A preliminary study on factors affecting betel quid chewing, smoking and alcohol use, following diagnosis of potentially malignant oral disorders and oral cancer

Abstract

Betel quid (BQ) chewing, smoking and alcohol use are known risk factors of oral potentially malignant disorders (OPMDs) and oral cancer. This study aimed to determine key factors for quitting or continuing these habits after diagnosis of such oral lesions. A cross sectional study was conducted among 50 participants who had risk habits diagnosed with OPMDs or oral cancer. A questionnaire validated in Sinhalese was used to gather information on dependence to risk habits. The sample consisted of a majority (82%) of males and >90% were from a low socio-economic background. A nearly equal age distribution of ≤60 years (44%) and >60 years (56%) were observed. 34% of them had all risk habits and when analyzed separately 82%, 58% and 56% had BQ, smoking and alcohol use respectively. Majority of BQ (93%) and alcohol users (79%) were dependent while only 14% of smokers were dependent on the habit. 34% of the sample had developed OPMDs while 66% were diagnosed with oral cancer. It revealed that after diagnosis of oral lesions, a significant (p<0.05) majority quit their habits; BQ (75%), smoking (79%), alcohol (68%) mainly due to factors like fear of death (BQ-35%; smoking-10%; alcohol-21%), pain and discomfort (BQ-29%; smoking-24%; alcohol- 26%), medical interventions (BQ-10%; smoking-22%; alcohol-11%) and presence of other co-morbidities (BQ-13%; smoking-14%; alcohol-16%). However, out of 10, 6 and 9 persons who continued BQ, smoking and alcohol use, 20% (2), 34% (2) and 78% (7) of BQ, smoking and alcohol users respectively were occasional users while the rest were extremely addicted daily users. Key factors for habit cessation after diagnosis of OPMDs or oral cancer include fear of death and pain/discomfort which can be emphasized through prevention programs, even prior to development of such oral lesions in those with risk habits.