Smokeless Tobacco Use and Its Association with Head and Neck Tumors and its relationship with Ethnicity; A Hospital Based Study

Abstract

Objective: To identify smokeless tobacco as a risk factor in the development of head and neck cancers and to assess the role of ethnicity in the use of smokeless tobacco in developing head and neck cancers.
 Study Design: Case-control study.
 Place and Duration of Study: Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi Pakistan, from Dec 2018 to Jun 2019.
 Methodology: Three hundred patients, aged 18-85 years of either gender were included in the study. Cases were the patients visiting Oncology OPD with biopsy-proven head and neck cancers (HNCs). Controls were patients presenting at the same hospital for a routine checkup. We interviewed participants by using a pre-designed proforma.
 Results: The mean age of the cases and controls were reported as 49.26±13.51 years and 40.12±14.89 years, respectively. Majority of the participants were consuming pan (37.0%), gutka (22.6%), tobacco (21.3%), betel nut (19.6%), naswar (12.0%) and mainpuri (9.0%). The participants who consumed tobacco (OR:2.95), gutka (OR:2.39), mainpuri (OR:4.89), pan (OR:2.06) and betel nut (OR:2.28) were times more likely to develop HNCs than those who did not consume tobacco, gutka, mainpuri, pan and betel nut (p<0.05). Among Urdu speaking, the participants who consumed tobacco (OR: 2.49), pan (OR:10.35), and betel nut (OR:3.34), had times more likely to develop HNCs than those who did not consume tobacco, pan and betel nut.
 Conclusion: Mainpuri, naswar, betel quid, and betel nut significantly affect the oral health of people and are potential risk factors for the development of risk factors.

Prevalence of betel or areca nut (AN) use and its associated factors among Bhutanese population aged 15-69 years old : an analysis of national health data of non-communicable disease (NCD) survey in 2019

“…In a case-control studies done in multiple countries where betel quid is a common habit, there were strong evidence of a higher risk of oral cancer in BQ chewers compared to non-chewers (Warnakulasuriya & Chen, 2022). A similar case-control study engaging 150 case and 150 control subjects at a military hospital in Pakistan showed that those who consumed betel were 2.28 times more likely to develop head and neck cancer as compared to people who did not consume betel and other products including tobacco ( (Nouman et al, 2022). A recent study confirmed high incidence of OSF in areas where habitual use of AN is prevalent (Senevirathna et al, 2023).…”