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Research Guide: Dr Ganesh Shenoy Panchmal Senior Professor & HOD PowerPoint Presentation
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Research Guide: Dr Ganesh Shenoy Panchmal Senior Professor & HOD

Research Guide: Dr Ganesh Shenoy Panchmal Senior Professor & HOD

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Research Guide: Dr Ganesh Shenoy Panchmal Senior Professor & HOD

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  1. A STUDY AMONG 18-24 YEAR OLD STUDENTS IN COLLEGES OF MANGALURU TALUKA,SOUTH INDIA FOR TOBACCO SURVEILLANCE.

  2. Research Guide: Dr Ganesh Shenoy Panchmal Senior Professor & HOD Department of Public Health Dentistry Yenepoya Dental College PhD Scholar: Dr Praveen Jodalli Reader 088/July 2012 Department of Public Health Dentistry Yenepoya Dental College

  3. Action taken against previous review Title modified and finalized- Approval from BOS pending Data collection is under progress

  4. Introduction Tobacco use is a major preventable cause of premature death and disease worldwide. Just over five million people die each year due to tobacco illness- a figure expected to increase more than eight million a year by 2030. unless a current trend is changed, the vast majority of these deaths are projected to occur in the developing world. 

  5. Prevalence and practices of tobacco use in India are varied and disparate. Tobacco consumption continues to grow at 2-3% per annum, and by 2020 it is predicted that it will account for 13% of all deaths in the country. Young adults aged 18-24 years, many of whom are in college, represent the youngest legal targets for tobacco industry marketing.

  6. College is a prime time in students lives where they have the choice to start, quit, or continuing using tobacco. A social context has been shown to be an important factor in the initiation of smoking, as well as becoming an established smoker.

  7. Mangalore taluka in Dakshina Kannada is hub for educational centres in India; lack of knowledge on tobacco use, type of tobacco use is a clear barrier to tobacco cessation initiatives.

  8. Literature survey Jitender S, Sarika G, Sharma P, MishraP(2017). Bidismoking: an underestimated issue of Indian society. Relevance: Bidi smoking has always been an under-talked issue of Indian society. Bidis are rolled in tendu leaves which are non porous and have low combustibility due to which they affect the smoker's lungs even more. In spite of the increased toxicology associated with bidis, they are often ignored. The reason for this can be attributed to their home-made production, decreased taxation and the greater prevalence of bidis in rural areas. Since bidis are rolled and packed at home, packaging does not have any warnings about the harmful effects of bidi smoking. Many cases of smoking-associated cancer have been recorded in the country lately. This raises a concern about the economic balance of the nation, as to whether there is a revenue generation with tax on the sale of tobacco or if there is an economic loss due to the various diseases that result from bidi smoking.

  9. Araghi M et al (2017) Use of moist oral snuff (snus) and pancreatic cancer: Pooled analysis of nine prospective observational studies. Relevance: While smoking is a well-established risk factor for pancreatic cancer, the effect of smokeless tobacco is less well understood. We used pooled individual data from the Swedish Collaboration on Health Effects of Snus Use to assess the association between Swedish snus use and the risk of pancreatic cancer. A total of 424,152 male participants from nine cohort studies were followed up for risk of pancreatic cancer through linkage to health registers. We used shared frailty models with random effects at the study level, to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for confounding factors. During 9,276,054 person-years of observation, 1,447 men developed pancreatic cancer. Compared to never-snus use, current snus use was not associated with risk of pancreatic cancer (HR 0.96, 95% CI 0.83-1.11) after adjustment for smoking. Swedish snus use does not appear to be implicated in the development of pancreatic cancer in men. Tobacco smoke constituents other than nicotine or its metabolites may account for the relationship between smoking and pancreatic cancer.

  10. Osazuwa- Peters N st al (2017) Characteristics and predictors of oral cancer knowledge in a predominantly African American community. Relevance: To characterize smoking and alcohol use, and to describe predictors of oral cancer knowledge among a predominantly African-American population. A cross-sectional study was conducted between September, 2013 among drag racers and fans in East St. Louis. Oral cancer knowledge was derived from combining questionnaire items to form knowledge score. Covariates examined included age, sex, race, marital status, education status, income level, insurance status, tobacco and alcohol use. Adjusted linear regression analysis measured predictors of oral cancer knowledge. Three hundred and four participants completed questionnaire; 72.7% were African Americans. Smoking rate was 26.7%, alcohol use was 58.3%, and mean knowledge score was 4.60 ± 2.52 out of 17. In final adjusted regression model, oral cancer knowledge was associated with race and education status. Compared with Caucasians, African Americans were 29% less likely to have high oral cancer knowledge (β = -0.71; 95% CI: -1.35, -0.07); and participants with a high school diploma or less were 124% less likely to have high oral cancer knowledge compared with college graduates (β = -1.24; 95% CI: -2.44, -0.41).There was lower oral cancer knowledge among African Americans and those with low education. The prevalence of smoking was also very high. Understanding predictors of oral cancer knowledge is important in future design of educational interventions specifically targeted towards high-risk group for oral cancer.

