Impact of Tobacco Smoking, Chewing, and Mixed Habits on the Prevalence of Oral Mucosal Lesions in Dental Patients

Objective: This study aimed to evaluate the prevalence and distribution of oral mucosal lesions in dental patients with tobacco habits and compare them to a control group without such habits. Study design: Cross-sectional study. Place and Duration of Study: Department of Oral Medicine, Khyber College of Dentistry, Peshawar; January 2023 to June 2023. Material and Methods: The sample consisted of 746 dental patients, with 596 tobacco users (chewing, smoking, or both) and 150 non-users. Clinical, demographic, and smoking data were recorded. The frequency of oral mucosal lesions was analyzed based on tobacco usage type, lesion nature, and anatomical distribution. Logistic regression was used to identify factors linked to lesion development Results: Tobacco users exhibited a significantly higher prevalence of oral mucosal lesions (86.6% vs. 20.7% in the control group). Common lesions in tobacco users included smoker's palate (16.8%), oral submucous fibrosis (OSMF) (17.4%), and leukoplakia (14.1%). Chewing tobacco was linked to hyperkeratosis and OSMF, while smoking was associated with leukoplakia, smoker's palate, and smoker's melanosis. Mixed users had a combination of lesions. The likelihood of lesion development was higher in males (OR = 1.4, p = 0.008), those with a longer smoking duration (>20 years) (OR = 4.75, p < 0.001), and frequent smokers (≥10 times/day) (OR = 3.6, p < 0.001). Conclusion: Tobacco use is strongly associated with oral mucosal lesions. Public health initiatives should focus on reducing tobacco-related oral health issues, alongside regular screenings to detect early mucosal changes.