PREVALENCE OF CHEWING TOBACCO AND ARECA-NUT USE AMONG PATIENTS ATTENDING DENTAL OPD AND ASSOCIATED ORAL MUCOSAL LESIONS.

J Peop Univ Med Health Sci. 2025:15(3), 114-123. http://doi.org/10.46536/jpumhs/2025/15.03.666

Abstract

BACKGROUND: Chewing tobacco (smokeless tobacco) and areca nut (Areca catechu
derivative) are widely consumed psychoactive substance in South Asian region, including
Pakistan. OBJECTIVE: To determine the prevalence of chewing tobacco and areca-nut use among
patients attending dental hospital and associated oral mucosal lesions METHODS: This descriptive
cross sectional study was carried out at Oral biology department of Bhittai Dental and Medical
College Mirpurkhas from April 2024 to September 2024. Individuals of chewing tobacco and areca
nut users, aged 18 years or older of either gender who visited the dental OPD for routine dental
examinations or treatment were included. After taking demographic information patients underwent a
comprehensive intraoral examination under adequate lighting, and review the medical record to assess
the oral lesions. Expected lesions were further evaluated using toluidine blue staining and, where
clinically indicated, subjected to incisional biopsy for histopathological confirmation. All patients
were interviewed about their chewing tobacco and areca nut consumption habits, including the type of
product used frequency, quantity, and duration of use. Data entry and analysis was done by SPSS
version 23. RESULTS: Total of 139 participants were studied, with most aged 31–60 years (49.6%)
and predominantly male (56.8%). Gutka was the most commonly used substance (66.2%), followed
by mainpuri (12.9%), a mix of betel and tobacco (8.6%), betel nut (7.2%), and naswar (4.3%). Over
half of the users (55.4%) had been consuming these products for less than one year, while 36.0%
reported use for more than five years. Pigmentation was the most common lesion (84.9%), among
gutka users, followed by white patches (48.9%, p=0.027) and ulcers (36.0%, p=0.001). Erosive
lesions (28.8%) and growths (24.5%) were also significantly associated with tobacco chewing p
0.001. additionally, white patches linked with oral submucous fibrosis (48.9%), whereas OSF features
(20.9%) and other OPMDs (8.6%) did not show significant associations (p->0.05), while only 14.4%
of participants had no mucosal changes (p=0.054). CONCLUSION: Gutka observed as the most
commonly used smokeless tobacco product, predominantly among middle-aged males, with a
considerable proportion using it for prolonged duration. Chewing of Tobacco observed significantly
linked to oral lesions, particularly pigmentation, white patches, ulcers, and erosive changes. However,
the findings highlighted the urgent need for targeted awareness, early screening, and preventive
strategies to reduce the burden of oral potentially malignant disorders in high-risk populations.