.01 and 26.03% respectively). A shift in abundance of microbiome was observed from control population to oral cancer via the tobacco chewing population. Maximum alpha diversity of oral microbiome was found in Indian tobacco chewers. Beta diversity of tobacco chewers was similar to both the healthy population as well as oral cancer patients suggesting transitioning of the oral microbiome from healthy to oral cancer microbiome via the tobacco chewers microbiome.Conclusion. The data provides evidence of oral bacterial dysbiosis due to tobacco chewing habits that can further lead to progression towards cancer.
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Affiliation(s)
- Shriya Sawant
- Department of Biological Sciences, Sunandan Divatia School of Science, NMIMS University, Vile Parle (West), Mumbai, India
| | - Jinesh Dugad
- Somaiya Ayurvihar -Asian Cancer Institute, Off Eastern Express Highway, Behind Everard Nagar, Somaiya Ayurvihar, Sion (East), Mumbai, India
| | - Deepak Parikh
- Somaiya Ayurvihar -Asian Cancer Institute, Off Eastern Express Highway, Behind Everard Nagar, Somaiya Ayurvihar, Sion (East), Mumbai, India
| | - Sathiyaraj Srinivasan
- Department of Bio & Environmental Technology, College of Natural Science, Seoul Women's University, Seoul 01797, Republic of Korea
- Gene Strand Technologies Pvt. Ltd., Chennai, India
| | - Harinder Singh
- Department of Biological Sciences, Sunandan Divatia School of Science, NMIMS University, Vile Parle (West), Mumbai, India
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Athukorala IA, Tilakaratne WM, Jayasinghe RD. Areca Nut Chewing: Initiation, Addiction, and Harmful Effects Emphasizing the Barriers and Importance of Cessation. JOURNAL OF ADDICTION 2021; 2021:9967097. [PMID: 34123457 PMCID: PMC8192186 DOI: 10.1155/2021/9967097] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/22/2021] [Accepted: 05/25/2021] [Indexed: 12/05/2022]
Abstract
Areca nut is a highly addictive substance with carcinogenic properties and causes many harmful effects to the human body. Alkaloids are the major chemicals found in areca nut, and their mechanism of action has been studied for several years. About 600 million people around the world use areca nut, and its usage is higher in Asian countries. Areca nut chewers get used to the habit mainly due to social influence, stress, or lack of awareness. Some studies have reported a dependence syndrome related to areca nut chewing. Even though there are many ongoing research studies regarding tobacco addiction, less concern has been given to the areca nut addiction. There are only few studies related to areca nut cessation, and even those few cessation programs are mainly designed using tobacco cessation methodology. Sociocultural influence, behavioral factors, and accessibility are the main barriers to cessation. Behavior changing interventions proved to be more effective in areca nut cessation, but recently studies on pharmacological therapies are also emerging.
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Affiliation(s)
- I. A. Athukorala
- Centre for Research in Oral Cancer, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - W. M. Tilakaratne
- Centre for Research in Oral Cancer, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - R. D. Jayasinghe
- Centre for Research in Oral Cancer, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
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Role of Yes-associated protein and transcriptional coactivator with PDZ-binding motif in the malignant transformation of oral submucous fibrosis. Arch Oral Biol 2021; 128:105164. [PMID: 34044344 DOI: 10.1016/j.archoralbio.2021.105164] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE(S) The objective of the present manuscript is to elucidate the role of matrix stiffness in the malignant transformation of oral submucous fibrosis. DESIGN The role of matrix stiffness in several cancers including oral cancer was reviewed with a tailored search strategy using relevant keywords as per the Medline format. The role of molecular mediators, Yes-associated protein 1 (YAP) and transcriptional coactivator with PDZ-binding motif (TAZ) was weighed in the context of OSF along two distinct pathways. RESULTS Increased matrix stiffness activates the transcriptional coactivators, YAP and TAZ shuttling between the nucleus and cytoplasm. YAP and TAZ, serve as mechanical transducers in promoting cell migration, invasion and epithelial-mesenchymal transition (EMT). The hypoxic microenvironment in the advanced stage of OSF promotes the migratory phenotype through mechanical memory. CONCLUSIONS Reprogramming of a stiff matrix has the potential to restore the Hippo-YAP/TAZ tumor suppressor pathway and reverse fibrosis-associated tumor development.
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Sahu RK, Patro S, Nayak B, Bardhan D, Panda S, Rajguru JP. Habit-associated salivary pH changes in oral submucous fibrosis: A cross-sectional study. Natl J Maxillofac Surg 2021; 12:78-82. [PMID: 34188405 PMCID: PMC8191565 DOI: 10.4103/njms.njms_39_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/15/2020] [Accepted: 10/08/2020] [Indexed: 11/26/2022] Open
Abstract
Background: Salivary pH plays a significant role in the pathogenesis of various oral diseases and conditions. Chewing of areca nut and various tobacco products changes salivary pH. Aim: The aim of the study was to measure the effect of habitual chewing of areca nut and various tobacco products on salivary pH. Materials and Methods: The present study included 360 individuals (chewers and nonchewers) of age group between 20 and 30 years who visited the Outpatient Department of Hi-Tech Dental College and Hospital. The patient's salivary pH was measured with the help of a digital pH meter before and after chewing areca nut and various tobacco products. Results: It was observed that, in all the groups of chewers, pH decreased after chewing except in the gutkha and lime chewing group, where pH increased (pH before chewing was 7.43 ± 0.41 and after chewing was 7.51 ± 0.399), the difference was strongly significant (P < 0.001). pH was found to be less in lime and tobacco chewers (6.83 ± 0.33) and more in tobacco, betel nut, and lime chewers (7.50 ± 0.41) in comparison to other groups before chewing; the difference was strongly significant (P < 0.001). In the mean ± standard deviation, increase in pH was found among chewers (7.32 ± 0.49) as compared to nonchewers (6.99 ± 0.14), which is the control group, and the data were statically significant (P < 0.001). Conclusion: pH is altered in areca nut and various tobacco chewers, rendering the oral mucosa vulnerable to the toxic effects of areca nut and various tobacco products.
