Publications

Given the many nicotine and tobacco products in use, studies of the interdependence of use patterns and transitions are needed.

Smokeless tobacco (SLT) is a tobacco-based product consumed without burning or smoking. Snuff, commonly known as naswar, is a widely used SLT product in Pakistan. This study is designed to investigate the concentrations of lead (Pb) and cadmium (Cd) in snuff and their associated health risks to consumers.

States adopt different tax bases for smokeless tobacco (SLT), making tax incidence on SLT not directly comparable across states. In addition, how taxes are passed through to SLT prices among states that impose specific taxes, and whether the pass-through rates for SLT are affected by the uptake and evolution of e-cigarettes, is unknown.

Smokeless Tobacco (SLT) use prevalence among youth in the United States (US) is comparable to youth prevalence of cigarette smoking. However, it is in general understudied compared to cigarettes and draws less attention nowadays compared to e-cigarettes (ECs).

The COVID-19 pandemic may have influenced alcohol and tobacco consumption in low-income and middle-income countries, yet the effects are relatively unknown. In this study, we estimated the medium-term effects of the pandemic on tobacco and alcohol consumption in India.

In cancer, chronic antigen stimulation drives effector T cells to exhaustion, limiting the efficacy of T cell therapies. Recent studies have demonstrated that epigenetic rewiring governs the transition of T cells from effector to exhausted states and makes a subset of exhausted T cells non-responsive to PD1 checkpoint blockade. Here, we describe an antigen-specific assay for T cell exhaustion that generates T cells phenotypically and transcriptionally similar to those found in human tumors. We perform a screen of human epigenetic regulators, identifying IKZF1 as a driver of T cell exhaustion. We determine that the IKZF1 degrader iberdomide prevents exhaustion by blocking chromatin remodeling at T cell effector enhancers and preserving the binding of AP-1, NF-κB, and NFAT. Thus, our study uncovers a role for IKZF1 as a driver of T cell exhaustion through epigenetic modulation, providing a rationale for the use of iberdomide in solid tumors to prevent T cell exhaustion.

The Global Adult Tobacco Survey (GATS) shows a drop in tobacco use worldwide. Despite the drop, there still continues to be a significant number of tobacco users in India. Research on tobacco use among young persons is commonly prioritised in India, while studies on tobacco use among middle-aged (45-59 years) and elderly (≥ 60 years) adults are noticeably lacking. We have conducted this study with objective to estimate the distribution, determinants and socioeconomic inequalities of smoking (SM) and smokeless tobacco (SLT) consumption across Indian states and union territories.

The present study revealed that various non-dietary items like pan masala, chewing tobacco, betel nuts, and toothpaste may contribute to the fluoride burden of the human body. In this line, an attempt was made to analyze the fluoride content of non-dietary items collected from Panipat City of Haryana. The study depicts that intake of pan masala, chewing tobacco, betel nuts, and toothpaste expose the consumers to 21.0 to 56.80, 18.00 to 36.20, 7.45 to 77.40, and 21.10 to 1118.20 µg fluoride/g respectively. The demand for these non-essential edible items is increasing daily, and people are unaware of the detrimental health effects of these products. The people of the study area are advised to prohibit these products as they contain an appreciable amount of fluoride.

Consuming products that contain smokeless tobacco or areca nut increases the risk of oral cancer. We aimed to estimate the burden of oral cancer attributable to smokeless tobacco or areca nut consumption globally and by type of smokeless tobacco or areca nut product in four major consuming countries.

Globally, besides being the second largest consumer of tobacco, India is also the second largest tobacco producer. There are very few studies that give data on economic burden of tobacco consumption. We estimated the prevalence of tobacco consumption along with monthly expenditure for the same among adult males. A community-based cross-sectional study was conducted among males aged ≥18 years residing in an urban area of Raipur city. Simple random sampling technique was applied and a total of 292 adult males participated in the study. Analysis was done on Statistical software package (STATA) software version 12. The mean age [standard deviation (SD)] was 41 (13) years. The prevalence of tobacco consumption (smoke and/or smokeless) was 73.6%, where use of smokeless tobacco was 60.6% and use of smoke tobacco was 33.6%. Beedi was the most common type of smoke used (11%), followed by a mix of cigarette and beedi (10.4%). Among occasional smokers, mean (SD) number of days of occasional smoking in a month was 7.8 (5.1) whereas among smokeless tobacco users, nearly 83% use them daily with 2-5 times in a day (66%). Nearly 67% of them had seen someone smoking and/or chewing tobacco in public places in the last 7 days. Mean [interquartile range (IQR)] monthly expenditure on tobacco products among study participants was INR 367 (0-355). Mean (IQR) monthly expenditure on smoking tobacco products and smokeless tobacco products was INR 244 (0-150) and INR 123 (0-225), respectively. This study gives insight to both consumer prospects about how much money they are spending on something that is going to harm in future (health problems due to tobacco use) and also to the policymakers of tobacco control programs to implement stringent rules on tobacco sale.

