• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10991-10992
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• 2015

Tobacco is a well known cause of death worldwide. With existing comprehensive laws and various other measures for tobacco control, the mortality and morbidity due to tobacco usage have unfortunately not been reduced. A large number of tobacco users have altered their pattern of tobacco use after the gutka ban. Traditional gutka is sold in the open market in a pre-mixed format. Manufacturers are supplying pan masala and tobacco in separate pouches as there is no restriction for sale of pan masala and tobacco individually in many states. Although most of the population is aware of the health hazards of tobacco, it is necessary to develop an effective structured strategy. Tobacco control programs need to be strengthened by separate tobacco control measures at various levels.

• Journal of Periodontal and Implant Science
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• v.44 no.3
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• pp.126-133
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• 2014

Purpose: Smokeless tobacco-based oral-use products like gutka are popular in India. Gutka usage leads to increased periodontal destruction and inflammation; however, the relevant mechanism remains unknown. This study aimed to elucidate the role of gutka in periodontitis by examining its effect on the levels of interleukin (IL) $1{\beta}$ and IL-8 from the gingival crevicular fluid (GCF). Methods: A total of 45 patients were enrolled in this study. Thirty patients with periodontitis (15 gutka chewers [GCP] and 15 nongutka chewers [NGC]) and 15 periodontally healthy controls (HC) were selected. The full-mouth plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), and recession (RC) were recorded. The IL-$1{\beta}$ and IL-8 levels in the GCF of all subjects were assessed through an enzyme-linked immunosorbent assay (Quantikine). Results: The IL-$1{\beta}$ and IL-8 levels were not significantly higher in the GCP group (IL-$1{\beta}$, $369.01{\pm}273.44{\mu}L$; IL-8, $205.97{\pm}196.78{\mu}L$) as compared to those in the NGC group (IL-$1{\beta}$, $195.57{\pm}96.85{\mu}L$; IL-8, $178.61{\pm}149.35{\mu}L$). More gingival RC and loss of attachment was seen among the GCP group (RC: $2.02{\pm}0.31$, P=0.013; CAL: $4.60{\pm}0.56$, P<0.001) than among the NGC group (RC, $1.21{\pm}1.15$; CAL, $3.70{\pm}0.32$); however, PD was deeper among the NGC subjects (P=0.002). PI and GI were significantly higher for the periodontitis group (P<0.001) when compared to the HC, but there was no difference among gutka chewers and non-chewers (P=0.22 and P=0.89). A positive correlation was found between the IL-8 levels and the duration of gutka chewing (r=-0.64, P<0.01). Conclusions: Gutka chewing leads to increased gingival RC and clinical loss of attachment. There was no effect seen in the proinflammatory cytokine levels in the GCF of gutka users.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.11
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• pp.4813-4818
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• 2016

Objective: The objective of the study was to determine the Knowledge, Attitude and Practice of chewing gutka,areca nut, snuff and tobacco smoking among the young population in the Northern India Population between the age of 15 to 22 years. Methods: The study was approved by the ethical committee. A total of 10 school and colleges located in the rural and urban areas was selected. A total of 1500 young individuals aged between 15 to 22 years were selected. A self-administered questionnaire was designed comprised of 14 closed ended questions about Knowledge, Attitude and Practice towards consumption of areca nut, gutka and tobacco smoking that were filled by the participants. Descriptive statistics were obtained and mean, standard deviation, frequency and percentages were calculated. Data was analyzed by using SPSS. Result: A total of 1050 out of 1500 students responded to the questionnaire. A total of 227 subjects agreed that they are consuming the tobacco. Out of this, 196 (86.34%) were boys and 31 (13.65%) were girls who agreed in consumption of tobacco product. Out of 196, 150 boys (76.5%) practices the habit of smoking 1 -5 times a day and 46 (23.4% ) practice the habit of chewing areca nut and gutkha 1 - 5 times a day. Out of 31 girls, 25 girls (80.6%) practices the habit of smoking 1 -5 times a day and 6 (19.4%) practice the habit of chewing areca nut and gutkha 1 - 5 times a day. Out of 740 subjects, 530 were boys and 210 girls have full knowledge of deleterious long term effects of tobacco consumption. Conclusion:The present study concluded that young population of North India lack Knowledge, Attitude and Practice regarding consumption of areca nut, gutka and tobacco smoking. Here is an urgent need to take effective steps, especially on launching community awareness programs for the school children and public to educate them about the consequences of tobacco use, and on assessing their effectiveness in curbing the problem.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7547-7554
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• 2015

Background: The use of smokeless tobacco (SLT) among women is increasing in India, especially among those with limited education and resources. Preventing the initiation of SLT among women is critical since it has known negative consequences for oral and reproductive health. Most research on tobacco initiation in India focuses on adolescents. This paper addresses the unrecognized issues of post marital initiation among women of reproductive age, highlighting the importance of reproductive stages in women's tobacco initiation. The objective is to examine the correlates of SLT initiation among low income women in Mumbai from pre-marriage through early marriage, first pregnancy and beyond, using case examples to illustrate initiation during each of these stages. Materials and Methods: In 2011-2012, cross-sectional community level survey data were collected from a representative sample of 409 daily SLT-using married women aged 18-40 years in a low income community in Mumbai. Information on socio-demographics, initiation by reproductive stage, types of tobacco use, childhood exposure to tobacco, learning to use, and initiation influences and reasons were collected through a researcher-administered survey. Univariate and bivariate analysis assessed factors influencing initiation of SLT use by reproductive stage. In addition 42 narratives of tobacco use were collected from a purposive sample of pregnant and non-pregnant married women addressing the same questions in detail. Narratives were transcribed, translated, and coded for key concepts including initiation of tobacco use. Results: Thirty-two percent of women initiated SLT use before marriage, 44% initiated after marriage but before pregnancy, 18.1% initiated during their first pregnancy and the remainder started after their first pregnancy. Mean age of marriage among women in this study was 16 years. Younger women (i.e. age at time of the interview of less than 30 years) were 0.47 [95% CI (0.32, 0.87)] percent less likely to initiate after marriage than women aged more than 30 years. Women who got married before 18 years of age were 2.34 [95% CI (1.40, 3.93)] times more likely to initiate after marriage than their counterparts. Childhood exposure was a predictor for initiating SLT use prior to marriage but not after. Women reporting tooth and gum pain were 1.85 times more likely to initiate after marriage than their counterparts. Husband and neighbours were the most significant influences on post-marital initiation. Narratives highlighted differences in processes of initiation pre and post marriage and during pregnancy. Conclusions: Most tobacco prevention interventions are directed to adolescents in school. This study suggests that especially for low literate or illiterate women, school based interventions are ineffective. To be effective strategies to prevent SLT initiation must reach women in urban areas at or immediately after marriage and during their first pregnancy. Messages must negate culturally rooted beliefs about the health benefits of SLT in order to prevent initiation and onset of daily use.