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Affiliation(s)
- Rohit Kumar Sahu
- Department of Oral Medicine and Radiology, Hi-Tech Dental College and Hospital, Bhubaneswar, Odisha, India
| | - Sangram Patro
- Department of Oral and Maxillofacial Surgery, Hi-Tech Dental College and Hospital, Bhubaneswar, Odisha, India
| | - Bikash Nayak
- Department of Oral Medicine and Radiology, Hi-Tech Dental College and Hospital, Bhubaneswar, Odisha, India
| | - Debajyoti Bardhan
- Department of Oral Medicine and Radiology, Hi-Tech Dental College and Hospital, Bhubaneswar, Odisha, India
| | - Swagat Panda
- Department of Conservative and Endodontics, Hi-Tech Dental College and Hospital, Bhubaneswar, Odisha, India
| | - Jagdish Prasad Rajguru
- Department of Oral and Maxillofacial Pathology, Hi-Tech Dental College and Hospital, Bhubaneswar, Odisha, India
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Patel R, Shah J, Dudhia B, Patel P. Role of areca nut and smokeless tobacco-related habit in altering physical properties of saliva – A comparative study. JOURNAL OF INDIAN ACADEMY OF ORAL MEDICINE AND RADIOLOGY 2021. [DOI: 10.4103/jiaomr.jiaomr_226_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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22
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Christy AW, Raja Devathambi TJ, Deepikalakshmi B. Need for regulation of pan masala advertisements in television media. JOURNAL OF INDIAN ACADEMY OF ORAL MEDICINE AND RADIOLOGY 2021. [DOI: 10.4103/jiaomr.jiaomr_122_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Minarovits J. Anaerobic bacterial communities associated with oral carcinoma: Intratumoral, surface-biofilm and salivary microbiota. Anaerobe 2020; 68:102300. [PMID: 33246097 DOI: 10.1016/j.anaerobe.2020.102300] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 11/06/2020] [Accepted: 11/18/2020] [Indexed: 12/12/2022]
Abstract
It was estimated that more than 700 bacterial species inhabit the oral cavity of healthy humans. Anaerobes comprise a significant fraction of the oral bacteriome and play an important role in the formation of multi-species biofilms attached to various anatomical sites. Bacterial biofilms are also associated with pathologic laesions of the oral cavity, including oral squamous cell carcinoma (OSCC), and distinct oral taxa could also be detected within the tumors, i.e. in deep biopsy samples. These observations suggested that certain oral bacteria or oral bacterial communities may play a causative role in oral carcinogenesis, in addition to the well characterized risk factors of oral cancer. Alternatively, it was also proposed that a subset of oral bacteria may have a growth advantage in the unique microenvironment of OSCC. Recently, a series of studies analysed the OSCC-associated bacterial communities using metataxonomic, metagenomic and metatranscriptomic approaches. This review outlines the major differences between the community structure of microbiota in tumor biopsy, surface-biofilm and salivary or oral wash samples collected from OSCC patients, compared to corresponding samples from control persons. A special emphasis is given to the anaerobic bacteria Fusobacterium nucleatum and Fusobacterium periodonticum that were characterised repeatedly as "OSCC-associated" in independent studies. Predicted microbial functions and relevant in vivo experimental models of oral carcinogenesis will also be summarized.
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Affiliation(s)
- Janos Minarovits
- University of Szeged, Faculty of Dentistry, Department of Oral Biology and Experimental Dental Research, H-6720 Szeged, Tisza Lajos krt. 64 Hungary.
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Subramaniam N, Dhar SK, Rao R, Prasad K, Das M. Novel tyrosine metabolites in the transcriptomic profiling of smokeless tobacco related oral cancer and their potential implications. Oral Oncol 2020; 113:105027. [PMID: 33012656 DOI: 10.1016/j.oraloncology.2020.105027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 09/21/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Narayana Subramaniam
- MSMF, MSMC, Narayana Health City, Bommasandra, Bangalore 560099, India; MAHE, Manipal, India
| | - Sujan K Dhar
- Sankhya Sciences, S-005 Krishna Greens, Dodda Bommasandra, Bangalore 560097, India
| | - Roopa Rao
- Department of Oral Pathology, M.S. Ramaiah Dental College, Bangalore 560012, India
| | - Kavitha Prasad
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, Bangalore 560054, India.
| | - Manjula Das
- MSMF, MSMC, Narayana Health City, Bommasandra, Bangalore 560099, India.