Patients with substance use disorders are common in general medical practice and are a major risk factor for several non-communicable diseases. Appropriate screening is a vital step for providing brief interventions which can provide a good opportunity to tackle this crisis and in achieving target 3.5 of the sustainable development goal which includes strengthening the prevention and treatment of substance abuse.

An estimated 78% of the total deaths attributable to smoking tobacco use occurred in low- and middle-income countries (LMICs) in 2019. In addition, smokeless tobacco increases the risk of all-cause mortality, all cancers including upper aero-digestive tract cancer, stomach cancer, ischaemic heart disease (IHD) and stroke; with 88% of the mortality burden being borne by the South-East Asian region. Evidence-based interventions from high income countries (HICs) are not easily transferable to LMICs, as patterns of tobacco use, health beliefs associated with tobacco use, and awareness of specific health risks vary substantially.

Tobacco quitline services offer telephone-based counseling to assist tobacco users in quitting through behavioral modification. It is a sponsored scheme by the Ministry of Health and Family Welfare, Government of India. The present study has two objectives: primarily, to study the correlation between socio-demographic variables and tobacco abuse, and secondly, to study the impact of National Tobacco Quit-Line Services (NTQLS) in India. The data for the study was collected from the registered callers who have completed at least one year of follow-ups at NTQLS, Vallabhbhai Patel Chest Institute, University of Delhi, between May 2016 and May 2021. The questionnaire was directly administered to the people who had called NTQLS for the first time to quit tobacco use. Callers were provided one year of continuous follow-up to ensure they remain long-term abstinent from tobacco and permanently quit. All the data were managed through an electronic database. A total of 85,807 individuals' data was taken for the study. The maximum number of callers were from Uttar Pradesh (28.03%), followed by Rajasthan (24.67%) and Madhya Pradesh (7.59%). The female population represented only 1.43%; the male population was significantly higher (98.57%). Youth (44.83%) and adults (53.78%) were more than seniors (0.9%) and adolescents (0.4%). Smokeless tobacco users (67.32%) were more common than smoking tobacco users (20.11%). Duration of tobacco use among the 71.74% of callers was found to be between 1 and 10 years; the remaining 24.03% had been using tobacco for over 10 years, while 4.23% were novice users. The abstinence rate achieved by NTQLS was 33.42% after one month of quitting and 21.91% after one year of quitting. We found a significant association between tobacco users' socioeconomic and demographic status. The number of male tobacco users was significantly higher than the number of female tobacco users. Among all the tobacco users, youth was persistently using tobacco the most. Individuals from low socio-economic status were more likely to use tobacco as compared to those from high socioeconomic status. These associations indicate the need for strengthening the enforcement of tobacco control policies and developing and monitoring comprehensive smoke-free legislation.

India has the highest incidence worldwide of smokeless tobacco (SLT)-associated oral cancer, accounting for nearly 70% of all SLT users globally. Nicotine and tobacco-specific -nitrosamines (TSNA) play critical roles in the addictive and carcinogenic potential, respectively, of SLT products. Our group has previously reported substantial variability in nicotine and TSNA levels across a small SLT product sample in India, calling for systematic surveillance. However, there is no information available on the current levels of these constituents in Indian SLT.

Underweight is a prevalent condition among older adults in developing countries and poses a substantial burden on health, social, and aged-care systems. In this study, we examined the influence of tobacco use and food insecurity on the risk of being underweight among adults aged 60 or older in India.

