Palatal changes associated with reverse smoking in Filipino women

Abstract

OBJECTIVE: To determine baseline data for the presence or absence of reverse‐smoking and conventional smoking associated oral palatal mucosal changes in women. DESIGN: A cross‐sectional evaluation of the clinical and cytological changes associated with the condition. SETTING: Nine rural barangays in Cabanatuan City, Philippines. SUBJECTS AND METHODS Ninety‐one volunteer women smokers (61 reverse and 30 conventional) were examined clinically and photographically. Smears were also taken from three areas of the palate to investigate the cytology of palatal mucosal epithelium. MAIN OUTCOME MEASURES: Variations in colour, texture and topography of the palatal mucosa; determination of epithelial cell characteristics and inflammatory cell populations present in the lesions. RESULTS: Clinical findings showed that subjects could be grouped into three categories: Group A subjects showed pigmentation and some erythema only; Group B subjects included those with ulceration, marked erythema and non‐descript mucosal roughening; Group C subjects (comprising the majority of reverse smokers) exhibited various combinations of leukoplakia, fissuring, thickening and pigmentation of the palatal mucosa. Additional features, including nodularity, erythema, prominence and reddening of minor salivary gland duct openings were also occasionally observed in this group. Cytologic analysis revealed that, within each smoking group, there was a significant site‐dependent difference in the predominant epithelial cell type present. CONCLUSIONS: This study reports the first systematic description of reverse smoking associated palatal mucosal changes in Filipino women. It also provides a basis for a classification of the palatal mucosal changes among reverse smokers.

Assessment of Lung Cytological Atypia among Shisha Smokers

“…Smoking was associated with a 35-to 50 percent increase in the risk of respiratory tract infections and inflammation [16]. These findings are in agreement with other studies suggesting that use of tobacco disturbs the normal maturation of the epithelial cells [17,18].…”

Potentially Malignant Oral Disorders and Cancer Transformation

“…Reverse smoking is seen in patients of low socioeconomic class and is more common in females (39). The palate and tongue are commonly affected areas in reverse smokers (40). Lesions associated with this habit range from palatal keratosis, excrescences, leukoplakia, and ulcerations to frank malignancy (40).…”

“…The palate and tongue are commonly affected areas in reverse smokers (40). Lesions associated with this habit range from palatal keratosis, excrescences, leukoplakia, and ulcerations to frank malignancy (40). Epithelial dysplasia and oral SCC occur in 83% and 13%, respectively, of reverse smokers (41).…”

Palatal changes of reverse smokers in a rural coastal Andhra population with review of literature

“…Reverse smoking was also reported in various other populations like rural barangays in Cabanatuan City, Philippines and also from few communities in South America, The Caribbean, The Netherlands, Columbia, Sardinia etc. [ 1 3 4 5 6 ] In India, this habit of reverse smoking is predominantly seen in regions of Andhra Pradesh like Srikakulam District, East Godavari District and in states of Orissa and Goa. [ 2 7 8 9 ] The female predominance has been consistently reported among all the above communities except in Sardinia.…”