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25
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Sari EF, Prayogo GP, Loo YT, Zhang P, McCullough MJ, Cirillo N. Distinct phenolic, alkaloid and antioxidant profile in betel quids from four regions of Indonesia. Sci Rep 2020; 10:16254. [PMID: 33004929 PMCID: PMC7529777 DOI: 10.1038/s41598-020-73337-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 08/21/2020] [Indexed: 11/09/2022] Open
Abstract
Betel quid (BQ) is a chewing mixed package that mainly contains areca nut (AN), betel leaf (Leaf) or betel stem inflorescence (SI), and slaked lime, and is consumed with or without tobacco BQ chewing is common in South East Asia and has been strongly associated with malignant and potentially malignant diseases of the oral cavity. Alkaloids such as arecoline are often accounted for the carcinogenic potential of BQ, however the chemical composition of BQ has not been studied in detail. In the current study, we investigated the total phenolic content (TPC), antioxidant activity (by mean of ferric reducing antioxidant power, FRAP), radical scavenging activity (DPPH test), polyphenolic profile and arecoline content in different components of BQ, namely AN, Leaf or SI, Husk, and blended BQ (BQ mix, containing AN, Leaf or SI and slaked lime). Samples were imported from 4 major regions of Indonesia, namely: Banda Aceh (BA), North Sumatra (NS), West Kalimantan (WK) and West Papua (WP). The highest TPC, FRAP, and DPPH values were detected in AN samples compared to other BQ components, while samples from WP region were of higher values compared to the other regions. High performance liquid chromatography—Mass Spectrometry (LC–MS) analysis showed that Husk contains the widest range of polyphenols, including hydroxybenzoic acids, hydroxycinnamic acids, flavanols, flavonols and stilbenes. Catechin and epicatechin were the main polyphenols detected in BQ, and they were present at the highest concentrations in WP–AN sample. Arecoline was detected in all AN and BQ mix samples and was significantly correlated with catechin and epicatechin, and significantly negatively correlated with p-hydroxybenzoic acid. Notably, arecoline concentration changed significantly when AN was blended in BQ mixtures. The current study is the first to extensively characterise the chemical composition of BQ and provides insight for a better understanding of the interactions of BQ alkaloids and phenolics in the development of oral submucous fibrosis and oral cancer.
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Affiliation(s)
- Elizabeth Fitriana Sari
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC, 3053, Australia. .,Faculty of Dentistry, Universitas Padjadjaran, Jl. Raya Sumedang KM 21, Jatinangor, 45363, Indonesia. .,Dentistry and Oral Health, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, 3550, Australia.
| | - Grace Puspita Prayogo
- School of Agriculture and Food, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC, 3052, Australia
| | - Yit Tao Loo
- School of Agriculture and Food, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC, 3052, Australia
| | - Pangzhen Zhang
- School of Agriculture and Food, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC, 3052, Australia.
| | - Michael John McCullough
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC, 3053, Australia
| | - Nicola Cirillo
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC, 3053, Australia.
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Chai AWY, Yee PS, Price S, Yee SM, Lee HM, Tiong VKH, Gonçalves E, Behan FM, Bateson J, Gilbert J, Tan AC, McDermott U, Garnett MJ, Cheong SC. Genome-wide CRISPR screens of oral squamous cell carcinoma reveal fitness genes in the Hippo pathway. eLife 2020; 9:e57761. [PMID: 32990596 PMCID: PMC7591259 DOI: 10.7554/elife.57761] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 09/28/2020] [Indexed: 02/06/2023] Open
Abstract
New therapeutic targets for oral squamous cell carcinoma (OSCC) are urgently needed. We conducted genome-wide CRISPR-Cas9 screens in 21 OSCC cell lines, primarily derived from Asians, to identify genetic vulnerabilities that can be explored as therapeutic targets. We identify known and novel fitness genes and demonstrate that many previously identified OSCC-related cancer genes are non-essential and could have limited therapeutic value, while other fitness genes warrant further investigation for their potential as therapeutic targets. We validate a distinctive dependency on YAP1 and WWTR1 of the Hippo pathway, where the lost-of-fitness effect of one paralog can be compensated only in a subset of lines. We also discover that OSCCs with WWTR1 dependency signature are significantly associated with biomarkers of favorable response toward immunotherapy. In summary, we have delineated the genetic vulnerabilities of OSCC, enabling the prioritization of therapeutic targets for further exploration, including the targeting of YAP1 and WWTR1.
