Effect of cessation of tobacco use on the incidence of oral mucosal lesions in a 10–yr follow‐up study of 12 212 users

Abstract

OBJECTIVE: To study the effect of cessation of tobacco use on the incidence of lichen planus, leukoplakia and other oral mucosal lesions. DESIGN: A 10–yr cohort study in a rural population of Ernakulam district, Kerala, India. MATERIAL AND METHODS: Some 12 212 tobacco users were interviewed and examined in a basetine survey and re‐examined annually for 10 years. At each examination they were exposed to health educational programs to encourage them to quit their tobacco use. The incidence rates were calculated using person‐years method among those who stopped their tobacco use and all others. RESULTS: A total of 77 681 person‐years of observation accrued among men and 32 544 among women. Among men 6.5% of these and among women 14.4% were in the stopped category. The incidence of oral lichen planus did not show any consistent association with cessation of tobacco habits (incidence ratio I.35) but for leukoplakia there was a substantial drop in the incidence after cessation (incidence ratio 0.3I). Several other tobacco‐associated oral mucosal lesions such as oral lichen planus‐like lesion, smoker's palate, preteukoplakia, central papillary atrophy of the tongue and leukoedema showed either zero, or very small incidence, after cessation. CONCLUSION: The reported association between tobacco use and lichen planus appears to be indirect but for all other lesions it is direct. The cessation of tobacco use led to a substantial fall in the incidence of leukoplakia and other lesions implying a reduced risk for oral cancer after cessation of tobacco use.

The effect of quitting smoking on the risk of unfavorable events after surgical treatment of oral potentially malignant lesions

“…Smoking has also been suggested in the etiology of erythroplakia 19 . Several intervention studies demonstrated significant reduction or disappearance of leukoplakia lesions in patients who quit their tobacco habit 11,15,20 . Consequently, motivation of patients with oral PM lesions to quit smoking was assumed to represent an important element of the treatment.…”

Tobacco use and cessation counseling in India-data from the Global Health Professions Students Survey, 2005-09

“…[4] Tobacco control is a multisectoral issue that needs active collaboration of various health professions, departments/ministries, civil society and non-governmental organizations. [5] Although both smokers, [6] and smokeless tobacco users, [7] derive substantial benefits from cessation, few successfully give up tobacco use. In India, only 1.7% were former daily smokers with the highest percentage in Kerala (4.9%) and lowest in Punjab, Chandigarh, and West Bengal (0.2%).…”

Total, direct, and indirect effects of paan on oral cancer

“…However, there is wide agreement that the form in which chewing tobacco that is used in South Asia is potentially carcinogenic [11]. An intervention aimed at reducing tobacco use in India resulted in lower incidence of oral precancerous lesions in the intervention group [20]. In South Asia chewing tobacco is largely used in paan [11,21].…”