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Nonsmoked Tobacco Addiction Playing a Major Role in Oral Mucosal Changes in Northern Indian Population Over Smoked and Alcohol Use

Background: Oral cavity is prone for myriad of changes with advancing age as well result of environmental and life style related factors like consumption of tobacco (smoke or smokeless) and alcohol. Aim: The aim of this study was to quantify and compare the association of oral mucosal changes (OMC) with nonsmoked tobacco over smoked tobacco and alcohol. Methods: Data of 11,145 subjects from 106 health screening camps, organized in Uttar Pradesh and Rajasthan between April 2015 to June 2017 was analyzed to unveil and determine the mode of addiction and prevalence of OMC. Bivariate and multivariable models were tested for comparison and identification of factors associated with an increasing risk of developing OMC. Results: The primary symptoms were mouth ulcer in 5.6% and trismus (1.0%). The overall proportions of tobacco chewing, smoking and alcohol addiction were 12.5%, 10.7% and 2.5% respectively. The highest prevalence of smoking noted in the age-group 55-64 years (14.4%), for tobacco chewing and alcohol consumption in the age-group 25-34 years was 15.6% and 4.2% respectively ( P < 0.001). The prevalence of mouth ulcers were 20.7% among smokers and 27.8% among tobacco chewers ( P < 0.001) while the percentage of trismus 26.1% among smokers and 53.0% among tobacco chewers ( P < 0.001). Conclusion: Results of this study can be used for creating awareness among the population regarding the hazards of tobacco use. More number of studies needs to be conducted all over India to understand the prevalence and the biologic behavior of these oral premalignant lesions and its progression to invasive diseases.