An epidemiological study of oral tobacco use amongst urban slum inhabitants in a town from central urban India

Introduction

The United Nations' World Health Organization (WHO) oversees global public health. The primary goal of the WHO, according to its constitution, is to ensure that everyone has the best possible level of health. Smokeless tobacco users receive levels of nicotine known to be addictive, and clinical symptoms of dependency and withdrawal for smokeless tobacco are identical to those for cigarettes. Smokeless tobacco usage patterns share significant parallels with patterns of use of other addictive drugs. The mandate of the WHO calls for global collaboration to enhance health, uphold world peace and harmony, and assist the vulnerable. It encourages a billion more people to participate in monitoring public health risks, coordinating emergency medical response efforts, promoting health and wellness, and implementing universal health care.

Pan is frequently taken with chewed smokeless tobacco products like Mishri and Pan masala (a chewable tobacco made with areca nuts). Smokeless tobacco use, particularly in the eastern, northern, and north-eastern regions of the country, is a socially accepted addiction. Most prior studies on the prevalence of tobacco use were either based on small-scale research surveys with an urban bias, small sample numbers, and poorly known sociodemographic correlates of tobacco use. Additionally, earlier prevalence estimations made in India are still extremely speculative and non-representative.¹ Use of oral tobacco increases the frequency of people spitting in public because everyone spits after using it. In developing nations, it raises the risk of airborne infectious diseases, among which tuberculosis (TB) dissemination is one. Our primary goal in this study is to evaluate the pattern, prevalence, and sociodemographic characteristics associated with smokeless tobacco use in urban slum dwellers. To prepare tobacco for these uses, tobacco leaves are harvested when they turn yellow and brownish stains begin to develop. The leaves are then uniformly dried in the field, tied into bundles with water or molasses to keep them moist, and then stored for a few weeks to ferment. There are several issues with South Asians using smokeless tobacco. It is widely used and becoming more so, especially with the introduction of new smokeless tobacco varieties in recent years that have attracted more consumers.²

Transport employees who are under stress are more likely to abuse alcohol and other drugs, with cigarettes being the most popular. There has been research on a connection between smoking and job stress. It is often believed that a substantial percentage of bus drivers and other employees smoke cigarettes. The second leading cause of death worldwide and the leading contributor to morbidity and mortality that may be prevented is tobacco smoking. Oral malignancies and possibly malignant lesions, the degree and depth of periodontal disease, and poor wound healing are the most harmful impacts of tobacco use on the oral cavity.³ Although its use varies around the world, betel quid (pan), the most popular type of smokeless tobacco, quickly adopted tobacco as a new ingredient after its introduction. However, the legal gaps are being effectively used. For instance, replacements like “supari mix” packets are offered for sale with a free packet of Zarda or Khaini chewing tobacco. Except for a few limited geographic locations, both men and women regularly chew betel nut, but smoking tobacco is far more prevalent among men in Bangladesh, India, Pakistan, and Sri Lanka than among women.⁴ To enable the creation and implementation of efficient intervention plans, this knowledge is necessary. The goal of the current report is to analyse in depth the smoking habits of a community in northern India and how they relate to the three different living strata, namely urban, urban-slum, and rural. However, the amount of substance being consumed, and the age of commencement are frequently not mentioned in these questionnaires. Studies on the epidemiology of coronary heart disease and its risk factors have either concentrated on urban or rural settings. studied the incidence of tobacco usage in northern Indian villages, towns, and cities.⁵ But it is crucial to emphasize a few points that are crucial for comprehending how addicted smokeless tobacco is. The use of smokeless tobacco rapidly increased, the products were found to be carcinogenic, and the demographics of users abruptly changed, all of which led to the development of smokeless tobacco addiction as a public health issue in the United States in the middle of the 1980s. Older folks were the main consumers of its products, and when they died off there were no new consumers to take their place. The smokeless tobacco business turned this trend around by creating new products, notably moist snuff products, and employing strong marketing techniques.⁶

Protocol

Discussion

Squamous cell carcinomas of the oral cavity (OSCC) make up a large percentage of cancer cases in India. The two most dangerous forms of oral cancer, with a higher incidence in India, are buccal mucosa and tongue OSCC.⁹ Patients with oral cancer are always expected to require an intubation or a difficult airway. The safest way to perform nasotracheal intubation in these circumstances is with FOB assistance.¹⁰ By autocrine and paracrine production of different growth factors, cytokines, and multiple proteolytic enzymes, the cancer-associated fibroblast would have the capacity to create an aggressive tumour phenotype. Invasive behaviour, local recurrence, and survival of carcinoma are all predicted by the expression of -SMA.¹¹ The main imaging modalities for loco-regional staging of head and neck squamous cell carcinoma continue to be CT and MRI. Both techniques aid in the evaluation of the primary tumour and the identification of non-palpable lymph nodes. Nevertheless, to distinguish between benign and malignant lymph nodes, both techniques rely on size-related and morphological parameters.¹² This choice justifies a trustworthy and economical strategy in patients with early-stage oral cancer. For minor to severe oral cavity deformities, inferiorly based islanded nasolabial flaps offer a one-stage procedure that is safer, quicker, and more dependable.¹³