REVERSE SMOKING AS A RISK FACTOR FOR PALATAL CANCER - A CROSS-SECTIONAL STUDY IN RURAL ANDHRA-PRADESH, INDIA

A cross-sectional study of reverse smoking and its association with pr e-malignant and malignant lesions of the palate was conducted in the n orth coastal areas of Andhra Pradesh, India. A total of 480 randomly s elected persons were interviewed. Information about smoking status, di et and access to mass media was obtained in each case and an examinati on of the oral cavity was performed. Reverse smoking of chutta was pra ctised by 33% of the total rural population. The prevalence rate of al l palatal lesions was 55%. The prevalence rates of the separate lesion s: leukoplakia palatii, palatal keratosis and palatal cancer, were 9.8 %, 18.1% and 1.9%, respectively. The presence of these (pre-)malignant lesions was strongly associated with reverse smoking and also associa ted with conventional chutta smoking. Reverse smoking induced signific antly more lesions than conventional chutta smoking, and was a major d eterminant of subsequent palatal cancer: all 9 newly diagnosed palatal cancers were observed within the group of reverse smokers. There was an inverse relationship between the incidence of palatal lesions and v itamin A intake. The study of access to mass media indicated that the most favourable medium for promoting a prevention campaign would be th e cinema. (C) 1993 Wiley-Liss, Inc.