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Affiliation(s)
- Annie Wai Yeeng Chai
- Head and Neck Cancer Research Team, Cancer Research Malaysia, Head and Neck Cancer Research TeamSubang Jaya, SelangorMalaysia
| | - Pei San Yee
- Head and Neck Cancer Research Team, Cancer Research Malaysia, Head and Neck Cancer Research TeamSubang Jaya, SelangorMalaysia
| | - Stacey Price
- Wellcome Sanger Institute, Wellcome Genome CampusCambridgeUnited Kingdom
| | - Shi Mun Yee
- Head and Neck Cancer Research Team, Cancer Research Malaysia, Head and Neck Cancer Research TeamSubang Jaya, SelangorMalaysia
| | - Hui Mei Lee
- Head and Neck Cancer Research Team, Cancer Research Malaysia, Head and Neck Cancer Research TeamSubang Jaya, SelangorMalaysia
| | - Vivian KH Tiong
- Head and Neck Cancer Research Team, Cancer Research Malaysia, Head and Neck Cancer Research TeamSubang Jaya, SelangorMalaysia
| | - Emanuel Gonçalves
- Wellcome Sanger Institute, Wellcome Genome CampusCambridgeUnited Kingdom
| | - Fiona M Behan
- Wellcome Sanger Institute, Wellcome Genome CampusCambridgeUnited Kingdom
| | - Jessica Bateson
- Wellcome Sanger Institute, Wellcome Genome CampusCambridgeUnited Kingdom
| | - James Gilbert
- Wellcome Sanger Institute, Wellcome Genome CampusCambridgeUnited Kingdom
| | - Aik Choon Tan
- Department of Biostatistics and Bioinformatics, Moffitt Cancer CenterTampaUnited States
| | - Ultan McDermott
- Oncology R&D AstraZeneca, CRUK Cambridge InstituteCambridgeUnited Kingdom
| | - Mathew J Garnett
- Wellcome Sanger Institute, Wellcome Genome CampusCambridgeUnited Kingdom
| | - Sok Ching Cheong
- Head and Neck Cancer Research Team, Cancer Research Malaysia, Head and Neck Cancer Research TeamSubang Jaya, SelangorMalaysia
- Department of Oral & Maxillofacial Clinical Sciences, Faculty of Dentistry, University of MalayaKuala LumpurMalaysia
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Anwar N, Pervez S, Chundriger Q, Awan S, Moatter T, Ali TS. Oral cancer: Clinicopathological features and associated risk factors in a high risk population presenting to a major tertiary care center in Pakistan. PLoS One 2020; 15:e0236359. [PMID: 32760151 PMCID: PMC7410283 DOI: 10.1371/journal.pone.0236359] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 07/03/2020] [Indexed: 12/19/2022] Open
Abstract
Oral squamous cell carcinoma (OSCC) has the highest prevalence in head and neck cancers and is the first and second most common cancer in males and females of Pakistan respectively. Major risk factors include peculiar chewing habits like areca nut, betel quid, and tobacco. The majority of OSCC presents at an advanced stage with poor prognosis. On the face of such a high burden of this preventable cancer, there is a relative lack of recent robust data and its association with known risk factors from Pakistan. The aim of this study was to identify the socioeconomic factors and clinicopathological features that may contribute to the development of OSCC. A total of 186 patients diagnosed and treated at a tertiary care hospital, Karachi Pakistan were recruited. Clinicopathological and socioeconomic information was obtained on a structured questionnaire. Descriptive analysis was done for demographics and socioeconomic status (SES) while regression analysis was performed to evaluate the association between SES and chewing habits, tumor site, and tumor stage. The majority of patients were males and the mean age of OSCC patients was 47.62±12.18 years. Most of the patients belonged to low SES (68.3%) and 77.4% were habitual of chewing. Gender (male) and SES were significantly associated with chewing habits (p<0.05). Odds of developing buccal mucosa tumors in chewers (of any type of substance) and gutka users were 2 and 4 times higher than non-chewers respectively. Middle age, chewing habits, and occupation were significantly associated with late stage presentation of OSCC (p<0.05). In conclusion, male patients belonging to low SES in their forties who had chewing habits for years constituted the bulk of OSCC. Buccal mucosa was the most common site in chewers and the majority presented with late stage tumors.
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Affiliation(s)
- Namrah Anwar
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Shahid Pervez
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Qurratulain Chundriger
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Sohail Awan
- Department of Otolaryngology, Head and Neck Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Tariq Moatter
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Tazeen Saeed Ali
- School of Nursing and Midwifery, Aga Khan University Hospital, Karachi, Pakistan
- * E-mail:
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Vashney M, Parmar A, Mishra AK. The Past, Present and Future of Literature Pertaining to Betel ( Areca) Nut: A Citation Analysis. Subst Use Misuse 2020; 55:1403-1412. [PMID: 32569540 DOI: 10.1080/10826084.2019.1660677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective and method: Betel (areca) nut has recently received interest from researchers and policy makers for its role as a psychoactive substance. It was historically limited to Asia-pacific region, but with the advent of globalization, it has become an equally challenging public health problem across the globe. Previously published literature can give us valuable insights in terms of historical interest and understanding related to betel nut. With the expansion of biomedical research a huge number of articles have been published on the same. In terms of understanding the impact of an article, citations are considered a proxy estimate measure. Thus we decided to analyze the top 100 cited articles (till November 2018) related to betel nut. The search in Google scholar database was done with the help of freely available software, Publish or Perish. Results: Overall we found that most articles were published from the fields of dentistry and oncology, with relatively minimal contribution from the field of Addiction Psychiatry. Hence, most articles have addressed the issue of epidemiology and mechanism with lesser share of treatment related publications. Various important information related to these articles have been discussed including the institutions, countries, journals and impactful authors in the field. Subsequently, original research articles are further classified into descriptive/epidemiology, mechanism, management, scale/measurement, imaging and medical psychiatry. Importance: This citation analysis provides valuable information with regards to the emphasis of researchers in the field, and areas where more emphasis is required from contemporary world.
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Affiliation(s)
- Mohit Vashney
- Department of Addiction Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Arpit Parmar
- Department of Addiction Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Ashwani Kumar Mishra
- Department of Biostatistics, National Drug Dependence Treatment Centre and Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
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Abstract
Background: Chewing of betel quid, popularly known as doma khamdo, is prevalent in Bhutan and is associated with Bhutanese customs and traditions. The objective of this paper was to determine the prevalence and explore the correlates of current betel quid use in Bhutan. Materials and methods: This is a retrospective study of secondary data from the National Health Survey 2012 (NHS 2012) of Bhutan. The outcome variable of interest was current betel quid use. The self-reported demographic characteristics were obtained using a questionnaire developed following the WHO STEPwise approach to the surveillance of non-communicable diseases (STEP). Univariate and multivariate logistic regression were performed to identify correlates for betel quid use. Results: The prevalence of current betel quid use in this study was 45.0%. The correlates associated with current betel quid use were: being female; having a primary, high school or a monastic education; being professionals in the armed forces, managers, technicians, service and sales workers, and machine operators; being current smokers; alcohol consumption; and intake of drugs. Correlates associated with decreased betel quid use were: having a diploma/certificate-level and non-formal education, and living in urban areas. Conclusion: The findings indicate that betel quid was consumed by nearly half of the Bhutanese population. Bhutan should immediately initiate national prevention programs targeting these correlates of betel quid use.
