Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter August 2, 2021

Tobacco use and clinical leukoplakia lesions among south Indian tribes

  • Amina Shajahan , Abel Chundankuzhiyil Mathew ORCID logo EMAIL logo , Vadavattath Padmanabhan Gangadharan and Dilip Chandrasekhar

Abstract

Objectives

Leukoplakia is a white mucosal thickening and perhaps undermining change in the oral mucosa transcendently found in tobacco users. Since the tobacco utilization is extensively higher with the indigenous groups in the Asia Pacific locale, the current examination implicated the prevalence of tobacco consumption and leukoplakial lesions and the relationship between the two.

Methods

This cross-sectional study was conducted through six tribal hamlets of Chithalayath Forest range at Wayanad district of Kerala, South India. Leukoplakia screening was led by a senior consultant on the basis of a visual investigation and pathological evaluation was not done. An organized questionnaire was utilized to gather data on demographic details and tobacco usage status and frequency. The prevalence of clinical oral lesions among tobacco users and non users was determined using statistical analysis.

Results

Clinical oral leukoplakia was diagnosed in 27 (8.5%) subjects among the 317 individuals screened. The prevalence of lesions was considerably higher among tobacco consumers in comparison with non users (11 vs. 3.7%). Also, the tobacco chewers group had a higher percentage of leukoplakia. Another significant finding of this study is that the incidence of provisional leukoplakia was observed to be comparatively high among the most frequent tobacco consumers 15 (65.2%) in comparison with 8 (34.8%) in the frequent and nonfrequent users.

Conclusions

Prevalence of abusive habits and clinical oral leukoplakial was substantial among the tribes. The cause and effect relationship and dose-response were also shown to have a significant association.


Corresponding author: Abel Chundankuzhiyil Mathew, Department of Pharmacy Practice, Al-Shifa College of Pharmacy, Perinthalmanna, Kerala, India, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The research related to human use has complied with all the relevant national regulations, institutional policies, and in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors' Institutional Review Board (Al Shifa College of Pharmacy).

References

1. Danver, SL. Native peoples of the world: an encyclopedia of groups, cultures and contemporary issues. New York, USA: Routledge; 2014.10.4324/9781315702155Search in Google Scholar

2. Indigenous World 2020: India. Available from: https://www.iwgia.org/en/india/3601-iw-2020-india.html [Accessed 1 Jun 2020].Search in Google Scholar

3. India’s forgotten people. Available from: https://frontline.thehindu.com/columns/Jayati_Ghosh/indias-forgotten-people/article8409146.ece [Accessed 11 Jul 2019].Search in Google Scholar

4. Digiacomo, M, Davidson, P, Abbott, P, Davison, J, Moore, L, Thompson, S. Smoking cessation in indigenous populations of Australia, New Zealand, Canada, and the United States: elements of effective interventions. Int J Environ Res Publ Health 2011;8:388–410. https://doi.org/10.3390/ijerph8020388.Search in Google Scholar PubMed PubMed Central

5. Carson, KV, Brinn, MP, Veale, A, Esterman, AJ, Smith, BJ. Interventions for smoking cessation in Indigenous populations. Cochrane Database Syst Rev 2012;1:CD009046. https://doi.org/10.1002/14651858.CD009046.pub2.Search in Google Scholar PubMed

6. Tribal Health in India. Available from: https://www.nhm.gov.in/nhm_components/tribal_report/Executive_Summary.pdf [Accessed 12 Jul 2019].Search in Google Scholar

7. Gaidhane, A, Nazli, K, Zahiruddin, Q, Bawankule, S, Zodpey, S. Prevalence and pattern of tobacco use among tribal adolescents: are tobacco prevention messages reaching the tribal people in India? Ann Trop Med PH 2011;4:74–80. https://doi.org/10.4103/1755-6783.85756.Search in Google Scholar

8. Neufeld, KJ, Peters, DH, Rani, M, Bonu, S, Brooner, RK. Regular use of alcohol and tobacco in India and its association with age, gender, and poverty. Drug Alcohol Depend 2005;77:283–91. https://doi.org/10.1016/j.drugalcdep.2004.08.022.Search in Google Scholar PubMed

9. Rani, M, Bonu, S, Jha, P, Nguyen, SN, Jamjoum, L. Tobacco use in India: prevalence and predictors of smoking and chewing in a national cross-sectional household survey. Tobac Contr 2003;12:e4. https://doi.org/10.1136/tc.12.4.e4.Search in Google Scholar PubMed PubMed Central

10. Subramanian, SV, Nandy, S, Kelly, M, Gordon, D, Smith, GD. Patterns and distribution of tobacco consumption in India: cross sectional multilevel evidence from the 1998–9 national family health survey. BMJ 2004;328:801–6. https://doi.org/10.1136/bmj.328.7443.801.Search in Google Scholar PubMed PubMed Central

11. IARC – International Agency for Research on Cancer. Available from: http://monographs.iarc.fr/ [Accessed 11 Jul 2011].Search in Google Scholar

12. WHO. WHO report on the global tobacco epidemic. Available from: https://www.who.int/tobacco/mpower/2008/en/ [Accessed 11 Jul 2011].Search in Google Scholar

13. Demographic status of scheduled tribe population of India. Available from:http://tribal.gov.in/WriteReadData/CMS/Documents/201306110208002203443DemographicStatusofScheduledTribePopulationofIndia.pdf [Accessed 11 Jul 2011].Search in Google Scholar