India bears the highest global burden of oral cancer, despite having an operational tobacco cessation framework. Occupational groups like solid waste management personnel face significant health challenges due to prevalent tobacco use, leading to oral potentially malignant lesions and oral cancer. Enhanced tobacco control strategies are essential for these groups.

Transcranial direct current stimulation (tDCS) targeting Broca's area has shown promise for augmenting language production in post-stroke aphasia (PSA). However, previous research has been limited by small sample sizes and inconsistent outcomes. This study employed a double-blind, parallel, randomized, controlled design to evaluate the efficacy of anodal Broca's tDCS, paired with 20-minute speech and language therapy (SLT) focused primarily on expressive language, across 5 daily sessions in 45 chronic PSA patients. Utilizing the Western Aphasia Battery-Revised, which assesses a spectrum of linguistic abilities, we measured changes in both expressive and receptive language skills before and after intervention. The tDCS group demonstrated significant improvements over sham in aphasia quotient, auditory verbal comprehension, and spontaneous speech. Notably, tDCS improved both expressive and receptive domains, whereas sham only benefited expression. These results underscore the broader linguistic benefits of Broca's area stimulation and support the integration of tDCS with SLT to advance aphasia rehabilitation.

Introduction Tobacco consumption is a significant public health threat worldwide and a looming pandemic. World Health Organization data display that about five million people face premature death per year worldwide due to tobacco use. India is a leading nation among tobacco users in this regard. The aim of the present study was to determine the most prevalent tobacco consumption habit and the oral potentially malignant disorders (OPMDs) found in such users with an assessment of awareness and change in various habits. Material and methods A cross-sectional study over a duration of six months was carried out, in which every patient visiting the hospital OPD was assessed and evaluated for tobacco-related habits. A detailed history of the duration and frequency of the habit, the type of tobacco product consumed, and the predominant reason for its consumption among males and females were recorded and evaluated. An oral examination was performed to determine the evidence of OPMDs. Subjects under the age of 13 years and with systemic/metabolic disorders with oral manifestations were excluded from the study. Data obtained were subjected to statistical analysis using Stata Statistical Software, version 13.1 for Windows (released 2013 StataCorp LLC, College Station, TX). Results Data revealed a higher prevalence of tobacco consumption in males, with chewing tobacco followed by smoking and a mixed form of habit being predominant. Misri chewing was most common in females. Subjects in the 20-50 years age group were most commonly affected, with tobacco pouch keratosis being the most prevalent lesion followed by leukoplakia, with stress being a major causative factor for tobacco consumption. Conclusion The present study promulgated the prevalence of OPMDs in consumers of various kinds of tobacco products, which is highly valuable in the early detection of OPMDs. OPMDs remain unnoticed until advanced stages due to their asymptomatic or mildly symptomatic nature and due to a relative lack of awareness about the deleterious effects of tobacco usage despite an upsurge in tobacco cessation-related content on digital media. Thus, healthcare sector professionals can be appropriately guided to ensure efficient patient care at an early stage.

Chronic arsenic exposure can lead to various health issues, including cancer. Concerns have been mounting about the enhancement of arsenic toxicity through co-exposure to various prevalent lifestyle habits. Smokeless tobacco products are commonly consumed in South Asian countries, where their use frequently co-occurs with exposure to arsenic from contaminated groundwater. To decipher the molecular and cellular responses to arsenic and/or smokeless tobacco, we performed temporal multi-omics analysis of the transcriptome and DNA methylome remodelling in exposed hTERT-immortalized human normal oral keratinocytes (NOK), as well as arsenic and/or smokeless tobacco genotoxicity and mutagenicity investigations in NOK cells and in human p53 knock-in murine embryonic fibroblasts (Hupki MEF). RNAseq results from acute exposures to arsenic alone and in combination with smokeless tobacco extract revealed upregulation of genes with roles in cell cycle changes, apoptosis and inflammation responses. This was in keeping with global DNA hypomethylation affecting genes involved in the same processes in response to chronic treatment in NOK cells. At the phenotypic level, we observed a dose-dependent decrease in NOK cell viability, induction of DNA damage, cell cycle changes and increased apoptosis, with the most pronounced effects observed under arsenic and SLT co-exposure conditions. Live-cell imaging experiments indicated that the DNA damage likely resulted from induction of apoptosis, an observation validated by a lack of exome-wide mutagenesis in response to chronic exposure to arsenic and/or smokeless tobacco. In sum, our integrative omics study provides novel insights into the acute and chronic responses to arsenic and smokeless tobacco (co-)exposure, with both types of responses converging on several key mechanisms associated with cancer hallmark processes. The generated rich catalogue of molecular programs in oral cells regulated by arsenic and smokeless tobacco (co-)exposure may provide bases for future development of biomarkers for use in molecular epidemiology studies of exposed populations at risk of developing oral cancer.

