• Asian Pacific Journal of Cancer Prevention
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• v.17 no.11
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• pp.5005-5009
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• 2016

Introduction: Gutkha contains harmful and carcinogenic chemicals and oral cancer caused by tobacco usage has been reported as a major preventable cause of death worldwide by the World Health Organization. The Telangana state government implemented a ban on gutkha usage starting in 2013 but how effective this ban has been remains unclear. Objectives: The objective of this study was to determine the actual impact of the gutkha ban on users and vendors. Methodology: A cross-sectional study was conducted among gutkha users and tobacco vendors in Ranga Reddy district, Telangana. Based on a pilot study the sample size was determined as 368 and 384 for users and vendors respectively. Two separate questionnaires were administered to these groups. The parameters studied mainly included knowledge regarding the ban, and its impact. Results: About 49.1% of the users were aware of the ban on gutkha. Newspapers were the main source of information regarding the ban as reported by 45.3% of users. After the ban, 29.8% of gutkha users switched to other tobacco products. Awareness of health hazards and non-availability of gutkha was the most important reason stated for quitting or reducing consumption. Conclusion: The perspective of ban when visualized from the users point of view depicted a negative impact while the vendors portrayed a positive impact. Considering the addictive potential of the ingredients of gutkha, recording the effects of the ban on regular consumers and determining whether they can still obtain the products by illicit trade, would be noteworthy for implementation of strict rules.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6439-6444
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• 2015

Background: In India smokeless tobacco users account for 25.9% of total tobacco use, Gutkha being the most common form. This study evaluated the association between serum lipid profile and Gutkha use as an early diagnostic and/or prognostic indicator for oral submucous fibrosis (OSMF) and oral cancer (Oral Ca) in non-smokers and non-alcohol consumers. Materials and Methods: A total of 163 participants were recruited from two sites in India. Participants were divided into four groups: individuals without any Gutkha chewing habit and without any oral lesions (control group), individuals with Gutkha chewing habit but without any oral lesions (GWL), patients with a confirmed clinical diagnosis of OSMF, and patients with a confirmed diagnosis of Oral Ca. Mixed linear modelling (MLM) was conducted to detect the change in mean serum lipid levels among four groups. Results: The sample consisted of 69% males and 31% females. Results of MLM show an inverse relationship between serum lipid levels in OSMF, and Oral Ca groups when compared to the control group. Conclusions: The results of our study demonstrated that GWL, OSMF and Oral Ca patients had lower serum lipid levels. Low serum lipid levels could be an indicator of initial neoplastic changes in oral cancer.

• 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.14 no.12
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• pp.7075-7080
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• 2013

Background: Oral submucosal fibrosis (OSMF) is one of the most prevalent premalignant conditions in India which is easy to diagnose but difficult to manage. At present it is considered as irreversible and incurable. It has also been referred to as an epidemic in India. Aims and Objectives: To correlate the frequency and duration of habits with clinical staging, functional staging and histopathological grading and to correlate the clinical and functional staging with histopathological grading. Materials and Methods: The study included a total of 90 subjects, 80 with OSMF in the experimental group and 10 patients in the control group. Patient personal history was recorded with chewing habits, including frequency and duration of chewing. The site of keeping the quid, time duration and whether he/she swallows it or spits it were also noted. Clinical staging was done on the presence of palpable fibrous bands. Functional staging was accomplished by measuring mouth opening. Incisional biopsy was done for all the patients for histopathological examination. Histopathological grading was according to Pindborg and Sirsat. Results: The experimental group comprised 71 males and 9 females, the majority of which were in the age group of 21-30 years. Correlation of habits with clinical staging, functional staging and histopathological grading were significant (p<0.05). Clinical and functional staging did not correlate with histopathological grading, but the correlation of clinical and functional staging was highly significant (p<0.01). Conclusions: The widespread habit of chewing gutkha is a major risk factor for OSMF, especially in the younger age group. In this study, it was found that with increase in the duration and frequency of the habit the severity of the disease increased.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.5
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• pp.2315-2317
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• 2012

Background: Use of smoke-less tobacco (SLT) is very common in South and South-East Asian countries. It is significantly associated with various types of cancers. The objectives of this study were to assess the proportion of hospital staff that use SLT, and to identify the factors associated with its use and their practices. Methods: In a cross-sectional study, 560 staff of two tertiary care hospitals were interviewed in the year 2009. Nurses, ward boys and technicians were counted as a paramedic staff while drivers, peons, security guards and housekeeping staff were labeled as non-paramedic staff. SLT use was considered as usage of any of the following: betel quid (paan) with or without tobacco, betel nuts with or without tobacco (gutkha) and snuff (naswar). Results: About half (48.6%) of the hospital staff were using at least one type of SLT. Factors found to be statistically significant with SLT were being a male (OR=2.5; 95% CI=1.8-3.7); having no/fewer years of education (OR=1.7; 95% CI=1.2-2.4) and working as non-paramedic staff (OR=2.6; 95% CI=1.8-3.8). Majority of SLT users were using it on regular basis, for > 5 years and keeping the tobacco products in the oral cavity for >30 minutes. About half of the users started due to peer pressure and had tried to quit this habit but failed. Conclusion: In this study, about half of the study participants were using SLT in different forms. We suggest educational and behavioral interventions for control of SLT usage.