• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.4
• /
• pp.1633-1637
• /
• 2012

Introduction: The incidence of oral premalignant and malignant lesions is on the rise due to an increased number of people taking in tobacco and alcohol related habits. Material and Methods: 1028 patients with tobacco, alcohol and areca nut habits attending our Department of Oral Medicine and Radiology formed the study sample. An interviewer based questionnaire was used to record the habit details. All the patients were then examined clinically for the presence of lesions. Chi square and Fisher exact tests were used to assess the statistical significance of the study parameters. Results: Males had a higher prevalence and comprised 87.9% of the sample. The commonest habit in this study sample was smoking (39.2%) followed by smokeless tobacco use (28.1%). Out of the 1028 patients with habits 40% had no clinically detectable changes in their mucosa. Of the mucosal changes leukoplakia (14%) was the commonest. Conclusions: This study provided information about the habit trends in the patients visiting this institution. The study may serve as a useful tool in educating the patients about the deleterious effects of oral tobacco, alcohol and betel exposure.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.6
• /
• pp.3455-3459
• /
• 2013

Background: Smoking and smokeless tobacco use are almost always initiated and established during adolescence. More than 80% of adult smokers begin smoking before 18 years of age. The main objective of the present study is to assess the feasibility of preventing adolescent tobacco use with the help of a specially designed tobacco control program. Materials and Methods: A cross sectional survey on tobacco use and related health effects was conducted using a structured questionnaire in 13 randomly selected schools in Kannur district of Kerala. These students were followed for a period of one academic year with multiple spaced interventions such as anti-tobacco awareness classes, formation of anti-tobacco task forces, inter-school competitions, supplying IEC (information, education and communication) materials and providing a handbook on tobacco control for school personnel. Final evaluation was at the end of one year. Results: There were 4,144 school children who participated in the first phase of the study. The prevalence of tobacco smoking and chewing habits were 9.85% and 2.24% respectively. Ninety-one percent had parental advice against tobacco use and only 3.79% expressed desire for future tobacco use. The final evaluation witnessed a sharp decline in the current tobacco use as 4.68%. We observed a statistically significant difference towards the future use of tobacco (p<0.001) and awareness about the ill effects of passive smoking (p<0.001) among boys and girls. Further a significantly increased knowledge was observed among boys compared to girls about tobacco and oral cancer (p=0.046). Conclusions: The comprehensive school based tobacco control project significantly reduced the tobacco use pattern in the target population. School tobacco projects incorporating frequent follow ups and multiple interventions appear more effective than projects with single intervention.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.18
• /
• pp.8365-8370
• /
• 2016

Background: Shammah is a traditional form of snuff dipping tobacco (a smokeless tobacco form) that is commonly used in Yemen. Oral mucosal changes due to the use of shammah can usually be observed in the mucosal surfaces that the product touches. The aim of this study was to determine the association between shammah use and oral leukoplakia-like lesions. Other associated factors were also determined. Materials and Methods: A cross sectional study was conducted on 346 randomly selected adult males. Multi-stage random sampling was used to select the study location. After completing the structured questionnaire interviews, all the participants underwent clinical exanimation for screening of oral leukoplakia-like lesions Clinical features of oral leukoplakia-like lesion were characterized based on the grades of $Ax{\acute{e}}ll$ et al (1976). Univariable logistic regression and multivariable logistic regression were used to assess the potential associated factors. Results: Out of 346 male participants aged 18 years and older, 68 (19.7%) reported being current shammah users. The multivariable analysis revealed that age, non-formal or primary level of education, former shammah user, current shammah user, and frequency of shammah use per day were statistically associated with the presence of oral leukoplakia-like lesions [Adjusted odds ratio (AOR) = 1.03; 95% confidence interval (CI) : 1.01, 1.06; P=0.006], (AOR=8.65; 95% CI: 2.81, 26.57; P=0.001), (AOR=3.65; 95% CI: 1.40, 9.50; P=0.008), (AOR=12.99; 95% CI: 6.34, 26.59; P=0.001), and (AOR=1.17; 95% CI: 1.02, 1.36; P=0.026), respectively. Conclusions: The results revealed oral leukoplakia-like lesions to be significantly associated with shammah use. Therefore, it is important to develop comprehensive shammah prevention programs in Yemen.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.3
• /
• pp.1269-1276
• /
• 2016