In India, tobacco (nicotine) addiction among youth has increased, leading to substantial socioeconomic burdens, mortality, and morbidity. While minimal short-term nicotine consumption may have antioxidant effects, chronic exposure results in various adverse health outcomes. This study examines the impact of chronic nicotine consumption on cellular oxidative stress and psychological stress, and their correlation with Homocysteine (Hcy) levels in unemployed tobacco consumers. This case-control study included 156 healthy, educated, unemployed male volunteers aged 20-40 years, divided into nicotine-addicted (n = 80) and non-addicted (n = 76) groups. Psychological stress was assessed using perceived stress scales (PSS) and coping self-efficacy (CSE) scales. Oxidative stress markers, including Malondialdehyde (MDA), Superoxide Dismutase (SOD), and Catalase, were measured. Hcy levels were quantified using high-performance liquid chromatography (HPLC). Nicotine-addicted participants exhibited significantly higher perceived stress (p = 0.0001) and lower coping self-efficacy (p = 0.0001) compared to non-addicted individuals. MDA levels in erythrocytes were significantly increased (p = 0.0006), while SOD (p = 0.0001) and Catalase (p = 0.02) activities were significantly decreased in the addicted group. Nicotine intake influenced Hcy concentrations, with 55% of addicted individuals falling into moderate, 27.5% into intermediate, and 7.5% into severe Hcy categories. Chronic nicotine intake also reflected the hematological parameters (WBCs, RBCs, HGB, and Platelets). Chronic tobacco consumption induces oxidative stress and perceived psychological stress, leading to elevated Hcy levels in nicotine consumers. The study highlights the detrimental effects of nicotine addiction on cellular defensive mechanisms, emphasizing the need for targeted interventions to address this growing health issue among unemployed Indian youth.

Tobacco addiction is an important public health problem. Among several theories of addiction proposed, PRIME theory of motivation is found to be a comprehensive one to synthesise prevention strategies.

South Asia and Southeast Asia account for more than 40% of the global stroke burden, with differences in stroke risk factors, mortality, and outcomes compared to high-income countries. Sociocultural norms compound the preexisting biological risk differences, resulting in a disproportionate burden of stroke in women in this region. This review summarizes the sex and gender differences across the stroke care continuum in South Asia and Southeast Asia over the past 20 years.

Background Smokeless tobacco (SLT) use, particularly gutkha, is prevalent in India, with cultural acceptance contributing to widespread use, especially among tribal populations. Despite awareness programs, there is limited assessment of their effectiveness, leading to continued vulnerability, even among educated groups. This study aims to evaluate public health strategies by developing and validating the SLT Awareness, Attitude, and Response Knowledge (STAARK) scale, which assesses knowledge and attitudes post-awareness programs on SLT usage through questionnaires, identifying vulnerable individuals, and enabling targeted interventions to reduce SLT use and associated health risks, particularly through integrated risk assessment (IRA). Methods This study was performed during an SLT awareness program in Nagaland, utilizing a comprehensive survey to assess participants' demographics, knowledge, and attitudes. The STAARK score was calculated by combining normalized attitude and knowledge scores, ranging from 0 to 10, categorizing participants' comprehension and attitudes toward SLT usage awareness. The obtained scores were assessed twice for consistency evaluation of the scale, and vulnerable individuals were subjected to IRA for targeted intervention recommendations. Reliability and correlation analyses were performed, with Cronbach's alpha validating the scale's internal consistency. Results About 182 participants took up the assessment, with only 180 completing the survey among the population attending the awareness program. Demographic data revealed a diverse participant group, with ages ranging from 13 to 42 years. The survey assessed participants' knowledge and attitudes toward SLT, scoring them on a 0-10 scale for knowledge and a 10-60 scale for attitude. The STAARK scale was developed to combine these scores, providing a comprehensive measure of participants' understanding and attitudes toward SLT. The mean STAARK score was 5.27 with an observed lower limit of 2.40 and an upper limit of 6.50 in the responded population. Reliability testing using Cronbach's alpha showed acceptable internal consistency, though attitude had a weaker correlation with the overall STAARK score compared to knowledge. In a follow-up assessment with 88 participants, the STAARK score averaged 5.10, reinforcing the initial findings. The risk assessment of 17 participants with STAARK scores above six identified varying levels of risk, with most falling into the low- or moderate-risk categories. The study highlights the importance of targeted interventions to address SLT usage, particularly in populations with lenient attitudes toward its consumption. Conclusions The STAARK scale can serve as a key tool for evaluating SLT awareness programs by assessing participants' knowledge and attitudes and identifying high-risk individuals requiring personalized interventions for SLT usage cessation. It standardizes the assessment, enabling comparison across groups and times, and helps identify individuals with lenient attitudes toward SLT for targeted interventions. Its reliability ensures consistency, and by tracking changes in scores before and after programs, it assesses impact and guides future improvements. The STAARK scale is crucial for personalized, evidence-based public health efforts to reduce SLT use. However, eradicating SLT requires ongoing commitment, adaptability, and a focus on long-term outcomes to translate knowledge into lasting change.

