Search Results (47)

Areca nut/betel quid (AN/BQ), a stimulant consumed across the Asia and Pacific region, has been associated with metabolic risks including obesity. This study investigated the association between AN/BQ use and obesity in Guam. Participants included 120 men and women 18+ years old. Recruitment and interviews were conducted at a central dental clinic in Guam between July 2013 and October 2014. Multivariate general linear models were utilized to estimate the association of AN/BQ chewing with body mass index (BMI). Of the participants with a mean BMI of 30.4 (SD 6.9) kg/m², 82.5% reported ever chewing AN/BQ. The mean adjusted BMI among AN/BQ chewers was 4.53 kg/m² (95% CI 1.19, 7.87) higher than among non-chewers in the minimally adjusted model; 4.72 kg/m² (95% CI 1.09, 8.35) higher with additional adjustment for annual household income, tobacco smoking, and alcohol use (n = 108); and non-significantly higher by 0.55 kg/m² (95% CI −3.92, 5.02) after additional adjustment for ethnicity. Although AN/BQ chewing was not associated with BMI after considering ethnicity, our results do not exclude the possibility that AN/BQ chewing can be considered a risk factor for obesity. Full article

Background/Objectives: Lip and oral cavity cancer (LOC) remains a critical public health challenge in Asia. This study evaluated spatiotemporal trends and risk factor contributions to LOC-related disability-adjusted life years (DALYs) from 1990 to 2021 to inform evidence-based healthcare policies. Methods: Using Global Burden of Disease (GBD) 2021 data, we analyzed LOC DALYs stratified by age, gender, risk factors (smoking, alcohol use, tobacco chewing), and subregions in Asia. Temporal trends were quantified via estimated annual percentage change (EAPC) across five geographic regions and sociodemographic index (SDI) categories. Age–period–cohort (APC) modeling was used to assess age-specific risk distributions. Results: From 1990 to 2021, Asia’s age-standardized DALY rate (ASDR) for LOC marginally increased (EAPC: 0.0883, 95% CI: 0.0802–0.0963). The alcohol-related ASDR increased sharply (EAPC: 1.033, 95% CI: 1.00–1.06), whereas decreases were detected in the smoking- and tobacco chewing-attributable ASDRs. Pronounced upward trends were observed in South Asia and low/low-middle-SDI regions. Tobacco chewing was the primary risk factor for women and for the populations in South Asia and lower-SDI regions, whereas smoking dominated among men and those in other geographic regions and in higher-SDI areas. APC analysis revealed age-driven increases in ASDR, with alcohol use and tobacco chewing risk increased with age. Notably, the steepest ASDR increase occurred in individuals aged 20–25 years. Conclusions: The LOC burden in Asia reflects divergent risk factor dynamics. Policy strategies must prioritize geographic and demographic targeting: alcohol control in rapidly developing areas and intensified tobacco cessation programs in endemic zones. Early prevention efforts focusing on adolescents and tailored to subregional risk profiles are essential to mitigate future disease burden. Full article

Oral squamous cell carcinoma (OSCC) is one the most prevalent head and neck cancers and represents a major cause of morbidity and mortality worldwide. The main established risk factors for OSCC include tobacco and alcohol consumption and betel quid chewing, which may contribute alone or in combination with other environmental factors to carcinogenesis. The oral microbiota is emerging as a key player in the establishment of the molecular and cellular mechanisms that may trigger or promote carcinogenesis, including in the oral cavity. Among the bacterial species found in the oral microbiota, Fusobacterium nucleatum, an anaerobic bacterium commonly found in oral biofilms and a periodontal pathogen, has gained attention due to solid evidence implicating F. nucleatum in colorectal cancer (CRC). F. nucleatum has been shown to induce chronic inflammation, promote cell proliferation and trigger cellular invasion while deploying immune evasion mechanisms. These experimental findings were first obtained in in vitro and in vivo models of CRC and are being confirmed in studies on OSCC. In this review, we summarize the most recent findings on the role of F. nucleatum in OSCC, discuss the clinical implications in terms of prognosis and provide an overview of the key mechanisms involved. Moreover, we identify research questions and aspects that require investigations to clarify the role of F. nucleatum in OSCC. We anticipate that studies in this emerging field may have a significant clinical impact on the diagnosis, prognosis and management of OSCC. Full article