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Affiliation(s)
- Kinley Wangdi
- Department of Global Health, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia.,Phuentsholing General Hospital, Phuentsholing, Bhutan
| | - Tshering Jamtsho
- School of Demography, ANU College of Arts & Social Sciences, The Australian National University, Canberra, ACT, Australia
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30
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Papke RL, Bhattacharyya I, Hatsukami DK, Moe I, Glatman S. Betel Nut (areca) and Smokeless Tobacco Use in Myanmar. Subst Use Misuse 2020; 55:1385-1394. [PMID: 31220988 PMCID: PMC7774082 DOI: 10.1080/10826084.2019.1624774] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Betel nut (areca) is the world's fourth most commonly used addictive substance. Arecoline, a muscarinic agonist in areca, is also a partial agonist for the addiction-related high-affinity brain nicotine receptors. In many countries, smokeless tobacco is commonly mixed with areca. Objective: We sought to evaluate the knowledge of self-harm, and addiction associated betel quid use in an unban population. Methods: We conducted a survey study of 200 betel quid users in Yangon, Myanmar, and a survey of betel quid vendors to determine the relative amounts of areca and tobacco in the available quids. Results: The data determined that a large majority of the survey subjects (84%) used tobacco with their areca. Users had a general awareness that betel chewing was "a bad habit" (85%) and 80% were aware of the cancer risks. Understanding areca addiction remains a challenge since, aside from the strong muscarinic activity of arecoline stimulating salivation, overt neurologic effects are difficult for even the users to identify. Fifty eight percent of the respondents indicated that chewing betel quid had effects like drinking coffee, and 55.5% indicated that it had effects like drinking alcohol. Data obtained from the quid vendors indicated that 75% added tobacco in equal amounts to areca. Conclusion: The concomitant use of nicotine and areca indicates that betel quid addiction includes a significant component of nicotine dependence. However, the additional activities of areca, including the muscarinic effects of arecoline, indicate that potential cessation therapies should optimally address other factors as well.
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Affiliation(s)
- Roger L Papke
- Department of Pharmacology and Therapeutics, University of Florida, College of Medicine, Gainesville, Florida, USA
| | - Indraneel Bhattacharyya
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida, College of Dentistry, Gainesville, Florida, USA
| | - Dorothy K Hatsukami
- Department of Psychiatry and the Masonic Cancer Center, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Ingyin Moe
- Ko Shwe Ventures Pte. Ltd, Yangon, Myanmar
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Chemistry, metabolism and pharmacology of carcinogenic alkaloids present in areca nut and factors affecting their concentration. Regul Toxicol Pharmacol 2019; 110:104548. [PMID: 31805361 DOI: 10.1016/j.yrtph.2019.104548] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 11/27/2019] [Accepted: 12/01/2019] [Indexed: 12/28/2022]
Abstract
Areca Nut (AN), the seed of tropical palm tree Areca catechu, is a widely chewed natural product with estimated 600 million users across the world. Various AN products, thriving in the market, portray 'Areca nut' or 'Supari' as mouth freshener and safe alternative to smokeless tobacco. Unfortunately, AN is identified as a Group 1 human carcinogen by International Agency for Research on Cancer (IARC). Wide variation in the level of alkaloids, broadly ranging from 2 to 10 mg/gm dry weight, is observed in diverse variety of AN sold worldwide. For the first time, various factors influencing the formation of carcinogenic alkaloids in AN at various stages, including during the growth, processing, and storage of the nut, are discussed. Current review illustrates the mechanism of cancer induction by areca alkaloids in humans and also compiles dose-dependent pharmacology and toxicology data of arecoline, the most potent carcinogenic alkaloid in AN. Careful monitoring of the arecoline content in AN can potentially be used as a tool in product surveillance studies to identify the variations in characteristics of various AN sample sold worldwide. The article will help to generate public awareness and sensitize the government bodies to initiate campaigns against AN use and addiction.
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32
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Khowal S, Wajid S. Role of Smoking-Mediated molecular events in the genesis of oral cancers. Toxicol Mech Methods 2019; 29:665-685. [DOI: 10.1080/15376516.2019.1646372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Sapna Khowal
- Department of Biotechnology, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, India
| | - Saima Wajid
- Department of Biotechnology, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, India
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Nair D, Singhvi H, Mair M, Qayyumi B, Deshmukh A, Pantvaidya G, Nair S, Chaturvedi P, Laskar SG, Prabhash K, DCruz A. Outcomes of surgically treated oral cancer patients at a tertiary cancer center in India. Indian J Cancer 2018; 54:616-620. [PMID: 30082545 DOI: 10.4103/ijc.ijc_445_17] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Oral cancers are one of the most common cancers in India. Surgery is the main modality of treatment for oral cancer patients. It is important to understand the postoperative morbidity and mortality as it influences patient outcomes. AIM The aim of this study was to determine oral cancer patients' characteristics, treatment details, 30-day morbidity and mortality, and survival outcomes. SETTINGS AND DESIGN This was a retrospective analysis of prospectively collected data in a tertiary cancer center. MATERIALS AND METHODS This study included 850 surgically treated oral cancer cases between January and December 2012. STATISTICAL ANALYSIS We performed univariate survival analysis by log-rank test, and all significant (P < 0.05) variables underwent multivariate analysis using Cox regression. RESULTS The median age was 52 years and the male-to-female ratio was 3.4:1. Nearly one-third of the patients received some form of prior treatment. Buccal mucosa (BM) was the most common subsite (64.94%). BM cancers (81.1%) were more likely to present in advanced stage compared to tongue cancers (52%) (P = 0.000). The incidence of postoperative morbidity and mortality was 36.4% and 0.9%, respectively. Complications were higher in cT3-4 (P = 0.000), cN positive (P = 0.000), and those requiring microvascular reconstruction (P = 0.004). The 5-year overall survival of the entire study group was 70.4%. The survival of early and locally advanced stages was 75.1% and 68.4%, respectively. The factors influencing survival were age (>50 years), advanced cT stage, nodal metastasis, overall stage, and presence of orocutaneous fistula. CONCLUSION The morbidity, mortality, and long-term outcomes of surgically treated oral cancer patients at our center are comparable to those treated in the developed world. Aggressive management of postoperative complications is crucial for early recovery and timely initiation of adjuvant treatment.