South Asia and Southeast Asia are the regions with relatively high and increased disease burden of oral cancer. The purpose of this study was to analyze the scientometric characteristics of oral cancer research in these regions.

Health warning labels (HWLs) are one of the key strategies for tobacco control. The current study assessed the individual characteristics affecting the noticeability of HWLs and the thought of quitting smokeless tobacco (SLT) on noticing HWLs. We further estimated the temporal changes in noticeability and thought of quitting after noticing HWLs over time in India.

Oral cancer is the most common malignancy in many developing countries, such as India, due to increased consumption of smokeless tobacco. The trace elemental components in commercially packaged forms of tobacco can play a significant role in the pathogenesis of oral cancer. To qualitatively assess the trace elements in various types of commercially packaged forms of tobacco using laser-induced breakdown spectroscopy (LIBS). Two popular varieties of 'Paan masala' that contained a mixture of slaked lime with areca nut, catechu, and other flavouring agents (tobacco was absent) and four types of packaged tobacco were obtained from 'Paan' shops. The contents in the packets were made into pellets using a hydraulic press and subjected to elemental analysis using LIBS. A ten-trial experiment was carried out on all six pellets. The National Institute of Standards and Technology (NIST) database was used to assess the emission lines. The elements obtained from commercially packaged tobacco and Paan masala were similar: calcium (Ca), iron (Fe), aluminium (Al), nickel (Ni), and chromium (Cr). Substances that cause DNA damage and carcinogenesis are inorganic elements such as nickel. Our study revealed that carcinogens such as nickel are present in the commercially packaged forms of tobacco and 'Paan masala' samples.

Public policy measures aimed at regulating tobacco use should consider the net gains for the nation, as the tobacco sector contributes to employment and tax revenue while also imposing substantial economic burden on the country. This study investigates the economy-wide impact of reducing tobacco consumption in India through the implementation of fiscal measures.

Anti-tobacco mass-media campaigns are an integral part of tobacco control. There is still a need to understand which mode of mass-media channels aids in promoting tobacco cessation. This study aimed to examine if exposure to anti-tobacco messages delivered through different media channels is associated with tobacco user's thoughts and attempts to quit.

Bacteriophages have evolved different mechanisms of infection and penetration of bacterial cell walls. In Siphoviridae-like viruses, the inner tail proteins have a pivotal role in these processes and often encode lytic protein domains which increase infection efficiency. A soluble lytic transglycosylase (SLT) domain was identified in the minor tail protein gp15 from the BFK20 bacteriophage. Six fragments containing this SLT domain with adjacent regions of different lengths were cloned, expressed and purified. The biophysical properties of the two best expressing fragments were characterized by nanoDSF and CD spectroscopy, which showed that both fragments had a high refolding ability of 90 %. 3D modeling indicated that the bacteriophage BFK20 SLT domain is structurally similar to lysozyme. The degradation activity of these SLT proteins was evaluated using a lysozyme activity assay. BFK20 might use its transglycosylase activity to allow efficient phage DNA entry into the host cell by degrading bacterial peptidoglycan.