Background: Esophageal cancer is a major public health issue, yet risk factors for its occurrence are still insufficiently known. This study aimed to estimate the global burden of esophageal cancer and its risk factors. Methods: This ecological study presented the incidence, mortality, and Disability-Adjusted Life Years (DALYs) of esophageal cancer in the world. This study collected the Global Burden of Disease study data from 1990 to 2019. Trends in esophageal cancer burden were assessed using the joinpoint regression analysis and calculating the average annual percent change (AAPC). Results: Globally, in 2019, in both sexes and all ages, the ASR for the incidence of esophageal cancer was 6.5 per 100,000 and for mortality, 6.1 per 100,000. The global proportion of DALYs for esophageal cancer attributable to selected behavioral, metabolic, and dietary risk factors was similar in males and females: chewing tobacco (3.8% vs. 5.1%), diet low in fruits (10.1% vs. 12.6%), diet low in vegetables (3.3% vs. 4.6%), and high body mass index (18.8% vs. 19.3%). However, the proportion of DALYs for esophageal cancer attributable to smoking and alcohol use was 4–5 times higher in males than in females (50.1% vs. 11.3%, and 29.6% vs. 5.1%, respectively). From 1990 to 2019, a significant decrease in global trends in rates of DALYs for esophageal cancer attributable to smoking (AAPC = −1.6%), chewing tobacco (AAPC = −0.5%), alcohol use (AAPC = −1.0%), a diet low in fruits (AAPC = −3.1%), and a diet low in vegetables (AAPC = −3.6%) was observed, while a significant increase in trends was observed in DALYs rates for esophageal cancer attributable to a high body mass index (AAPC = +0.4%). Conclusions: More epidemiological research is needed to elucidate the relationship between esophageal cancer and certain risk factors and guide prevention efforts. Full article

Background: States adopt different tax bases for smokeless tobacco (SLT), making tax incidence on SLT not directly comparable across states. In addition, how taxes are passed through to SLT prices among states that impose specific taxes, and whether the pass-through rates for SLT are affected by the uptake and evolution of e-cigarettes, is unknown. Objective: This study will calculate the tax incidence on SLT and investigate how SLT taxes are passed to prices at the 25th, 50th, and 75th percentile levels, as well as whether these pass-through rates vary by e-cigarette uptake and evolution. Methods: We regressed SLT prices on specific taxes using ordinary least square regressions while controlling for state-, year-, and quarter-fixed effects. We then tested the difference in tax pass-through rates by different periods. Findings: The average tax incidence on chewing tobacco, moist snuff, dry snuff, and snus was 22%, 22%, 23%, and 20%, respectively. For moist snuff, taxes were fully passed to prices at the 25th and 50th percentiles (rate = 1.01, p < 0.001) and overly passed to prices at the 75th percentile (rate = 1.25, p < 0.001). The e-cigarette uptake and evolution significantly raised taxes by 13 cents and 14 cents per ounce, respectively, for moist snuff at the 75th percentile prices (p < 0.05). Conclusions: If harm is considered a criterion for taxing tobacco products, the tax incidence on SLT could be further increased. Considering that lower-priced SLT have lower tax pass-through rates, price promotion restrictions and minimum pricing laws may be needed to increase the cost of lower-priced products. Additionally, we observed that tobacco companies tended to increase tax pass-through for premium SLT products as e-cigarettes gained popularity, which may indicate a strategic response to shifting consumer preferences. Full article