Background: Tobacco consumption continues to be the leading cause of preventable deaths globally. The objective of this study was to examine the associaton of selected socio-demographic variables with current tobacco use in five countries that participated in the Phase II Global Adult Tobacco Survey in 2011 - 2012. Materials and Methods: We analysed internationally comparable representative household survey data from 33,482 respondents aged ${\geq}15years$ in Indonesia, Malaysia, Romania, Argentina and Nigeria for determinants of tobacco use within each country. Socio-demographic variables analysed included gender, age, residency, education, wealth index and awareness of smoking health consequences. Current tobacco use was defined as smoking or use of smokeless tobacco daily or occasionally. Results: The overall prevalence of tobacco use varied from 5.5% in Nigeria to 35.7% in Indonesia and was significantly higher among males than females in all five countries. Odds ratios for current tobacco use were significantly higher among males for all countries [with the greatest odds among Indonesian men (OR=67.4, 95% CI: 51.2-88.7)] and among urban dwellers in Romania. The odds of current tobacco use decreased as age increased for all countries except Nigeria where. The reverse was true for Argentina and Nigeria. Significant trends for decreasing tobacco use with increasing educational levels and wealth index were seen in Indonesia, Malaysia and Romania. Significant negative associations between current tobacco use and awareness of adverse health consequences of smoking were found in all countries except Argentina. Conclusions: Males and the socially and economically disadvantaged populations are at the greatest risk of tobacco use. Tobacco control interventions maybe tailored to this segment of population and incorporate educational interventions to increase knowledge of adverse health consequences of smoking.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.15
• /
• pp.6299-6302
• /
• 2015

Background: The rise in consumption of tobacco products among youth is a public health concern in India. Several studies have shown that advertisements promoting tobacco products influence decisions and behaviour of youth towards smoking. Objective: To ascertain which method of Tobacco Advertising, Promotion and Sponsorship (TAPS) was more influential for initiating tobacco use in youth in India. Materials and Methods: The secondary data of youth (15-24 years) from nationally representative Global Adult Tobacco Survey (GATS) conducted in 2009-2010 was analyzed. Odds ratio and p-value were used to know the association between TAPS and initiation of use of tobacco products among youth. Logistic regression was used to determine the most significant means of TAPS altering the youth's behaviour towards tobacco products. Results: Out of 13,383 youths, 1,982 (14.7%) used smokeless forms of tobacco and 860 (6.38%) used smoke forms. Logistic regression reveals that promotional activities mainly through cinemas (p<0.05) and providing free samples of tobacco products (p < = .001) were most influential means of initiating consumption of tobacco products among youth. Conclusions: The smoking in youth is associated with watching advertisements particularly in cinema and promotional activities like distribution of free samples, coupons and sales on the price of tobacco products. Stronger legislative measures should be enforced to curb promotional advertisements in cinemas and distribution of free samples.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.8
• /
• pp.4173-4176
• /
• 2012

Background: Adolescent tobacco use is a major public health problem. However, there is little information about the impact of tobacco advertising and availability near schools on adolescent tobacco use in India. Methods: The various tobacco products and brands available in outlets within 100 meters of two high schools in an Indian town were identified. A stratified random sample of 172 participants from these two schools completed a questionnaire on tobacco use and socioeconomic status. Results: Eighteen outlets selling tobacco products were identified. In the two schools the current use of smoked and smokeless tobacco was 9.1% and 17.4% respectively. School location and low socio-economic status of adolescents were associated with tobacco awareness of advertisements (p=0.001) and the receipt of a free sample (p= 0.032). Advertisements on billboards, posters and the receipt of a free tobacco sample were significant factors (p=0.031, p=0.016, p=0.017 respectively) in current tobacco use. Conclusion: In this study a significant proportion of adolescents used tobacco. Tobacco-promotion activities (advertising, the receipt of a free sample), school location and economic status were found to be associated with adolescent tobacco initiation. The local environment should be included in the prevention of adolescent tobacco initiation.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.2
• /
• pp.539-543
• /
• 2012

