BACKGROUND: The consumption of smokeless tobacco (SLT) is highly prevalent in various regions of India, especially in rural areas posing significant health risks. The oral potentially malignant disorders (OPMD) are also on the rise. This study investigated the various social and behavioral determinants of SLT use among adults and its association with the prevalence of OPMD in a district of Karnataka state, India.
METHODS: An oral cancer screening program was conducted in rural areas across Dakshina Kannada district of Karnataka state, India. After obtaining ethical clearance, adult patients who were SLT users and consented to participate were included in the study. A pre-tested questionnaire was used to collect data on SLT use, age of initiation, frequency and duration of use, oral and systemic health condition, etc. Clinical examinations were done to identify the presence of OPMD. Data was analysed using the Chi-squared test.
RESULTS: Among the 8181 participants screened, 683 participants gave a history of SLT use. About 69.4% of SLT users were males, predominantly (22%) in the age group of 51-60 years and 68.3% belonged to the lower socio-economic group. About 48.7% had initiated the habit at the age interval of 18-30 years. A vast majority (61.3%) consumed the SLT at a frequency of 3-5 times per day, and 33.8% consumed the SLT for more than 15 years. Among the various types of SLTs consumed, the consumption of betel leaf with areca nut, lime, and tobacco was most commonly noted (52.1%). About 75 % of them kept the SLT for duration of 5-10 mins in the mouth. About 272 (39.8%) individuals were found to have OPMD, of which Oral submucous fibrosis was the most prevalent followed by leukoplakia.
CONCLUSIONS: The rising consumption of SLT and the increase in OPMD among Indian adults are concerning, highlighting the need for strong tobacco control policies.