Background: Underweight is a prevalent condition among older adults in developing countries and poses a substantial burden on health, social, and aged-care systems. In this study, we examined the influence of tobacco use and food insecurity on the risk of being underweight among adults aged 60 or older in India. Methods: We used data from the 2017–2018 Longitudinal Aging Study in India. The sample size was 27,902 adults aged 60 years and above. We distinguished between smoking and smokeless tobacco use to examine how they may independently contribute to the outcome, while food insecurity was measured using the four-item version of the Food Insecurity Experience scale. Multivariable logistic regressions were conducted to assess the impact of tobacco use and food insecurity on the outcome. Additionally, we tested interactions between tobacco use and education, as well as between tobacco use and wealth. Results: The prevalence of underweight was 27% in the study population. Older adults who used smoking tobacco were twice more likely to be underweight than non-users (OR = 2.07, 95% CI = 1.79 to 2.40, p < 0.001), controlling for other confounders. The positive association between smokeless tobacco use and underweight was weaker but still significant (OR = 1.26, 95% CI = 1.11 to 1.42, p < 0.001). Food-insecure older adults were also more likely to be underweight (OR = 1.27, 95% CI = 1.10 to 1.48, p < 0.001). Other risk factors of underweight included males, rural residents, lower socioeconomic status (in terms of education, wealth, and caste), chewing disability, poor self-rated health, chronic lung disease, and tuberculosis. Interestingly, tobacco use moderated the relationship between wealth and underweight, such that smokers are more likely to be underweight as they become more affluent. Conclusions: Tobacco use and food insecurity have adverse implications on the nutritional status of the older persons in developing countries such as India. More targeted tobacco cessation measures and active food assistance programs for older adults are warranted to improve the overall health status of the older demographic. Full article

Smokeless tobacco (ST) is an alternative to smoking, which involves not the burning of tobacco. Although ST has been used for thousands of years, its health effects are not well characterized, and it is the subject of misconceptions throughout society. Therefore, it is crucial to identify the risks associated with ST use. We conducted a comprehensive search of the scientific literature to identify studies reporting associations between tobacco chewing and the risk of oral cancer and premalignant lesions. Our review discusses the molecular mechanisms associated with ST components, along with the role of ST use in speech impairment and cancer progression. We also examine the effectiveness of tobacco cessation strategies and review the existing perceptions held by ST consumers. Our findings indicate significant health risks associated with ST use, including increased cancer risk and speech impairments. As societal perceptions and misconceptions about ST are important factors that influence its use, there is a need for comprehensive public awareness campaigns to correct these misconceptions and to promote healthier lifestyle choices. We call for further research to improve cessation interventions and to increase public awareness of relevant research discoveries. By providing a thorough discussion of the health impacts of ST, we aim to inform policy decisions and public health strategies to reduce the prevalence of ST use. Full article

Background: The purpose of this study is to evaluate the knowledge, attitudes, and behaviours (KAB) of health and non-health-related students at university concerning oral health. Materials and Methods: This cross-sectional study with a 3-month duration in 2023 was conducted amongst King Khalid University (KKU) students. This study used a self-administered, anonymous web-based survey with a simple random sampling strategy as part of its cross-sectional design. The questionnaire had four sections totalling 26 questions to evaluate KAB. A chi-square test was used to evaluate significant differences between categories. Results: Of the 845 respondents who completed the survey, 43.78% were health-related students, while 56.21% were non-health-related students. The completed responses included bacteria causing gingival problems (60.81% vs. 36%), fizzy soft drinks adversely affecting teeth (67.83% vs. 40%), tobacco chewing or smoking possibly causing oral cancer (68.37% vs. 44%), white patches or dental plaque on teeth (61.89% vs. 41.47%), brushing teeth twice a day to improve oral health (81.62% vs. 42.52%), keeping teeth clean (64.86% vs. 41.68%), improper brushing leading to gum disease (70% vs. 40.63%), brushing with fluoridated toothpaste to prevent tooth decay (63% vs. 40%), bleeding gums denoting gum infection (26.98% vs. 21.30%), the importance of teeth similar to any body part (61.62% vs. 37.89%), prioritising teeth as other parts of the body (61.05% vs. 36.21%), brushing teeth twice daily (55.67% vs. 37.05%), and routine dental check-ups (55.40% vs. 14.10%) for health and non-health-related students, respectively (p < 0.05). Conclusion: The results of the current study demonstrated less oral health KAB in non-health-related students than in health-related students. Nonetheless, healthcare students provided erroneous information regarding oral health. Therefore, we urge the appropriate authorities to offer health and non-health-related students the best oral health promotion programmes and services, thereby seeking to improve their oral health knowledge while stressing the importance of practising excellent oral hygiene. Full article