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Affiliation(s)
- Deepa Nair
- Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Hitesh Singhvi
- Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Manish Mair
- Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Burhanuddin Qayyumi
- Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Anuja Deshmukh
- Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Gouri Pantvaidya
- Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Sudhir Nair
- Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Pankaj Chaturvedi
- Department of Head and Neck Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | | | - Kumar Prabhash
- Medical Oncologist, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Anil DCruz
- Director, Tata Memorial Centre, Mumbai, Maharashtra, India
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Bhartiya D, Kumar A, Kaur J, Kumari S, Sharma AK, Sinha DN, Singh H, Mehrotra R. In-silico study of toxicokinetics and disease association of chemicals present in smokeless tobacco products. Regul Toxicol Pharmacol 2018; 95:8-16. [PMID: 29505798 DOI: 10.1016/j.yrtph.2018.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/11/2018] [Accepted: 03/01/2018] [Indexed: 12/24/2022]
Abstract
Smokeless tobacco (SLT) products are consumed by millions of people in over 130 countries around the world. Consumption of SLT has been estimated to cause a number of diseases accounting to more than 0.65 million deaths per year. There is sufficient epidemiological evidence on the association of SLT products with nicotine addiction, cancers of oral cavity and digestive systems but there is a lack of understanding of the role of toxic chemicals in these diseases. We provide the first comprehensive in-silico analysis of chemical compounds present in different SLT products used worldwide. Many of these compounds are found to have good absorption, solubility and permeability along with mutagenic and toxic properties. They are also found to target more than 350 human proteins involved in a plethora of human biological processes and pathways. Along with all the previously known diseases, the present study has identified the association of compounds of SLT products with a number of unknown diseases like neurodegenerative, immune and cardiac diseases (Left ventricular non compaction, dilated cardiomyopathy etc). These findings indicate far-reaching impact of SLT products on human health than already known which needs further validations using epidemiological, in-vitro and in-vivo methodologies. Thus, this study will provide one stop information for the policy makers in development of regulatory policies on toxic contents of SLT products.
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Affiliation(s)
- Deeksha Bhartiya
- Data Management Laboratory, National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh 201301, India
| | - Amit Kumar
- Data Management Laboratory, National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh 201301, India
| | - Jasmine Kaur
- Informatics, Systems and Research Management, Indian Council of Medical Research, New Delhi 110029, India
| | - Suchitra Kumari
- Data Management Laboratory, National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh 201301, India
| | - Amitesh Kumar Sharma
- Informatics, Systems and Research Management, Indian Council of Medical Research, New Delhi 110029, India
| | - Dhirendra N Sinha
- WHO FCTC Global Knowledge Hub of Smokeless Tobacco, National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh 201301, India
| | - Harpreet Singh
- Informatics, Systems and Research Management, Indian Council of Medical Research, New Delhi 110029, India.
| | - Ravi Mehrotra
- WHO FCTC Global Knowledge Hub of Smokeless Tobacco, National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh 201301, India; National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh 201301, India
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35
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Niaz K, Maqbool F, Khan F, Bahadar H, Ismail Hassan F, Abdollahi M. Smokeless tobacco ( paan and gutkha) consumption, prevalence, and contribution to oral cancer. Epidemiol Health 2017; 39:e2017009. [PMID: 28292008 PMCID: PMC5543298 DOI: 10.4178/epih.e2017009] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 03/09/2017] [Indexed: 01/19/2023] Open
Abstract
Smokeless tobacco consumption, which is widespread throughout the world, leads to oral submucous fibrosis (OSMF), which is a long-lasting and devastating condition of the oral cavity with the potential for malignancy. In this review, we mainly focus on the consumption of smokeless tobacco, such as paan and gutkha, and the role of these substances in the induction of OSMF and ultimately oral cancer. The list of articles to be examined was established using citation discovery tools provided by PubMed, Scopus, and Google Scholar. The continuous chewing of paan and swallowing of gutkha trigger progressive fibrosis in submucosal tissue. Generally, OSMF occurs due to multiple risk factors, especially smokeless tobacco and its components, such as betel quid, areca nuts, and slaked lime, which are used in paan and gutkha. The incidence of oral cancer is higher in women than in men in South Asian countries. Human oral epithelium cells experience carcinogenic and genotoxic effects from the slaked lime present in the betel quid, with or without areca nut. Products such as 3-(methylnitrosamino)-proprionitrile, nitrosamines, and nicotine initiate the production of reactive oxygen species in smokeless tobacco, eventually leading to fibroblast, DNA, and RNA damage with carcinogenic effects in the mouth of tobacco consumers. The metabolic activation of nitrosamine in tobacco by cytochrome P450 enzymes may lead to the formation of N-nitrosonornicotine, a major carcinogen, and micronuclei, which are an indicator of genotoxicity. These effects lead to further DNA damage and, eventually, oral cancer.