Background: The results of the Global School Personnel Survey (GSPS) conducted in India in 2009 are compared with 2006 GSPS to assess any change in 2009 on tobacco use and knowledge and attitudes to tobacco use, training and availability of tobacco control teaching material in schools and the existence of school tobacco control policies. Methods: GSPS is a cross sectional survey conducted twice (2006 and 2009) in entire India. A total of 180 schools were surveyed each time. Results: Of the participating school personnel, 2660 in 2006 and 2575 in 2009, about 95% were teachers and the balance administrators. In 2009, compared to 2006 the prevalence of current smoking of cigarettes (19.6% in 2006 and 10.3% in 2009) and bidis (21.5% in 2006 and 13.9% in 2009) was found to be significantly lower; the percentage of teachers receiving training on preventing youth tobacco use has significantly reduced (16.7% in 2006 and 10.1% in 2009); access of teachers to educational materials on tobacco use and how to prevent its use among youth had not increased (34.6% in 2006 and 37.8% in 2009); there was no change in policy prohibiting tobacco use among students and school personnel; however, ever use of any tobacco on school premises was significantly lower (15.6% in 2006 and 9.6% in 2009). Conclusions: The prevalence of current smoking (cigarettes/bidis) among school personnel and use of any tobacco on school premises were significantly decreased in 2009 as compared to 2006. Necessary action should be planned to increase the number of teachers trained and the availability of teaching materials on preventing youth tobacco use in order to have effective prevention of tobacco use among students.

• Safety and Health at Work
• /
• v.12 no.2
• /
• pp.282-283
• /
• 2021

• Safety and Health at Work
• /
• v.12 no.2
• /
• pp.284-285
• /
• 2021

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.18
• /
• pp.7891-7895
• /
• 2014

Background: Tobacco products continue to be used in large quantities in India despite the mandatory inclusion of pictorial health warnings (PHWs) on all tobacco packaging. The circumstances as to how people could continue the use of tobacco to the point of developing head and neck cancer despite enhanced awareness about the ill effects of tobacco is the main focus of this study. Materials and Methods: This study concerned patients with least 5-years history of tobacco use, having been diagnosed with histopathologically proven malignancies of the hypopharynx, larynx, oropharynx and oral cavity presenting at the Government Medical College-Haldwani, Nainital, India. A total of 183 patients were eligible for inclusion during July 1 2013 - June 30 2014. Of these, 59 patients used smoked tobacco exclusively, 22 patients used smokeless tobacco exclusively, and 102 patients used both forms of tobacco. Among users of smoked forms, 75.2% (n=121) were beedi users, and 24.8% (n=40) were cigarette users. Patients were asked direct questions as to whether they had noticed the presence of PHWs upon tobacco products. The reasons as to why PHWs were not effective in stopping the patients from tobacco use were investigated. Results: Of the 183 patients, 146 reported being aware about the presence of PHWs, and when they were asked reasons as to why they continued tobacco despite being aware of ill-effects, the commonest reason chosen (by 53.4%) was that patients had not regarded themselves as using tobacco heavy enough to cause cancer. Among the 36 patients who reported as being oblivious to the presence of PHWs on tobacco products, 63.9% reported that the products they used never displayed any PHWs, and 36.1% reported never having paid attention to the packaging. The awareness about PHWs was higher among cigarette smokers in comparison to beedi smokers (100% vs 76.1%, p=0.0002). Conclusions: Locally produced and marketed tobacco products such as beedis and oral tobacco often fail to display PHWs. The presence of PHWs without doubt enhances awareness about the carcinogenic risks of tobacco. However, enhanced awareness alone may not be enough, and as elucidated by this study, some persons continue to use tobacco to the point of developing malignancies. The need of the hour is the implementation of legal and economic sanctions discouraging the use of tobacco products.