Introduction. Smokeless tobacco is considered one of the major risk factors for oral cancer. It is estimated that over 90%of the global\nsmokeless tobacco use burden is in South Asia. This paper aims to systematically review publications reporting epidemiological\nobservational studies published in South Asia from 1984 till 2013. Methods. An electronic search in ââ?¬Å?Medlineââ?¬Â and ââ?¬Å?ISI Web of\nKnowledgeââ?¬Â yielded 734 publications out of which 21 were included in this review. All publications were assessed for quality using a\nstandard quality assessment tool. Effect estimates (odds ratios (OR)) were abstracted or calculated from the given data. A random\neffects meta-analysis was performed to assess the risk of oral cancer with the use of different forms of smokeless tobacco. Results and\nConclusion.The pooled OR for chewing tobacco and risk of oral cancer was 4.7 [3.1ââ?¬â??7.1] and for paan with tobacco and risk of oral\ncancer was 7.1 [4.5ââ?¬â??11.1]. The findings of this study suggest a strong causal link between oral cancer and various forms of smokeless\ntobacco. Public health policies in affected countries should consider SLT specific cessation programs in addition to campaigns and\nactivities incorporated into smoking cessation programs.
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