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Tobacco and health
Published in Sally Robinson, Priorities for Health Promotion and Public Health, 2021
Tobacco products which are designed to be chewed or sniffed are often called smokeless tobacco. Chemicals such as nicotine are quickly absorbed into the blood stream through the mucous lining of the mouth or nasal passages. Chewing tobacco is normally made from tobacco leaves which are air cured and crushed, with added flavourings. Dipping is the process of holding the tobacco between the lip and the gum. Varieties include gutka – dried tobacco leaves, areca nut, slaked lime, catechu, flavourings and sweetenersmishri – burnt tobacco rubbed into gums, used for teeth cleaningnass/naswar/niswar – tobacco, ash, cotton or sesame oil and water, rolled into a ballsnus – a Swedish form of snuff containing tobacco, moisturisers, sodium carbonate, salt, sweeteners and flavourings in small tea bagstambaku paan/betel quid – a combination of tobacco, areca nut and slaked lime folded into a betel leaf and chewedzarda – boiled and dried tobacco leaves with lime, spices, colourings, areca nut and flavourings
Oral Health Care
Published in Meera Patel, Nakul Patel, Kevin Lewis, Raman Bedi, Gaman Patel, Nakul Patel, Dental Public Health, 2018
Meera Patel, Nakul Patel, Kevin Lewis, Raman Bedi, Gaman Patel, Nakul Patel
Betel, paan and guthka (tobacco) chewing is socially acceptable and widespread in India, with 60% to 70% of my sample admitting to all three. The cheap, appetite-depressing guthka packages are particularly popular among street children, as well as adults, who can go through up to 15 packets a day. This is causing concern amongst dentists and doctors, since it can give rise to cancerous lesions in the mouth and a long-term chewing habit can lead to severe attrition, abrasion and gingival recession.
Oral Cavity Cancer
Published in Dongyou Liu, Tumors and Cancers, 2017
Risk factors for oral cavity cancer include (i) tobacco smoking/chewing, (ii) alcohol drinking, (iii) betel quid or gutka chewing, (iv) diet low in beta-carotene–rich vegetables and citric fruits, (v) poor oral health, (vi) infection with Candida albicans, human herpes virus, and human papillomavirus, (vii) exposure to sunlight or UV, (viii) premalignant lesions and other oral conditions, and (ix) immunosuppression. Genetic changes observed in oral cavity cancer include mutations in chromosomes 3, 9 (P16), 11 (PRAD1), and 17 (H-ras) [2].
Substance use and non-communicable diseases in India: evidence from National Family Health Survey-4
Published in Journal of Substance Use, 2021
Nutan Kumari, Pradeep S. Salve
Globally, non-communicable diseases (NCDs) are the leading cause of disability and premature mortality. The prevalence of NCDs is escalating at a rapid pace in low and middle-income countries (Arokiasamy, 2018; Niessen et al., 2018; Prabhakaran et al., 2018; WHO, 2019a). It is estimated that in 2016, around 41 million deaths occurred due to NCDs. These deaths were attributed mainly to hypertension, diabetes, cancer and cardiovascular diseases, including heart attack and stroke (Bennett et al., 2018). Exposure to substance use, including tobacco (smoking and smokeless) and alcohol, are the leading determinants of NCDs in low and middle-income countries (Parry et al., 2011; Saikia & Debbarma, 2019; WHO, 2018a, 2019b). In India, about 28.6% of the population consumes tobacco and 14.6% alcohol (TISS and MoHFW, 2017). The prevalence of tobacco and alcohol is particularly high in the states of Punjab, Tripura, Chhattisgarh, Arunachala Pradesh, Manipur, Mizoram and Nagaland (Ambekar et al., 2019; Saikia & Debbarma, 2019). It is also estimated that about one-third of substance users consume country liquor (also referred to as “desi sharab”). Tobacco is consumed in the form of Khaini1 (11.2% of users) and Gutka2 (6.8%), and smoked as Bidis3 (7.7%). These have adverse effects on the health of the consumers (Ambekar et al., 2019; TISS and MoHFW, 2017). Due to various factors, males tend to consume more substances than females. Exposure to substance use by men is determined by their age, educational levels and nature of occupation (Salve et al., 2019).
“Introducing Modified Dakkak and Bennett Grading System for Indian Food in Oral Submucous Fibrosis”: A Dharwad Study
Published in Journal of Dietary Supplements, 2019
Chaithra Kalkur, Atul P. Sattur, Kruthika S. Guttal, Anusha R. Lakshman
Patients with OSMF initially present with a blanched or marble-like pale mucosa, vesiculations, and intolerance to hot and spicy food. Gradually, the patient may develop fibrous bands in the buccal and labial mucosa that cause a restriction in opening the mouth. The various components of this syndrome have been enumerated as follows: Gutka facies: sunken and stiff cheeks, pseudo proptosis, multiple perioral skin foldsGutka mouth: whitening of the oral mucosa, still oral aperture, poor oral hygiene, bald tongue, chronic nonhealing ulcers, retracted soft palate and uvula, unhealthy gingival melanosis, and reduced salivary outputGutka speech: peculiar due to lack of mobility of tongue and cheeksGutka swallowing: suck and swallow, dysphagia, and avoidance of eating in publicGutka hearing: hearing changes in advanced stages (Hebbar et al., 2014)
Comparison of periodontal inflammatory parameters among habitual gutka-chewers and naswar-dippers: a split-mouth retrospective clinical study
Published in Acta Odontologica Scandinavica, 2018
Zohaib Akram, Tariq Abduljabbar, Mervyn Hosain, Zeyad H. Al-Sowygh, Nawwaf Al-Hamoudi, Fahim Vohra, Fawad Javed
Gutka is one of the several smokeless tobacco (ST) formulations that is generally a mixture of powdered tobacco, areca-nut, slaked lime (aqueous calcium hydroxide paste) and fragrances such as menthol and saffron (Figure 1(A)) [1]. Gutka is commercially available in sachets (average weight 3.5 g) [1]; and is commonly consumed in South Asian countries including India, Pakistan, Bangladesh, and Sri Lanka [2,3]; however, due to its global export, gutka is also consumed by immigrants in countries such as United Kingdom and the United States [4–6]. Gutka is placed in the buccal vestibule and gently chewed and sucked. It is then held in the buccal vestibule for a prolonged duration and continued to be gently chewed and sucked intermittently. The contents may either be swallowed or spat out when desired. Likewise, Naswar (also known as Nass or Niswar) is a form of dipping ST product and is an amalgam of ground tobacco leaves (Nicotina rustica), slaked-lime, wood ash and flavourings such as cardamom and menthol [7]. Naswar also contains a small quantity of water and colouring agents such as indigo (average weight 9.2 g) [7,8]. Naswar is commonly sold in small polythene pouches (almost the size of a tea bag) (Figure 1(B)) [9]. Usually a small bolus of naswar is manually shaped into a ball and placed in the buccal vestibule between the mandibular premolars and first molar teeth. It is gently sucked intermittently for extended periods of time and spat out when desired.