Cytological Changes in Buccal Mucosa Among Yemeni Qat Chewers in Hadhramout Governorate: A Comparative Cross-Sectional Study

Qat (Catha edulis) chewing is a common practice in Yemen, associated with oral mucosal irritation. The objective of the current study is to compare cytological findings of buccal mucosa between Qat chewers and non-chewers. A comparative cross-sectional study was designed. Buccal smears were collected from chewers (n = 100) and non-chewers (n = 100), fixed, and stained with Harris hematoxylin staining. Smears were assessed for inflammatory changes and cytological atypia by two blinded examiners; disagreements were resolved by consensus. The inflammatory cells were observed in 21% of chewers compared to 8% of controls (P = 0.009), while atypical cytological changes were present in 16% of chewers and absent in controls (P < 0.001). Longer duration of chewing correlated with increased inflammatory and atypical findings (P = 0.003 and P = 0.010, respectively), while weekly frequency showed no significant association. The statistical values presented reflect the original complete dataset analyzed at the time of study completion. The present revision focuses on clarifying the interpretation of association patterns, consistent with the study’s cross-sectional design. Qat chewing is associated with increased inflammatory and cytological atypical changes in the buccal mucosa. These findings reflect correlations rather than causation.