Human papillomavirus (HPV) is implicated in over 90% of cervical cancer cases, with factors like regional variability, HPV genotype, the population studied, HPV vaccination status, and anatomical sample collection location influencing the prevalence and pathology of HPV-induced cancer. HPV-16 and -18 are mainly responsible for the progression of several cancers, including cervix, anus, vagina, penis, vulva, and oropharynx. The oncogenic ability of HPV is not only sufficient for the progression of malignancy, but also for other tumor-generating steps required for the production of invasive cancer, such as coinfection with other viruses, lifestyle factors such as high parity, smoking, tobacco chewing, use of contraceptives for a long time, and immune responses such as stimulation of chronic stromal inflammation and immune deviation in the tumor microenvironment. Viral evasion from immunosurveillance also supports viral persistence, and virus-like particle-based prophylactic vaccines have been licensed, which are effective against high-risk HPV types. In addition, vaccination awareness programs and preventive strategies could help reduce the rate and incidence of HPV infection. In this review, we emphasize HPV infection and its role in cancer progression, molecular and immunopathogenesis, host immune response, immune evasion by HPV, vaccination, and preventive schemes battling HPV infection and HPV-related cancers. Full article

Nowadays, smoking and tobacco-related habits (chewing tobacco) are recognized as the most frequent environmental risk factor for periodontal disorders. Atorvastatin calcium (ATV) is a well-known lipid-lowering drug, but recent studies have discussed its pleiotropic effects, including anti-inflammatory properties, anti-bacterial properties, etc. This anti-inflammatory effect can be studied as an adjunct for scaling and root planing (a non-surgical process to remove dental tartar and smooth root surfaces) for periodontic problems. The goal of the study is to formulate and evaluate ATV-niosomes, introduce them in a gel-based formulation by utilizing an appropriate gelling agent, and evaluate them for various parameters. The niosomal vesicles were prepared using the thin-film hydration method. Gel was prepared using the dispersion method, and an in vitro drug release study was conducted using a Franz diffusion cell. According to the results evaluated, ATV niosomal gels loaded with different concentrations of Carbopol 934 were effectively produced utilizing ATV-niosomes that were formulated through the thin-film hydration process using cholesterol and Span 60. The ATV-niosomes showed the highest entrapment efficiency, up to 84%, and the zeta potential (−18 mV) and PDI (0.106) showed stable and homogenous behavior in the vesicles formed. The performance of the optimized gel containing 1% Carbopol 934 showed in vitro release of up to 8 h following zero-order release. The gel also proved to have antimicrobial activity against S. aureus and P. aeruginosa. Therefore, we conclude that 1% Carbopol 934 gel comprising ATV-niosomes showed a prolonged effect compared to plain ATV and can effectively work to improve the periodontal condition as an adjunct to scaling and root planing. Full article

Oral cancer (OC) is the 16th most common cancer worldwide. In Sri Lanka, OC is the most prevalent cancer among men and the eighth among women. In most instances, OC is preceded by clinically recognizable disorders appearing on the oral mucosa, termed oral potentially malignant disorders (OPMD). The distribution of OC among low- and middle-income socioeconomic groups contributes to various factors. Poor oral health literacy, a lower quality of higher education, and the economic burden results in neglected oral health. The further economic recession has led to the formation of risk habits, such as chewing betel quid, smoking and the consumption of alcohol, among these groups to minimize stress levels. But with a lack of oral health awareness, the incidences of OC increase in this category. This review elaborates on a few cross-sectional studies conducted in various locations in Sri Lanka, discussing the low awareness of neglected oral health, the usage of tobacco in a smokeless and non-smokeless manner, consuming alcohol, and the chewing of betel nuts. This review aims to overcome the barriers in these low- and middle-income socioeconomic groups in developing nations such as Sri Lanka by creating more awareness and minimizing the incidence and diagnosis and treatment at early stages to improve the quality of life as well as longevity. Full article

Background: Areca nut and betel quid (ANBQ) chewing is a widespread carcinogenic habit. The BENIT (ClinicalTrials—NCT02942745) is the first known randomized trial designed for ANBQ chewers. Methods: We compared the intensive behavioral treatment intervention condition (IC) with the control condition (CC) in the BENIT and included a 5-stage early stopping rule. We report the primary analysis at stage 3. English-literate adults in Guam and Saipan who self-identified as ANBQ chewers with tobacco were enrolled between August 2016 and August 2020. IC participants (n = 88) received five in-person sessions over 22 days and a brochure containing quitting advice. CC participants (n = 88) received only the brochure. Participants were assessed at baseline and on day 22 of follow-up. Self-reported chewing status at day 22 was determined by a composite of two survey items with disparate wording and response options for cross-verification. Results: Cessation rates were 38.6% (IC) and 9.1% (CC). Proportional hazards regression revealed a p = 0.0058, which met the Stage 3 criteria for significance, and an estimated reduction in ANBQ chewing for IC compared to the CC of 71% (95% CI: 41%–88%). Conclusions: Robust self-reported intervention effects at day 22 suggest that intensive cessation programs such as BENIT should be further developed and implemented on a larger scale. Full article

