Smokeless Tobacco (Shammah) in Saudi Arabia: A Review of its Pattern of Use, Prevalence, and Potential Role in Oral Cancer

Alsanosy, Rashad Mohammed

doi:10.7314/apjcp.2014.15.16.6477

Cited by 59 publications

(60 citation statements)

References 61 publications

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“…Other risk habits such as smokeless tobacco, betel quid, and areca nut use are also particularly uncommon in the Arab world and were not practiced by any of the study patients. This pattern of risk habits could explain the observed prevalence of OPMDs which was more similar to prevalences reported from western countries rather than Asian countries where habits such as smokeless tobacco, betel quid, and areca nut are much more common (Johnson et al, 2011;Sujatha et al, 2012;Mini et al, 2014;Alsanosy, 2014).…”

Section: Discussionsupporting

confidence: 61%

Oral Potentially Malignant Disorders among Dental Patients: a Pilot Study in Jordan

Hassona¹,

Scully²,

Almangush³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: To determine the prevalence, types, and risk factors of oral potentially malignant disorders (OPMDs) among a group of Arab Jordanian dental patients, and to evaluate their awareness and attitudes toward early diagnosis and treatment. Materials and Methods: A total of 1,041 patients attending a University Hospital for dental care were examined for the presence of OPMDs. Histopathological examination was performed on all cases clinically diagnosed and patients were directly interviewed to evaluate their knowledge and attitudes toward early detection and treatment of oral cancer. Results: The prevalence of OPMDs overall was 2.8%. Lichen planus/lichenoid lesions were the most common lesions (1.8%) followed by leukoplakias (0.48%), chronic hyperplastic candidiosis (0.38%), and erythroplakia (0.096%). Smoking, alcohol, and age (>40 years) were the main identifiable risk factors. Patients with OPMDs displayed a general lack of awareness and negative attitudes towards early diagnosis and treatment. Conclusions: OPMDs among Arab dental patients are relatively uncommon and awareness about oral cancer among Jordanian dental patients is low. Interventions to improve public knowledge about oral cancer and attitudes toward early diagnosis and treatment are urgently indicated.

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Section: Discussionsupporting

confidence: 61%

Oral Potentially Malignant Disorders among Dental Patients: a Pilot Study in Jordan

Hassona¹,

Scully²,

Almangush³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…The sites of Shammah retention in the oral cavity have been reported to include the buccal cavity, the lingual vestibule of the mouth, the gingivobuccal sulcus, the lower labial, or buccal vestibules. 13,14 The use of smokeless tobacco in Kingdom of Saudi Arabia is most frequently observed in Jazan province, although it is not restricted to this province. 13 Khat has a very complex alkaloid composition.…”

Section: 5005/jp-journals-10024-2060mentioning

confidence: 99%

Tooth Wear Patterns among Khat and Shammah Users in Jazan City, Kingdom of Saudi Arabia: A Cross-sectional Survey

