A cross-sectional study conducted by the National Institute of Cancer Prevention and Research (NICPR) and AIIMS on 2,000 Delhi residents, who were previously screened for oral malignant disorders, established a direct relationship between tobacco use and oral lesions — confirming that oral screening of high-risk individuals along with tobacco cessation is essential.
Recently published in Translational Research in Oral Oncology, the study was conducted in 2016-2017 to assess the status of tobacco-related oral lesions over 16 years. The previous study was carried out between 2002 and 2005 among 2,000 individuals from the peri-urban population of the capital living within a 15-km radius of AIIMS. Taking it as a baseline study, researchers conducted a follow-up every six months to understand the effect of counselling.
Of the 2,000 residents, researchers were able to trace 265 individuals after 16 years and found that 34% of them had either decreased the use or had quit tobacco. Among these, 37% were smokers; 48.3% used smokeless tobacco (SLT); 9.1% used areca-nut products (with or without tobacco); 11% used both forms of tobacco; and 22.6% also reported alcohol consumption. Of the total participants, 69.4% had one or more tobacco-related oral lesions.
“We found out that the effect of counselling lasted more than 15 years. They were only asked to take multi-vitamin tablets,” said Dr Ravi Mehrotra, the leading author of the study and NICPR director.
“A significant change was observed between present and past tobacco consumption (cigarette, gutkha, supari) and alcohol habit, including in those who smoked and consumed SLTs,” he said.
Experts suggested that tobacco cessation be incorporated in preventive health programmes.
“This could help in early detection of oral potentially malignant disorders and prevent the same,” added Dr Mehrotra.
According to experts, the attrition rate of 86.8% was mainly due to participants belonging to the lowest socio-economic strata. Many were unavailable during home visits due to various reasons such as migration to a different location within or outside the city, working hours, locked residence, demolishment of the former residence or death.