Oral Quality of Life in Tobacco Users: Need of a Newer Perspective

Dear Editor, This is in relation to the article titled “To Assess the Impact of Oral Quality of Life (QoL) in Teenage Population with Habit History of Tobacco/Areca Nut/Gutka/Smoking Using OHIP14 in Bhilai Region” in your esteemed journal.[1] The authors have ably highlighted the role of an often-neglected aspect related to oral health, i.e. quality of life. However, there are a few aspects which mandate further exploration to develop a better understanding of the subject. As stated in the title, the study focused on assessing the impact of oral QoL in teenage population with habit history. However, there are no longitudinal data mentioned in the study which underlines that the recording of QoL had any impact on the studied population. Was there any change in the perception or behavior of the participants post due to this? Unless there is a prospective follow-up, it is very difficult to ascertain the impact of oral QoL. If we come to the objective of the study mentioned, it is “to assess the current level of awareness of oral health related QoL” which reflects the essence of the work done. Authors inferred that higher numbers of negative social impact were present in the study group. This is a very interesting finding which underlines the relationship between oral health conditions and QoL. It is also to be noted that this relationship cannot be analyzed in a unidirectional way considering the multidirectional nature of QOL. It is possible that in some patients, this association could be the other way round and people with negative social impacts may get more habituated to the deleterious habits. It has also been indicated in the past research that low QoL may be associated with higher odds of initiation of deleterious habits.[2] In addition, the presence of associated factors such as age, gender, and educational status cannot be overlooked. It has also been reported that the QoL instruments are widely applicable and facilitates the researchers to compare QoL between healthy and sick individuals across different social and cultural backgrounds. On the flipside, these instruments are not sensitive to the specific aspect of QoL related to particular morbidity. This fact must be kept in mind while assessing the correlation between and morbidity such as oral lesions or tissue abuse habits and QoL.[3] In addition, given the multiple medical, psychological, and social needs that low income and underprivileged tobacco users face, we also need to further explore the factors that induce smoking or use of tobacco in them.[4] The group of participants studied by the authors are also a socially vulnerable age group, considering the various physical, hormonal, social, and behavioral changes that they go through and the inducting factors towards their habituation of tobacco must be analyzed. These further needs deeper understanding of psychological status and behavior of tobacco users amongst all age groups. In the present article at three different points (title, objective, and discussion), mention of impact, awareness, and effect of oral QoL in the study group has been done adding to the conundrum regarding the exact research questionary. However, it must be appreciated that the authors emphasized the need of intervention programs to discourage the use of tobacco, gutka, and other deleterious habits. We recommend that psychological assessment and assistance shall also be made a part of this initiative to understand the root causes of initiation of these habits as well as the management, especially in socially vulnerable groups such as teenagers. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.