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Affiliation(s)
- Kamal Niaz
- International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran.,Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.,Toxicology and Diseases Group, Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Faheem Maqbool
- International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran.,Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.,Toxicology and Diseases Group, Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fazlullah Khan
- International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran.,Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.,Toxicology and Diseases Group, Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Haji Bahadar
- Institute of Paramedical Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Fatima Ismail Hassan
- International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran.,Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.,Toxicology and Diseases Group, Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Abdollahi
- International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran.,Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.,Toxicology and Diseases Group, Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran
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36
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Agarwal K, Chauhan A, Prasad J, Mehra P, Kumar S, Pahuja BK, Ahirwar AK. Effect of Areca Nut Consumption on Hypoxia-inducible Factor-1 Alfa Expression in Patients with Oral Squamous Cell Carcinoma. ACTA ACUST UNITED AC 2017. [DOI: 10.5005/jp-journals-10054-0026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
ABSTRACT
Introduction
Oral squamous cell carcinoma (OSCC) is a major health problem in Southeast Asia, including India. Areca nut chewing is a major health hazard in India, which has been implicated in the etiology of OSCC. Hypoxia-inducible factor-1 (HIF-1) is a major transcription factor involved in adaptation under hypoxic condition, a common finding in solid tumors. The present study was conducted to evaluate the effect of different habits including areca nut chewing on HIF-1 expression in patients with OSCC.
Materials and methods
It was a hospital-based observational case-control study. The study comprised 50 histologically proven cases of OSCC and 50 healthy controls. The HIF-1α level was measured by commercially available enzyme-linked immunosorbent assay (ELISA) in the blood samples. The data were analyzed using Statistical Package for the Social Sciences (SPSS) software version 20.
Results
The HIF-1α levels were found significantly higher in the patients with areca nut consumption in addition to other addictive habits. Isolated influence could not be discerned as there was only one patient who gave history of only areca nut chewing.
Conclusion
Our findings prove that HIF-1α expression is upregulated by areca nut chewing, which leads to worse prognosis. This calls for widespread awareness programs regarding the deleterious effects of areca nut chewing among the general population.
How to cite this article
Prasad J, Goswami B, Agarwal K, Mehra P, Kumar S, Pahuja BK, Chauhan A, Ahirwar AK. Effect of Areca Nut Consumption on Hypoxia-inducible Factor-1 Alfa Expression in Patients with Oral Squamous Cell Carcinoma. Indian J Med Biochem 2017;21(2):81-85.
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Prevalence of areca nut chewing habit among high school children of Parsa district of Nepal. J Oral Biol Craniofac Res 2016; 7:161-166. [PMID: 29123993 DOI: 10.1016/j.jobcr.2016.10.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 10/26/2016] [Indexed: 10/20/2022] Open
Abstract
Aim Consumption of areca nut products among school going children has become very common social evil in some areas of Nepal especially adjoining the Indian subcontinent. The aim of this study was to assess the prevalence of areca nut chewing habit among high school children in Terai belt of Nepal. The use of areca nut has become indigenous in this part and is being used by itself and in various formulations. The regular use of areca nut has been recognized as being carcinogenic to humans. Materials and methods Data on areca nut chewing habit among high school children was collected from 1359 students of age group 14-18 years from 13 schools of Parsa district of Nepal by random selection and the information was obtained from self administered questionnaire. Results The results from this study shows that the areca nut chewing habit is significant among the students of Parsa district (30.4%) and the frequency of chewing plain Supari was reported to be high (81.6%) followed by pan masala (10.4%) and gutkha (08.0%) and the habit increased with age. Conclusion It is mandatory to motivate the children not to initiate the habit and to enable the adolescent children to realize the potential health risk of areca nut products.
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Mohan SP, Chitturi RT, Ragunathan YT, Lakshmi SJ, Nallusamy J, Joseph I. Minor Salivary Gland Changes in Oral Epithelial Dysplasia and Oral Squamous Cell Carcinoma - A Histopathological Study. J Clin Diagn Res 2016; 10:ZC12-5. [PMID: 27630945 DOI: 10.7860/jcdr/2016/20218.8116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 05/23/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The most common etiology for Oral Squamous Cell Carcinoma (OSCC) is tobacco and tobacco related products which cause nuclear damage to the keratinocytes. The chemical carcinogens not only affect the lining of oral epithelium but also affect the lining epithelium of the excretory ducts of the salivary glands. Thus, there is a possibility of epithelial dysplasia of the salivary duct epithelium which may lead to potential malignant transformation. AIM The study was performed to see the changes in the minor salivary glands and excretory ducts in cases of oral epithelial dysplasia and OSCC. MATERIALS AND METHODS A total of 278 archival cases of mild, moderate and severe epithelial dysplasia, carcinoma in situ, OSCC including verrucous carcinoma were histopathologically evaluated to observe changes in the excretory ducts and the minor salivary glands. RESULTS In the study there were 56.5% males and 43.5% females. The age group that was most commonly affected in both the sexes was 50-60 yr old. Buccal mucosa was the most common site of involvement. Ductal changes observed in the excretory duct include simple hyperplasia, metaplastic changes such as mucous, oncocytic & squamous, and infiltration of inflammatory cells and malignant cells. Acinar changes observed were degeneration, squamous metaplasia, myoepithelial cell proliferation and inflammatory cell infiltration. Both the excretory ducts and ducts within the gland showed dysplasia. CONCLUSION According to observations in our study it is suggested that histopathological interpretation for oral mucosal lesions especially oral epithelial dysplasias and OSCC should also include changes related to salivary gland tissue to provide a better treatment plan and prevent recurrence of the malignant tumours.
