Pattern and prevalence of tobacco use and associated oral mucosal lesions: a hospital based cross sectional study at a tertiary care hospital in central India

Ambrish Mishra, Divashree Sharma, Geeta Mishra Tripathi, Paharam Adhikari, Vikrant Kabirpanthi, Manish Kumar


Background: Tobacco is known to mankind since ages. Despite the widespread awareness about tobacco related health hazard and vigorous efforts to regulate its use in various form of strict tobacco control legislation; its use is increasing at an alarming rate. Tobacco use carries a high risk of major health-related illness and several forms of cancers. The epidemic of tobacco use in India is inflicting a huge damage on the human health and the associated health care costs are creating a huge financial burden on the government. The objective of the study was to assess the prevalence of tobacco consumption and related oral mucosal lesions among patients reporting to dental outpatient department of a tertiary care centre in Rewa (M.P.).

Methods: Out of the total patients reporting to the outpatient department of dentistry during the study period, 5185 patients were considered for this study, 1285 were found consuming tobacco in one or other form. The consent for participation in the study was given by 1178 tobacco users. They were interviewed through prepared questionnaires and clinically examined for tobacco associated oral lesions. The data were collected, cleaned and compiled.

Results: The overall prevalence of tobacco use was 24.78%. Out of the 1178 tobacco users studied, 893 (75.80%) were males and 285 (24.19%) females. Smoked form was the most commonly used tobacco for males (44.56%) while smokeless tobacco was preferred by majority of females (69.12%). 23.94% of the tobacco users were in the age group of 21-30 years. Oral mucosal lesions were seen in 32.51% subjects.

Conclusions: The number of tobacco users visiting the dental hospital is reasonably high; Tobacco consumption is a common cause of addiction, preventable illness, disability and death. The public health system should be strengthened for effectively designing, implementing and evaluating tobacco control and prevention programs. All health care professionals should be sensitized and educated for implementing measures for tobacco control and cessation.



Tobacco, Smoked, Smokeless, Prevalence, Oral lesions

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Gururaj G, Girish N. Tobacco use amongst children in Karnataka. Indian J Pediatr. 2007;74:1095-8.

The MPOWER package, warning about the dangers of tobacco. Geneva: WHO, 2011. WHO Report on The Global Tobacco Epidemic, 2011.

Gupta VM, Sen P. Tobacco: the addictive slow poison. Indian Journal of Public Health. 2001;45:75-81.

Chaly PE. Tobacco control in India. Indian J Dent Res. 2007;18(1):2-5.

International Institute for Population Sciences (IIPS), Mumbai. Global adult tobacco survey India (GATS India), 2009- 2010. New Delhi; Ministry of Health and Family Welfare, Government of India; 2010.

Singh A, Ladusingh L. Prevalence and Determinants of Tobacco Use in India: Evidence from Recent Global Adult Tobacco Survey Data. PLoS ONE. 2014;9(12):e114073.

Goswami A, Reddaiah V, Kapoor S, Singh B, Dwivedi S, Kumar G. Tobacco and alcohol use in rural elderly Indian population. Indian J Psychiatry. 2005;47:192-7 .

Shimkhada R, Peabody JW. Tobacco control in India. Bull World Health Organ. 2003;81:48-52.

IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. IARC; 2002. Tobacco Smoke and Involuntary Smoking; p. 83.

A WHO / The Union monograph on TB and tobacco control: Joining efforts to control two related global epidemics. Tobacco consumption. 2010: 8–10.

Chaudhry K, Prabhakar A, Prabhakaran P, Prasad A, Singh K, Singh A. Prevalence of tobacco use in Karnataka and Uttar Pradesh in India. Final report of the study by the Indian Council of Medical Research and the WHO South East Asian Regional Office, New Delhi; 2001.

Kasat V, Joshi M, Somasundaram KV, Viragi P, Dhore P, Sahuji S. Tobacco use, its influences, triggers, and associated oral lesions among the patients attending a dental institution in rural Maharashtra, India. J Int Soc Prevent Communit Dent. 2012;2:25-30.

Vellappally S, Jacob V, Smejkalová J, Shriharsha P, Kumar V, Fiala Z. Tobacco habits and oral health status in selected Indian population. Cent Eur J Public Health. 2008;16(2):77-84.

Sinha DN, Gupta PC, Pednekar MS. Tobacco Use in A Rural Area Of Bihar, India. Indian Journal of Community Medicine. 2003;XXVIII(4):167-70.

Patil PB, Bathi R, Chaudhari S. Prevalence of oral mucosal lesions in dental patients with tobacco smoking, chewing, and mixed habits: A cross-sectional study in South India. J Family Community Med. 2013;20(2):130–5.

Chandra P, Govindraju P. Prevalence of oral mucosal lesions among tobacco users. Oral Health Prev Dent. 2012;10(2):149-53.

Kawatra A, Lathi A, Kamble SV, Sharma P, Parhar G. Oral premalignant lesions associated with areca nut and tobacco chewing among the tobacco industry workers in area of Rural Maharashtra. National Journal of Community Medicine. 2012;3(2):333-8.

Gupta PC, Sinor PN, Bhonsle RB, Pawar VS. Mehta HC: Oral submucous fibrosis in India: A new epidemic? National Med J Ind. 1998;11:113-6.

Johnson SE, Charles WC, Coleman, Choiniere CJ. Self-reported exposure to tobacco warning labels among U.S. middle and high school students. Am J Prev Med. 2014;47(2S1):S69–S75.

Oakley E, Demaine L, Warnakulasuriya S. Areca (betel) nut chewing habit among high-school children in the Commonwealth of the Northern Mariana Islands (Micronesia). Bull World Health Organ. 2005;83:656-60.