Sayed¹,

Hamdi²,

Hakami³

et al. 2017

The Journal of Contemporary Dental Practice

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Aim The effect of Khat and Shammah habits, with the parafunctional jaw activities that accompany them, on the structure and integrity of the natural dentition has not yet been investigated. The literature lacks studies that identify the patterns of tooth wear among Khat and Shammah users. Therefore, this study is the first attempt to address this concern in Jazan City population, Kingdom of Saudi Arabia. Materials and methods A cross-sectional survey study was conducted among 300 recruits among dental clinics in Jazan City, Kingdom of Saudi Arabia from October 1, 2015, to April 30, 2016. Questionnaires were used for data collection on oral habits (Khat and Shammah use), age, gender, intake of acidic food or beverages, food habits (intake of fruits, grains, and vegetables), systemic diseases, oral hygiene habits (brushing frequency, technique, and type of toothbrush), parafunctional habits, stress, and acid reflux. Clinical examination was performed to assess the grade of tooth wear. Bivariate analysis was performed to determine the empirical relationship between the independent variables and outcomes. In addition, binary logistic regressions were used to measure the relationship between the independent variables and each of the dependent variables (presence of occlusal wear, tooth wear grade 0 through 4). Results Khat and Shammah use was statistically significantly associated with tooth wear (p < 0.05). A significant association of tooth wear was observed with age, gender, intake of acidic food and beverages, oral hygiene habits, and stress. Conclusion Consumption of Khat and Shammah may be attributed as one of the major reasons associated with tooth wear among the Saudi population. Clinical significance The habitual use of Khat and Shammah causes tooth wear of varying severity, which may negatively affect esthetics, phonetics, and function and necessitate a complex restorative treatment. How to cite this article Sayed ME, Hamdi AD, Hakami BM, Mugri MH, Bhandi SH. Tooth Wear Patterns among Khat and Shammah Users in Jazan City, Kingdom of Saudi Arabia: A Crosssectional Survey. J Contemp Dent Pract 2017;18(6):429-436.

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“…The user quite often places it in the buccal cavity as a quid till the affect and the flavor of the substance lasts. Studies performed in Saudi Arabia have revealed frequent use of shamma among the people living in the Jazan province, which is situated in the southern tip of the Arabian Peninsula (Allard et al, 1999;Al Sanosy, 2014). Residents as young as 10-13 years of age have been reported to be indulged in the habit of shamma dipping.…”

Section: Introductionmentioning

confidence: 99%

Oral Squamous Cell Carcinoma and Associated Risk Factors in Jazan, Saudi Arabia: A Hospital Based Case Control Study

Quadri

Alharbi²,

Bajonaid³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: Oral cancer is the third most common malignancy in Saudi Arabia, the highest incidence of which is reported from Jazan province. The objective of this study was to evaluate the association of various locally used substances, especially shamma, with oral cancer in the Jazan region of Saudi Arabia. Materials and Methods: A hospital-based case-control study was designed and patient records were scanned for histologically confirmed oral cancer cases. Forty eight patients who were recently diagnosed with oral cancer were selected as cases. Two healthy controls were selected for each observed case and they were matched with age (+/-5 years) gender and location. Use of different forms of tobacco such as cigarettes, pipe-smoking and shamma (smokelesstobacco) was assessed. Khat, a commonly used chewing substance in the community was also included. Descriptive analysis was first performed followed by multiple logistic regression (with and without interaction) to derive odds ratios (ORs) and 95% confidence interval (CIs). Results: Mean age of the study sample (56% males and 44% females) was 65.3 years. Multinomial regression analysis revealed that shamma use increased the odds of developing oral cancer by 29 times (OR=29.3; 10.3-83.1). Cigarette (OR=6.74; 2.18-20.8) was also seen to have an effect. With the interaction model the odds ratio increased significantly for shamma users (OR=37.2; 12.3-113.2) and cigarette smokers (OR=10.5; 2.88-3.11). Khat was observed to have negative effect on the disease occurrence when used along with shamma (OR=0.01; 0.00 -0.65). Conclusions: We conclude that shamma, a moist form of smokeless tobacco is a major threat for oral cancer occurrence in the Jazan region of Saudi Arabia. This study gives a direction to conduct further longitudinal studies in the region with increased sample size representing the population in order to provide more substantial evidence.

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Smokeless Tobacco (Shammah) in Saudi Arabia: A Review of its Pattern of Use, Prevalence, and Potential Role in Oral Cancer

Cited by 59 publications

References 61 publications

Oral Potentially Malignant Disorders among Dental Patients: a Pilot Study in Jordan

Oral Potentially Malignant Disorders among Dental Patients: a Pilot Study in Jordan

Tooth Wear Patterns among Khat and Shammah Users in Jazan City, Kingdom of Saudi Arabia: A Cross-sectional Survey

Oral Squamous Cell Carcinoma and Associated Risk Factors in Jazan, Saudi Arabia: A Hospital Based Case Control Study

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