14. Kc, D, Jose, M, Prabhu, V. Prevalence and type of tobacco habits and tobacco related oral lesions among Wayanad tribes, Kerala, India. Indian J Public Health Res Dev 2013;4:63. https://doi.org/10.5958/j.0976-5506.4.2.015.Search in Google Scholar

15. Critchley, JA. Health effects associated with smokeless tobacco: a systematic review. Thorax 2003;58:435–43. https://doi.org/10.1136/thorax.58.5.435.Search in Google Scholar PubMed PubMed Central

16. Coelho, KR. Challenges of the oral cancer burden in India. J. Cancer Epidemiol 2012;2012:1–17. https://doi.org/10.1155/2012/701932.Search in Google Scholar PubMed PubMed Central

17. Reddy, KS, Gupta, PC, editors. Report on tobacco control in India. Available from: https://www.who.int/fctc/reporting/Annex6_Report_on_Tobacco_Control_in_India_2004.pdf [Accessed 11 Jul 2020].Search in Google Scholar

18. Warnakulasuriya, S, Johnson, NW, van der Waal, I. Nomenclature and classification of potentially malignant disorders of the oral mucosa. J Oral Pathol Med 2007;36:575–80. https://doi.org/10.1111/j.1600-0714.2007.00582.x.Search in Google Scholar PubMed

19. Gupta, PC, Mehta, FS, Pindborg, JJ, Bhonsle, RB, Murti, PR, Daftary, DK, et al.. Primary prevention trial of oral cancer in India: a 10-year follow-up study. J Oral Pathol Med 1992;21:433–9. https://doi.org/10.1111/j.1600-0714.1992.tb00970.x.Search in Google Scholar PubMed

20. Khanna, S. The interaction between tobacco use and oral health among tribes in central India. Tob Induc Dis 2012;10:16. https://doi.org/10.1186/1617-9625-10-16.Search in Google Scholar PubMed PubMed Central

21. Kumar, S, Muniyandi, M. Tobacco use and oral leukoplakia: cross-sectional study among the Gond tribe in Madhya Pradesh. Asian Pac J Cancer Prev 2015;16:1515–8. https://doi.org/10.7314/apjcp.2015.16.4.1515.Search in Google Scholar PubMed

22. Palliyal, S. Assessment of oral lesions and its association with smoking habits in Paniya tribes of India. J Glob Oncol 2018;4(2 Suppl). https://doi.org/10.1200/jgo.18.38800.Search in Google Scholar

23. Carrard, VC, van der Waal, I. A clinical diagnosis of oral leukoplakia; a guide for dentists. Med Oral Patol Oral Cir Bucal 2018;23:e59–64. https://doi.org/10.4317/medoral.22292.Search in Google Scholar PubMed PubMed Central

24. Van der Waal, I, Schepman, KP, van der Meij, EH. A modified classification and staging system for oral leukoplakia. Oral Oncol 2000;36:264–66. https://doi.org/10.1016/s1368-8375(99)00092-5.Search in Google Scholar PubMed

25. Chattopadhyay, A, Ray, JG. Molecular pathology of malignant transformation of oral submucous fibrosis. J Environ Pathol Toxicol Oncol 2016;35:193–205. https://doi.org/10.1615/jenvironpatholtoxicoloncol.2016014024.Search in Google Scholar

26. Pindborg, JJ, Joyce, K, Gupta, PC, Chawla, TN. Studies in oral leukoplakias: prevalence of leukoplakia among 10,000 persons in Lucknow, India, with special reference to use of tobacco and betel nut. Bull World Health Organ 1967;37:109–16.Search in Google Scholar

27. Dhekale, DN, Gadekar, RD, Kolhe, CG. Prevalence of tobacco consumption among the adolescents of the tribal areas in Maharashtra. J Clin Diagn Res 2011;5:1060–3.Search in Google Scholar

28. Sinor, PN, Gupta, PC, Murti, PR, Bhonsle, RB, Daftary, DK, Mehta, FS, et al.. A case-control study of oral submucous fibrosis with special reference to the etiologic role of areca nut. J Oral Pathol Med 1990;19:94–8. https://doi.org/10.1111/j.1600-0714.1990.tb00804.x.Search in Google Scholar PubMed

29. Chattopadhyay, A, Ray, JG. Molecular pathology of malignant transformation of oral submucous fibrosis. J Environ Pathol Toxicol Oncol 2016;35:193–205. https://doi.org/10.1615/jenvironpatholtoxicoloncol.2016014024.Search in Google Scholar

30. Horowitz, AM, Goodman, HS, Yellowitz, JA, Nourjah, PA. The need for health promotion in oral cancer prevention and early detection. J Publ Health Dent 1996;56:319–30. https://doi.org/10.1111/j.1752-7325.1996.tb02459.x.Search in Google Scholar PubMed

31. Murray, RP, Connett, JE, Lauger, GG, Voelker, HT. Error in smoking measures: effects of intervention on relations of cotinine and carbon monoxide to self-reported smoking. The Lung Health Study Research Group. Am J Publ Health 1993;83:1251–7. https://doi.org/10.2105/ajph.83.9.1251.Search in Google Scholar PubMed PubMed Central

Received: 2020-06-14
Accepted: 2021-06-28
Published Online: 2021-08-02

© 2021 Walter de Gruyter GmbH, Berlin/Boston

Downloaded on 23.4.2024 from https://www.degruyter.com/document/doi/10.1515/jbcpp-2020-0347/html
Scroll to top button