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Affiliation(s)
- Sunil Paramel Mohan
- Head of Department, Deparment of Oral Pathology, Director, Department of Stem Cells and Regenerative Medicine, Dean, Sree Anjaneya Institute of Dental Sciences , Calicut, Kerala, India
| | - Ravi Teja Chitturi
- Lecturer, Department of Oral Biology, School of Dentistry, Faculty of Medical Sciences, The University of the West Indies , St. Augustine Campus, Trinidad and Tobago
| | | | - Suman Jhansi Lakshmi
- Professor, Department of Oral Medicine and Radiology, K S R Institute of Dental Science and Research , Tiruchengode, Tamilnadu, India
| | - Jaisanghar Nallusamy
- Professor, Department of Oral Medicine and Radiology, Sree Anjaneya Institute of Dental Sciences , Calicut, Kerala, India
| | - Isaac Joseph
- Professor and Head, Department of Oral Pathology, Sree Moogambigai Dental College , Kulasekharam, Tamil Nadu, India
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Krishna Rao SV, Mejia G, Roberts-Thomson K, Logan R. Epidemiology of oral cancer in Asia in the past decade--an update (2000-2012). Asian Pac J Cancer Prev 2015; 14:5567-77. [PMID: 24289546 DOI: 10.7314/apjcp.2013.14.10.5567] [Citation(s) in RCA: 278] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The prevalence of oral cancers (OC) is high in Asian countries, especially in South and Southeast Asia. Asian distinct cultural practices such as betel-quid chewing, and varying patterns of tobacco and alcohol use are important risk factors that predispose to cancer of the oral cavity. The aim of this review is to provide an update on epidemiology of OC between 2000 and 2012. A literature search for this review was conducted on Medline for articles on OC from Asian countries. Some of the articles were also hand searched using Google. High incidence rates were reported from developing nations like India, Pakistan, Bangladesh, Taiwan and Sri Lanka. While an increasing trend has been observed in Pakistan, Taiwan and Thailand, a decreasing trend is seen in Philippines and Sri Lanka. The mean age of occurrence of cancer in different parts of oral cavity is usually between 51-55 years in most countries. The tongue is the leading site among oral cancers in India. The next most common sites in Asian countries include the buccal mucosa and gingiva. The 5 year survival rate has been low for OC, despite improvements in diagnosis and treatment. Tobacco chewing, smoking and alcohol are the main reasons for the increasing incidence rates. Low socioeconomic status and diet low in nutritional value lacking vegetables and fruits contribute towards the risk. In addition, viral infections, such as HPV and poor oral hygiene, are other important risk factors. Hence, it is important to control OC by screening for early diagnosis and controlling tobacco and alcohol use. It is also necessary to have cancer surveillance at the national-level to collect and utilise data for cancer prevention and control programs.
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Affiliation(s)
- Sree Vidya Krishna Rao
- Australian Research Centre for Population Oral Health, Adelaide, South Australia, Australia E-mail :
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Tiwari RV, Megalamanegowdru J, Gupta A, Agrawal A, Parakh A, Pagaria S, Sahu A. Knowledge, attitude and practice of tobacco use and its impact on oral health status of 12 and 15 year-old school children of Chhattisgarh, India. Asian Pac J Cancer Prev 2015; 15:10129-35. [PMID: 25556437 DOI: 10.7314/apjcp.2014.15.23.10129] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tobacco is a leading preventable cause of deaths worldwide; the situation is particularly serious in the developing countries. Tobacco use amongst the children and adolescents is already a pandemic and they are vulnerable targets of tobacco industry. This is also the case in India. OBJECTIVES 1) Document and monitor the prevalence of tobacco use including smoked, smokeless and other forms of tobacco; 2) Understand studentknowledge and attitudes related to tobacco use and its health impact; 3) Assess the impact of tobacco on the oral health status of school-going children in India. MATERIALS AND METHODS The sample was 1,500 school children of the age group 12-15 years age. A pretested, close ended questionnaire was administered in the form of extensive face to face interview to understand student knowledge, attitudes and behavior related to tobacco use and its health impact and to assess the prevalence of tobacco use including smoked, smokeless and other forms of tobacco. Oral health status was assessed using the Community Periodontal Index (CPI). Frequency distribution, Chi-square tests and Odd's ratio was calculated. RESULTS Prevalence of tobacco usage amongst the prevalence was 20.4%: 9.2% reported smoking, 15.8% used tobacco in the chewable form and 25.3% children were involved in consuming betel nut/areca nuts. The OR (Odd's ratio) for calculus formation was highest for guthka chewers (OR=14.322), paan masala chewers had the highest odds of developing bleeding on probing when compared to the others. CONCLUSIONS There is an urgent need to launch school-based tobacco prevention programs for community awareness of children and the public, as preventing the initiation of a habit is far easier than stopping it.
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Affiliation(s)
- Ram Vinod Tiwari
- Public Health Dentistry, Rungta College of Dental Sciences and Research , Bhili, India E-mail :
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