Dose Responsive Effects of Smoking/Drinking Habits on Oral Lesions

Objectives: To investigate the dose response effects of betel quid chewing, cigarette smoking and alcohol drinking on leukoplakia and oral submucous fibrosis from a community screening of Taiwan. Methods: An oral cancer/precancer screening was conducted in 1 remote island and 4 aboriginal communities of Taiwan. Diagnosis of oral lesions was determined by dentists and specialists. Personal habits on chewing, smoking and drinking were collected by one to one interview. Dose response effects of oral habits were investigated by multiple logistic regressions with adjustment of the other two habits, age and gender. Three measures of dose responsive effects in this study included daily amount, years of duration and year-pak. Results: There were 2020 participants examined for oral cancer/precancer lesions. The prevalence rates were 11.1% for leukoplakia and 4.4% for oral submucous fibrosis. Both leukoplakia and oral submucous fibrosis were significantly associated with betel quid chewing habits on 3 dose response measures. In terms of cigarette smoking, only leukoplakia was significantly associated with daily amount, years of smoking and year-paks. The 3 dose response measures of alcohol consumption were not associated oral lesions. Conclusion: Although alcohol drinking is an important risk for oral caner/precancer in European countries, it usually does not show significance in South-east Asia. The betel quid in Taiwan does not contain any tobacco. Our study still identified that leukoplakia is related to both chewing and smoking habit, and oral submucous fibrosis is only related to betel quid chewing.