Betel quid and tobacco chewing habits and its associated clinical findings in a rural tertiary care hospital


  • D. Indraneel Reddy Department of Otorhinolaryngology, PESIMSR, Kuppam, Chittoor District, Andhra Pradesh, India
  • M. Lakshmi Narayana Department of Otorhinolaryngology, PESIMSR, Kuppam, Chittoor District, Andhra Pradesh, India
  • Vivek Viswambharan Department of Otorhinolaryngology, PESIMSR, Kuppam, Chittoor District, Andhra Pradesh, India
  • N. Reddy Chaithanya Department of Otorhinolaryngology, PESIMSR, Kuppam, Chittoor District, Andhra Pradesh, India



Smokeless tobacco, Tobacco products, Carcinogens, Head and neck neoplasms, Squamous cell carcinoma of head and neck


Background: Among all forms of tobacco, smokeless tobacco is known to be more carcinogenic than smoking according to various studies. Smokeless tobacco is consumed through various forms in our region like kaddipudi, gutkha, khaini, pan, etc. This study aims at evaluating the different chewing patterns of tobacco and to assess their impact on the oral mucosa.

Methods: The patients who attended ENT department with the habit of chewing tobacco were taken into this study after considering the inclusion and exclusion criteria. A detailed questionnaire including various habits and chewing patterns were filled and received from all the subjects, and a comprehensive ENT examination was done for them.  

Results: In our study, a total of 120 subjects were included who chewed tobacco in various combinations, which we divided into 6 categories; of which 97 users were under category 2 (betel leaf, betel nut, slaked lime and kaddipudi). Among 120 subjects, 35 had malignancy, 51 potentially malignant lesions, 30 early changes and 4 had no changes. There was a statistically significant correlation noted between the duration of chewing for >15 years (p=0.000); frequency of chewing >5 times/day (p=0.004) and also overnight tobacco placement (p=0.027) with the occurrence of potentially malignant lesions and malignancy.

Conclusions: In our study, the combination of betel leaf, betel nut, slaked lime with kaddipudi was the most commonly used combined form of smokeless tobacco. The duration, frequency of tobacco chewing, and overnight placement were statistically significant associated with potentially malignant lesions and malignant lesions.



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