Oral cavity cancer is a growing concern, especially in developing countries like India, due to risk factors such as tobacco use, alcohol consumption, nutritional deficiencies, and spicy food intake. Early detection through screening and Mouth Self-examination (MSE) can significantly improve outcomes, but limited awareness and pain in advanced stages lead to delayed detection. This study aimed to assess the knowledge and practice of MSE among tobacco users in urban and rural populations.

Introduction The widespread use of tobacco is a major global health threat, causing significant morbidity and mortality. The World Health Organization (WHO) estimates that annually, millions of people die prematurely due to tobacco use, with this number projected to increase significantly in the future. Developing countries, including India, bear a substantial burden of tobacco-related deaths, often beginning during adolescence. This study estimated the prevalence of tobacco use among adolescents in the 13-19 years age group, identified the types of tobacco products used, explored the reasons for initiation, and examined the influence of family, peers, and socio-demographic factors on tobacco use. Methods A community-based cross-sectional study was conducted from August 2022 to June 2024 in a medical college's urban and rural field practice areas in Pune district, Maharashtra. A total of 310 adolescents were surveyed using convenience sampling. Data were collected using a pre-designed, pre-tested questionnaire, and statistical analysis was performed using Jamovi software version 2.3.28. Chi-square and Fisher's exact tests were applied to assess associations between variables. Results Out of 310 participants, 94 (30.32%, 95% CI: 25.25%-35.77%) reported using tobacco. Among these 94 participants, 82 (87.23%) used smokeless tobacco, 19 (20.21%) used the smoked form of tobacco, and seven (7.45%) used both forms. The mean age of initiation was 15.94 years for smoking and 15.59 years for smokeless tobacco. The data indicate a higher percentage of tobacco use among females (50%) compared to males (24.8%). However, in terms of absolute numbers, more males (60) than females (34) reported using tobacco due to the larger number of males in the study sample. The most common reasons for initiation included curiosity (43.74%) and peer pressure (53.99%). Specifically, 49 individuals (42.6%) aged 13-15 were using tobacco, compared to 23 individuals (30.3%) aged 16-17, and only 22 individuals (18.5%) aged 18-19. Participants from urban areas reported higher tobacco use (48%) compared to those from rural areas (46.7%). Among those from joint families, about 24 (31.6%) reported tobacco use, while in nuclear families, it was slightly lower at about 70 (29.9%). Conclusion Factors such as peer pressure and curiosity played significant roles in the initiation of tobacco use, with more than half of the participants citing peer influence as the primary reason for starting. This study revealed differences in tobacco usage patterns across age groups, with younger participants showing higher usage rates. The findings highlight the need for targeted interventions, such as health education and anti-tobacco media campaigns, to reduce tobacco use among adolescents.

Background The prevalence of smokeless tobacco (SLT) use among Indian women, particularly those from lower socioeconomic backgrounds with little access to formal education, has been steadily increasing, which is a cause for concern. Women frequently use various forms and companies of powdered, rubbed, and chewed SLT, with or without betelnut and flavorings, often simultaneously, starting at an early age and persisting into their reproductive years. Consequently, they are vulnerable to both the chance of developing cancer and experiencing health issues during pregnancy and childbirth. The purpose of the study was to assess the prevalence of women using SLT and the factors that were linked to these outcomes. Methodology The community-based analytical, cross-sectional study was carried out for four months (February-May 2024) in the selected rural areas of Kolar district, Karnataka, India. Women aged 15 years and above who lived in the selected rural areas of Kolar district as permanent residents and had a history of nicotine use were included. Women using smoked forms of tobacco and bedridden or terminally ill cancer patients were excluded from the study. An interviewer administered a semistructured interview schedule to collect data. The questionnaire included sections on sociodemographic characteristics (age, education, occupation, marital status, socioeconomic status, and type of family), nicotine use patterns (types of SLT/nicotine products used and mode of use), maternal history, menstrual history, alcohol consumption history, morbidity conditions, and nicotine dependence, which were assessed by Fagerstrom Test for Nicotine Dependence (FTND). Results The participants, 92 women, ranged in age from 15 to 80 years old, with a mean age of 41.2 years. Most of the participants were diagnosed with oral cancer (n = 19, 20.7%), followed by esophageal cancer (n = 13, 14.1%). When participants were enquired about the mode of usage of tobacco, most of them used chewable form (n = 43, 46.7%). When dependence was assessed by the Fagerstrom nicotine dependence scale, high dependence was observed in 83.7% of women (n = 77), whereas low-to-moderate dependence was observed in 16.3% of women (n = 15). Among the 92 participants, only 16 participants (17.3%) made attempts to quit using SLT. The sociodemographic factors associated with nicotine dependence included age between 41 and 60 years, illiteracy, lower economic status, widowhood, unmarried status, unemployment, Hindu by religion, nuclear family, non-alcoholic, irregular menstrual cycles, and significant maternal history (P-value less than 0.05). Conclusion The development of tailored interventions that address the specific needs of illiterate, unemployed, lower-class, and unmarried women in nuclear families was observed. These interventions should incorporate mental health screening, psychoeducation, and community-based support to promote cessation of SLT and improve their overall well-being.

