Association Between Tobacco Consumption and Oral Cancer Among Adults In Central India

Abstract

Oral cancer is a major public health problem in India, where tobacco use in smoked and smokeless forms remains common among adults. Central India has a long-standing pattern of tobacco chewing, gutkha, khaini, zarda, bidi smoking and dual use, creating a preventable exposure pathway for oral malignancy. The present thesis examines the association between tobacco consumption and oral cancer among adults in Central India, with emphasis on type of tobacco, frequency, duration, age at initiation and related behavioural factors. A hospital-based analytical case-control design was adopted among 300 adults aged 18 years and above in Central India. The study included 150 adults diagnosed with oral cancer and 150 controls without oral cancer. Data were collected through a structured questionnaire, oral examination and clinical record review. Tobacco use was assessed by type, frequency, duration, age at initiation and dual use. Tobacco consumption was substantially higher among oral cancer cases than controls. Among cases, 84.0% reported current or past tobacco consumption compared with 45.3% among controls. Smokeless tobacco was the most common form, followed by dual use and smoking only. Tobacco users had markedly higher odds of oral cancer than non-users, with risk increasing among participants using smokeless tobacco, dual users, those consuming tobacco for more than 10 years and those using tobacco more than five times per day. Buccal mucosa and tongue were the most frequent anatomical sites of oral cancer.