Head and neck squamous cell carcinoma (HNSCC) is a group of malignancies, involving the oral cavity, pharynx, hypopharynx, larynx, nasal cavity, and salivary glands, that together compose the seventh most common cancer diagnosis worldwide. With 890,000 new cases and 450,000 deaths annually per GLOBOCAN estimates, HNSCC accounts for roughly 4.5% of cancer diagnoses and deaths. In the developing world, the incidence of HNSCC is growing with increasing consumption of tobacco (smoked or chewed), alcohol, and areca nut (betel quid). Alcohol and tobacco have a synergistic effect, with the heavy consumption of both increasing HNSCC risk 40-fold. In developed nations, HPV-related HNSCC surpasses tobacco- and alcohol-related disease. HPV-related HNSCC more commonly affects the oropharynx, hypopharynx, and larynx than the oral cavity, and is associated with a significantly longer median survival (130 months vs. 20 months). Discrepancies in etiology as well as disparities in lifestyle choices and access to healthcare may account for the greater incidence and poorer survival of HNSCC among minority and lower-socioeconomic-status communities in developed nations. Pharmacotherapy and counseling together have been shown to be effective in promoting smoking and alcohol cessation. Education on cancer risk and community engagement have reduced areca nut consumption in Asia as well as in diaspora communities. HPV vaccination, starting at age 11–12 for both sexes, has been shown to reduce the prevalence of high-risk HPV serologies and prevent pre-cancerous lesions of the cervix, vagina, and vulva. As of 2020, 58.6% of eligible adolescents in the US have received the full two-vaccine series. Increased adoption of vaccination, education on safe sex practices, and routine visual oral screening for high-risk patients would curb growing HNSCC incidence in developed nations. Full article

Head and neck (HN) squamous cell carcinomas (SCCs) originate from the epithelial cells of the mucosal linings of the upper aerodigestive tract, which includes the oral cavity, the pharynx, the larynx, and the sinonasal cavities. There are many associated risk factors, including alcohol drinking coupled with tobacco use, which accounts for 70% to 80% of HNSCCs. Human papilloma virus (HPV) is another independent risk factor for oropharyngeal SCC, but it is only a minor contributor to oral cavity SCC (OSCC). Betel quid chewing is also an established risk factor in southeast Asian countries. However, OSCC, and especially oral tongue cancer, incidence has been reported to be increasing in several countries, suggesting risk factors that have not been identified yet. This review summarizes the established risk factors for oral cavity squamous cell carcinomas and examines other undemonstrated risk factors for HNSCC. Full article

Tobacco use is associated with diseases worldwide, including cancer. This is one of the major public health problems globally, causing more than 19 million new cases in 2020. Lip and oral cavity cancer (LOCC) is neoplastic growth in the tongue, gums, and lips. The objective of this ecological study was to quantify the strength of the association between incidence and mortality of LOCC, with tobacco use and with the Human Development Index (HDI). Incidence and mortality data on LOCC were obtained for 172 countries in 2020, from the Global Cancer Observatory (GLOBOCAN). The prevalence of tobacco smoking and chewing was obtained from reports conducted in 2019. The inequality in human development was estimated using the HDI from the United Nations Development Program, Human Development Report (2019). Statistically significant correlations were observed between the incidence of LOCC and tobacco smoking and chewing prevalence, except for negative correlations between the prevalence of tobacco smoking LOCC mortality in women, just as in the case of the HDI. No statistically significant differences were found between the prevalence of tobacco chewing only and the incidence of LOCC overall and by sex. A higher LOCC incidence overall and by sex was associated with higher HDI. In conclusion, the present study found positive correlations for various HDI socioeconomic indicators and tobacco use with the incidence and mortality of LOCC, but also a few inverse correlations. Full article