The aim of the study was to assess the prevalence of quid-induced oral mucosal lesion (QIOML) among the population in Jodhpur, western Rajasthan, and to ascertain if they are associated with chewing tobacco, arecanut, or both tobacco and arecanut.

The aim of the study was to determine the prevalence of oral potentially malignant disorders (OPMDs) among individuals in the northern population of India who have a habit of using tobacco.

Little information exists about the association between alcohol and tobacco use and self-reported depressed mood, such as feeling sad, blue, or depressed days (SBDD), among older adults in India.

Smokeless tobacco (SLT) use is a phenomenon that is detrimental to the health of adults worldwide and dramatically impacts the health of resettled populations. The prevalence of SLT has exponentially grown as a public health threat for the refugee and immigrant populations and is worthy of addressing. This research study examined the SLT cultural drivers of the Texas immigrant and refugee community, which led to their knowledge, perception, awareness, and cessation practices.

Tobacco use among adolescents and young women is a global health concern. This study investigates the prevalence and determinants of tobacco use among adolescents and young women in India.

The AZFc partial deletions of Y chromosome and lifestyle/epidemiological factors such as the use of smokeless chewing tobacco (SCT) exhibit intriguing variations in their association with male infertility across the population, ethnicity, and genetic background. Here, a pioneering attempt has been made to elucidate the interactions of such deletions with the habits of SCT consumption among the participating individuals, using their large epidemiological data. This screening program was conducted among Bengali-speaking men in West Bengal, India. We screened the prevalence and association of distinct partial deletions (gr/gr, b1/b3, and b2/b3) of the AZFc region using locus-specific sequence-tagged site (STS) markers among 728 case subjects and compared them with 264 ethnicity- and age-matched proven-fertile control men. The recorded epidemiological data of the study group and the outcome of partial deletion analysis were compiled to frame the plausible Gene × Epidemiological factor (G × E) interactions. The gr/gr deletion was reported to be significantly associated with azoospermic ( = .0015, odds ratio [OR] = 3.413) and oligozoospermic ( = .0382, OR = 3.012) case subgroups, and b1/b3 deletions were also detected among the infertile persons only. The G × E model revealed that men who carried microdeletions as well as were SCT users had an elevated risk of infertility ( = .002, OR = 6.38). The study highlights the fact that AZFc partial deletions and SCT, when co-occurred, synergistically increase the risk of infertility among men. This work helps to get more insight into the etiology of male infertility in the light of gene-environmental interaction.

Tobacco consumption is associated with an increased risk of morbidity and mortality. India is one of the largest consumers of tobacco worldwide. We assessed the trend of tobacco use among Indian males over a period of 20 years using data obtained from four rounds of the National Family Health Survey (NFHS).

There have been significant changes in the lifestyles of individuals in the past few decades, which has led to increased morbidity and mortality worldwide. Both smoking and chewing forms of tobacco are highly prevalent, especially in India, and are implicated as causes of diseases, including oropharyngeal carcinomas. Effective tobacco cessation techniques and sources can help overcome addiction and reduce the disease burden in society. The aim was to evaluate the quality and readability of contents of various sources on an internet website about tobacco cessation.

