Awareness Regarding Impact of Tobacco on Oral Health: An Original Study.

INTRODUCTION: The use of tobacco in all forms is increasing day by day globally causing its ill effects on oral as well as overall health of the people and affecting their sense of well-being and quality of life. AIM AND
OBJECTIVES: The present study was done to investigate among patients the awareness of tobacco use and its ill effects on oral health.
MATERIALS AND METHODS: This descriptive, cross-sectional study was conducted at Dr. RRK Dental College and Hospital, Akola. A total of 297 patients were asked using a self-structured questionnaire.
RESULTS: Out of a total of 297 patients participating in the study, 48 (16.2%) were female and 248 (83.8%) were male. About 81.7% of the patients were aware that heart problems can be one of the ill effects of tobacco chewing, while 3.7% were still not sure about it.
CONCLUSIONS: We found that patients had a knowledge about the impact of tobacco on oral health. Copyright:

INTRODUCTION

Any form of tobacco use is a major public health problem, over 1.1 billion people been addicted around the globe.[1] Tobacco kills more people each year more than any other major diseases. Tobacco use whether smoked or smokeless is associated with many other diseases, such as oral cancer, cardiac diseases, lung diseases as well as with many health problems. The use of tobacco is causing a heavy toll of deaths every year worldwide. Tobacco use has its detrimental impact on oral health. Tobacco causes oral health problems, ranging from life-threatening (precancerous changes leading to oral cancer) and serious (periodontal disease and teeth decay) to social (bad breath).[2] In recent years, oral cancer has become a common health hazard, with approximately 300378 new patients and 2.7 per 100000 mortality worldwide in 2012 and the incidence increased in young- and middle-age population groups.[3] Smoking is a known risk factor for many diseases, and increasing evidence suggests that smoking adversely affects periodontal health.[4] Hence, the objective of the study was to investigate the awareness about the effects of tobacco consumption on oral health among the patients visiting a dental college.

MATERIALS AND METHODS

This descriptive study was carried out among patients visiting a dental college. A self-structured questionnaire inquired participants' awareness about the effects of smoking on oral health. Those who were voluntarily ready for participation were included in the study. The significance of this study was explained in detail to all patients. They were also requested to respond in a complete bias-free manner. This study was conducted as a questionnaire study because we can get all the necessary information about personal perceptions and opinions, as well as it also enhances clarity. The questionnaire was given to 312 patients from which 297 patients came out with positive responses. The negative responses are mainly unwillingness to participate in the study. The questionnaire was regarding the patient's awareness regarding the impact of tobacco use on oral health. The information collected by the questionnaire included the demographic data such as gender and questions to assess ill effects of tobacco use and attitude toward it. The obtained data were tabulated, entered, and statistically evaluated using basic statistical analysis and using the Chi-square test. P < 0.05 was considered significant (P < 0.05).

RESULTS

Out of total of 297 patients participating in the study, 48 (16.2%) were female and 248 (83.8%) were male. The patients were categorized into different age groups [Table 1].

Table 1

Age groups of the study participants (n=297)

Age groups (years)	n (%)
18-25	102 (34.3)
26-33	57 (19.2)
34-41	59 (19.9)
42-49	36 (12.1)
50 and above	43 (14.5)

While 64.3% of the patients stated that they use toothpaste to brush their teeth, only 2% reported that they use Mishri to clean their teeth on daily bases. While 23.6% used Manjan, 5.7% used charcoal and 1% used neem stick as their tooth-cleaning method for daily routine. When asked about their awareness of smoking or tobacco chewing, causing cancer, around 90.8% knew that tobacco causes cancer. Most of the patients (72.3%) know that tobacco chewing causes dental problems. About 81.7% of the patients were aware that heart problems can be one of the ill effects of tobacco chewing, while 3.7% were still not sure about it. Nearly 87.8% of the patients believed that the stoppage of tobacco use habit can improve the overall health of the individual. When patients were asked about the interlink between smoking habit and tobacco chewing habit with their mental stress, 132 patients (44.6%) responded yes, while 157 (53%) responded they do not interlink their habit with their mental stress. The patients visiting the college were more proclined to tobacco chewing habit than smoking [Figure 1]. When the patients were asked about smoking or tobacco chewing habit, causing teeth to become sensitive or having pain, most of them responded positively [Figure 2]. Few patients have tried to stop or discontinue their habit earlier [Figure 3].

Figure 1

Form of tobacco use

Figure 2

Smoking or tobacco chewing habit, causing teeth to become sensitive or having pain

Figure 3

Stoppage of habit

Around 133 (44.8%) patients felt that they did not have any side effect after stopping tobacco use habit.

DISCUSSION

The study found that 32.6% of the patients were smokers. This finding is consistent with the results of a study conducted in Tabuk city, Saudi Arabia, that reported a smoking prevalence of 34% among male students.[5] The prevalence rate of smoking and chewing tobacco has found to be significantly high among males (83.8%) as compared to females (16.2%) in the present study which is comparable to the study done by Sarkar et al. where 21.5% of the women population either smoked or chewed tobacco.[6] Similar results were also found in the study done by Petkar et al.[7] where 92.8% of the tobacco users were male, while 7.2% were female. This could be due to that it is not seen socially acceptable for women to consume tobacco in any form, and the number of females participating was also less compare to males. In this study, 64.3% of the patients used toothpaste to brush their teeth, only 2% reported that they use Mishri to clean their teeth on daily bases, which means that patients had awareness about oral hygiene. Effective self-care oral hygiene practices such as toothbrushing and the use of interdental cleaning are the key means of preventing and controlling periodontal diseases.[8] The prevalence of tooth pain or sensitivity in the present study was high (50.2%). The finding is in accordance with the study by Patil et al., the mechanism through which tobacco causes tooth wear lesion may be through local frictional and vascular effects.[9] It was reported that patients attempted to stop smoking. O'loughlin et al. reported that 25% of the study participants were willing to quit smoking.[10] Marshall et al. revealed that 62.1% of high-school students were willing to stop smoking.[11] This study found that the 53% of the patients did not interlink the smoking habit and tobacco chewing habit with mental stress. The study by Chao et al. found that the association between cigarette smoking and total food craving was no longer significant after accounting for depression and stress, suggesting that depression and stress may account for the relationship between smoking and total food craving. The study also concluded that cigarette smokers, especially those with higher nicotine dependence, may have greater difficulties in addressing food craving and changing eating habits, particularly in the context of depression and stress.[12] The limitation of the study was that different age groups were not correlated. The attitude of the patients was not considered. The future study should provide more sessions of awareness about the adverse effects of smoking on oral health over a considerable period using a randomized controlled trial.

CONCLUSIONS

The study found that most of the patients were aware of the impact of tobacco consumption in any form that would affect the oral as well as the general health but may be due to patient compliance they were reluctant to stop the habit. Hence, smoking cessation campaigns should incorporate education of adverse effects of smoking on oral health in their programs. Dentists routinely come into contact with patients with tobacco use habit to provide the primary care in dental issues; they can contribute to tobacco control programs through a range of public health interventions to provide positive intervention among the patients to discontinue the habit of tobacco use by different methods.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.