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Original Article
Smokeless tobacco consumption and its association with tobacco control factors in the Western Pacific Region: results from the Global Youth Tobacco Survey 2015-2019
Chandrashekhar T. Sreeramareddy, Anusha Manoharan
Epidemiol Health. 2022;44:e2022103.   Published online November 8, 2022
DOI: https://doi.org/10.4178/epih.e2022103
  • 2,870 View
  • 92 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We estimated the prevalence of smokeless tobacco (ST) consumption and its associations with tobacco control factors among school-going youth in 18 Western Pacific Region (WPR) countries.
METHODS
We analyzed school-based Global Youth Tobacco Survey (2014-2019) microdata from 18 WPR countries and estimated weighted prevalence rates of ST consumption, cigarette smoking, and dual use. We used multilevel binary logistic regression to examine the associations of ST consumption and dual use with demographic variables, exposure to pro-tobacco and anti-tobacco factors, national income, and MPOWER indicators.
RESULTS
Data from 58,263 school-going youth were analyzed. The prevalence of past 30-day ST consumption was highest in Kiribati (42.1%), the Marshall Islands (26.1%), Micronesia (21.3%), Palau (16.0%), and Papua New Guinea (15.2%). In adjusted multilevel models, ST consumption and dual use were significantly associated with sex, age, parental smoking, pro-tobacco factors, national income, and MPOWER score. For each unit increase in score for cessation programs, we observed approximately 1.4-fold increases in the odds of youth ST consumption (adjusted odds ratio [aOR], 1.38; 95% confidence interval [CI], 1.15 to 1.66) and dual use (aOR, 1.47; 95% CI, 1.16 to 1.86). Similarly, for each unit increase in score for health-related warnings, the odds of both ST consumption (aOR, 0.47; 95% CI, 0.42 to 0.53) and dual use (aOR, 0.35; 95% CI, 0.30 to 0.42) decreased by approximately 60%.
CONCLUSIONS
The prevalence of youth ST consumption was substantial in the Pacific Islands, exceeding that of cigarette smoking in some countries. Implementing MPOWER measures for ST products could help reduce ST consumption.
Summary
Key Message
The prevalence of smokeless tobacco consumption, and cigarette smoking is considerably high among the school going youth in five pacific island nations of Western Pacific Region. Exposure to pro-tobacco factors and parental smoking were positively associated with youth smokeless tobacco consumption as well as dual use (both smokeless tobacco and cigarettes smoking) Closer monitoring and strict tobacco control policies are needed to prevent further escalation of smokeless tobacco consumption.
Review
Smokeless tobacco (paan and gutkha) consumption, prevalence, and contribution to oral cancer
Kamal Niaz, Faheem Maqbool, Fazlullah Khan, Haji Bahadar, Fatima Ismail Hassan, Mohammad Abdollahi
Epidemiol Health. 2017;39:e2017009.   Published online March 9, 2017
DOI: https://doi.org/10.4178/epih.e2017009
  • 37,606 View
  • 739 Download
  • 110 Web of Science
  • 116 Crossref
AbstractAbstract PDF
Abstract
Smokeless tobacco consumption, which is widespread throughout the world, leads to oral submucous fibrosis (OSMF), which is a long-lasting and devastating condition of the oral cavity with the potential for malignancy. In this review, we mainly focus on the consumption of smokeless tobacco, such as <i>paan</i> and <i>gutkha</i>, and the role of these substances in the induction of OSMF and ultimately oral cancer. The list of articles to be examined was established using citation discovery tools provided by PubMed, Scopus, and Google Scholar. The continuous chewing of <i>paan</i> and swallowing of <i>gutkha</i> trigger progressive fibrosis in submucosal tissue. Generally, OSMF occurs due to multiple risk factors, especially smokeless tobacco and its components, such as betel quid, areca nuts, and slaked lime, which are used in <i>paan</i> and <i>gutkha</i>. The incidence of oral cancer is higher in women than in men in South Asian countries. Human oral epithelium cells experience carcinogenic and genotoxic effects from the slaked lime present in the betel quid, with or without areca nut. Products such as 3-(methylnitrosamino)-proprionitrile, nitrosamines, and nicotine initiate the production of reactive oxygen species in smokeless tobacco, eventually leading to fibroblast, DNA, and RNA damage with carcinogenic effects in the mouth of tobacco consumers. The metabolic activation of nitrosamine in tobacco by cytochrome P450 enzymes may lead to the formation of N-nitrosonornicotine, a major carcinogen, and micronuclei, which are an indicator of genotoxicity. These effects lead to further DNA damage and, eventually, oral cancer.
Summary

Citations

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