Most of the world's 300 million smokeless tobacco (ST) users live in South Asia but ST policies for that region are poorly researched, developed and implemented. Longitudinal studies to understand the uptake and use of ST and smoking, and influences on these, such as health promotion strategies, are lacking. We planned to conduct longitudinal surveys among secondary school students in three countries with the highest ST burden: Bangladesh, India and Pakistan to explore ST and smoking uptake, use and health promoting strategies. Before running that longitudinal study, we assessed the feasibility of conducting such a multi country survey using a mixed-methods design. The survey (and feasibility study) was conducted in 24 secondary schools (eight per country, three classes per school). Three data sources, researcher records/fieldnotes, survey data of 1179 students, and interview/focus group discussion data from 24 headteachers, 64 teachers and 76 students, were used to understand the feasibility of three study tasks: 1) selecting, recruiting, and retaining schools and student participants; 2) survey administration; and 3) robustness of the data collection instruments. The datasets were analysed separately and triangulated. Overall, we could select and recruit schools and students using consistent methods across countries although recruitment was challenged by securing higher authority permissions and parental consent. Recommended improvements were for permission/consent processes. Survey administration was generally feasible and acceptable with recommendations for scheduling and researcher-student ratios. Questionnaire completion was 83%-100% across countries, with suggestions to improve readability and understanding, addressing students' queries and questionnaire simplification. Due to COVID-19, we could not conduct follow-up surveys, so were unable to assess school or student retention. In conclusion, incorporating the lessons learnt from this study would improve the feasibility of conducting such a multi-country survey in the future. Reported benefits included increasing tobacco health risks' knowledge with potential for increased tobacco control support.

Hospitalization provides a key opportunity to address tobacco use. Few studies have examined cessation treatment in hospitals in low- and middle-income countries (LMIC). We aimed to measure tobacco abstinence among individuals discharged from a Mumbai hospital after the implementation of cessation counseling compared to abstinence among those discharged pre-implementation.

The Government of India established National Tobacco Quitline Services (NTQLS) to provide free and effective telephonic counselling to help people quit tobacco. The objective of the paper is to present the data of tobacco quitters who quit tobacco through NTQLS, Mumbai, in the years 2021-2022 and the factors that influenced tobacco quitting. This is a prospective study where individuals willing to quit tobacco utilised NTQLS. Effective counselling was provided and was followed up. Multiple logistic regression analysis was conducted. Tobacco quitting is the dependent variable while sociodemographic characteristics, tobacco consumption habits, previous quit attempts, alcohol consumption, other substance use and co-morbidity were independent variables. In the years 2021-2022, a total of 448,893 calls hit the system. Of these, 127,163 (28.3%) calls were attended. Of the attended calls, a quit date was set for 21,504 calls (16.9%); of these, 8,276 (38.5%) callers quit tobacco. Individuals with no previous quit attempts [OR: 1.48, 95% confidence interval (CI): 1.25-1.75], never consumed alcohol (OR: 1.37, 95%CI: 1.2-1.56), consumed tobacco within 6-30 minutes (OR: 1.29, 95% CI: 1.12-1.49) and 30-60 minutes after waking up (OR: 1.26, 95% CI: 1.05-1.51) had higher quitting rates. While, female callers (OR: 0.59, 95% CI: 0.35-0.99), private sector workers (OR: 0.70, 95% CI: 0.61-0.81), individuals consuming more than ten tobacco units/packets (OR: 0.70, 95% CI: 0.61-0.79), tobacco use more than 10 years (OR: 0.85, 95% CI: 0.73-0.97), expenditure of more than 5,000 rupees on tobacco (OR: 0.58, 95% CI: 0.44-0.77) and those with no known co-morbid conditions (OR: 0.8, 95% CI: 0.71-0.91) were less likely to quit tobacco. Reduced tobacco consumption will inadvertently reduce the non-communicable disease (NCD) burden and help in achieving the sustainable development goals related to tobacco control and NCD. Quitline plays an important role in tobacco control.

There is a well-established link between the use of smokeless tobacco (ST) and the development of oral cancer. This study was conducted to evaluate the impact of tobacco use, quid use, and other adverse habits related to smoking and alcohol consumption on ST-induced localized lesions.