This is due to the presence of some potent carcinogens in tobacco like nitrosamines, polycyclic aromatic hydrocarbons, and radiation-emitting polonium. The nitrosamines can be metabolized by target tissues to compounds that can modify cellular genetic material. It must be remembered that India is home to the maximum number of oral cancer cases in the world.
According to the International Union Against Tuberculosis and Lung Disease (The Union), tobacco control is a public health priority because tobacco kills more than 14,000 people each day – nearly 6 million people each year. Included in this death toll are some 600,000 non-smokers who are exposed to second-hand smoke. In 2004, children accounted for 31% of these deaths. Almost half of children regularly breathe air polluted by tobacco smoke. The Union highlighted that 63% of all deaths are caused by non-communicable diseases, for which tobacco use is one of the greatest risk factors.
Apart from oral cancer, the various ingredients in the various existing forms of chewable tobacco can cause a host of other diseases. They act as abrasives which erode the tooth enamel leading to hypersensitivity; a wad of tobacco kept in the mouth over long periods damages the periodontal tissues which, over a period of time, can damage the supporting bones; constant irritation may lead to injury of gums and subsequent recession leading to hypersensitivity to hot and cold. Compromised periodontal health in due course of time leads to loosening of the teeth and eventually their permanent loss.
Apart from oral cancer, the various ingredients in the various existing forms of chewable tobacco can cause a host of other diseases. They act as abrasives which erode the tooth enamel leading to hypersensitivity; a wad of tobacco kept in the mouth over long periods damages the periodontal tissues which, over a period of time, can damage the supporting bones; constant irritation may lead to injury of gums and subsequent recession leading to hypersensitivity to hot and cold. Compromised periodontal health in due course of time leads to loosening of the teeth and eventually their permanent loss.
Manufacturers add sugar to the various chewable products of tobacco in order to improve the taste. This sugar content acts as a substrate for the naturally occurring bacteria in the mouth leading to acid production which in turn leads to tooth decay. Long term use of tobacco leads to staining of teeth and tongue and results in bad breath. Tobacco consumption also alters our taste and smell sensations. It has been seen that habitual tobacco users start consuming more salt and sugar-- excess of both of which is harmful for the body.
In chronic tobacco chewers, the gums, cheeks and lips remain in constant contact with the irritants present in tobacco for prolonged periods of time leading to white patches with leathery looking wrinkled skins called Leukoplakia. This is actually a precancerous lesion, and in 3-5% of cases it results in cancer. Apart from the effects due to direct contact, smokeless tobacco contains a high concentration of various carcinogenic agents which increase the risk of cancers of the oral cavity, pharynx, larynx and oesophagus.
The early warning signs could be a lump or white patch in the mouth; a mouth sore that does not heal; a prolonged soreness/restricted feeling in the throat; restricted movement of the tongue or jaws; difficulty in chewing. Pain is rarely an early symptom. So one must not ignore any of these danger signals and seek immediate medical help. Of course, a better way would be to not let these problems occur in the first place, or else nip them in the bud.
So do not embark upon the dangerous and often fatal path of consuming tobacco in any form. If you have already succumbed to this vice, then quit now. Else it will be too late for yesterday is gone and tomorrow never comes.
Dr.Shivani Sharma
(Dr Shivani Sharma is a senior dental surgeon at One Stop Smile Shop, a faculty for Vote for Health campaign, and a former consultant of FORTIS Hospital, Navi Mumbai. She is an alumni of King George's Medical College (KGMC). Email: drshivani1477@gmail.com)
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