  11. Wang TH (2017) Association of Smoking, Alcohol Use, and Betel Quid Chewing with Epigenetic Aberrations in Cancers. Relevance: Numerous environmental factors such as diet, alcohol use, stress, and environmental chemicals are known to elicit epigenetic changes, leading to increased rates of cancers and other diseases. The incidence of head and neck cancer, one of the most common cancers in Taiwanese males, is increasing: oral cancer and nasopharyngeal carcinoma are ranked fourth and tenth respectively, among the top ten cancers in this group, and a major cause of cancer-related deaths in Taiwanese males. Previous studies have identified smoking, alcohol use, and betel quid chewing as the three major causes of head and neck cancers; these three social habits are commonly observed in Taiwanese males, resulting in an increasing morbidity rate of head and neck cancers in this population. In this literature review, we discuss the association between specific components of betel quid, alcohol, and tobacco, and the occurrence of head and neck cancers, lung cancer, gastrointestinal cancers, and urethral cancer. We focus on regulatory mechanisms at the epigenetic level and their oncogenic effects. The review further discusses the application of FDA-approved epigenetic drugs as therapeutic strategies against cancer.

  12. Present status :International, national and local scenarios International : There are 1.1 billion tobacco users in the world. This number is expected to increase to 1.6 billion over the next two decades. Fourteen countries (Bangladesh, Brazil, China, Egypt, India, Mexico, Philippines, Poland, Russian Federation, Thailand, Turkey, Ukraine, Uruguay and Viet Nam) completed GATS during 2008-2010. Eight countries (Argentina, Indonesia, Malaysia, Nigeria, Pakistan, Panama, Romania and South Africa) planned to implement GATS in 2011.

  13. National : According to Indian fact sheets 2009-2010 Current Tobacco use in any form : 34.6% adults ; 47.9% males and 20.3% females. Current smokers: 14% adults; 24.3% males and2.9% females. Current smokeless tobacco users: 25.9% adults; 32.9% males and 18.4% females.

  14. CURRENT TOBACCO-USE IN INDIA In India, the use of tobacco shows a clear and continual increase with the decreasing wealth quintiles among both men and women . Seven in 10 men in the lowest wealth quintile consume tobacco products while four in 10 men in the highest wealth quintile do so. Twenty-two percent of women in the lowest wealth quintile consume tobacco. There is an equally clear and continual increase in tobacco-use with decreasing levels of education. Women and men from the scheduled castes and scheduled tribes (the poorest among poor in India) are more likely to use tobacco than those from other castes or tribes . India is now demonstrating a steely resolve to contain the menace of tobacco through a comprehensive control strategy that combines several demand and supply reduction measures. 

  15. Social relevance of the study Tobacco results in damage to the personal health, social costs like reduced productivity and health care burden, environmental damage and poverty to the family. Tobacco use by the young adults may be considerably higher than has been detected by previous analyses limited to cigarettes. Little is known about the full spectrum of tobacco use among the college population or about risk factors for the use of different tobacco product. This information is essential to guide the development of interventions. The purpose of this research is to provide a comprehensive overview of this tobacco problem among college students. This research enhances the role of government and the non governmental sector in surveillance, monitoring of tobacco use and key tobacco control indicators, and policy and program.

  16. Aim To assess the tobacco use among 18-24 year old college students in Mangalore taluka, Dakshina Kannada

  17. Objectives • To assess the tobacco use, exposure to second hand smoke, and quit attempts • To measure the key aspects of tobacco surveillance • To assess indirectly the impact of tobacco control and prevention initiatives • To evaluate comprehensive tobacco control policies • To determine the prevalence of various potentially malignant disorders (oral premalignant lesions and conditions). • To develop an implementable design for tobacco control program.

  18. Methodology Overview: • The study is designed to produce the estimate among college students across Mangalore taluka. • The target population will include 18-24 year old male and female college students Target population and study eligibility: • The study includes all eligible 18-24 year college students. • Individuals who are native of DakshinaKanadaTaluka. • The study design excludes institutionalized population.

  19. Sample size and expected precision: The study is designed to produce the estimate by urban/rural classification, by gender and by the cross of gender and urbanicity with a confidential interval of 95%, margin of error 3% for a tobacco use rate of 40% and assuming a design effect of 2 %. N = Z21 – α/2 p(1-p) * δ d2 where p= expected proportion = 0.4 d= absolute precision=3 δ=design effect=2 α=significance level=95% z=1.96 n= 2049 which will be rounded to 2060 (for convenience) .

  20. Data collection procedure: The tobacco questions for this study used will be a validated, recommended subset of key GATS (Global Adult Tobacco survey) question. A face to face interview method will be used for data collection which will be followed by oral screening for any precancerous lesions or condition. Statistical methods to be used for data analysis: The data analysis was performed using the Statistical Package for Social Studies version 21.0 (SPSS Inc., IBM 2012, USA).

  21. Basic study design: The sampling will be carried out in 3 stages: Stage I: primary sampling units • Information regarding total number of colleges in Mangalore taluka is collected (n=148) • Among the colleges by using a proportionality sampling( 20% proportion) randomly 30 colleges will be selected ( N= 148X20 = 29.6) 100 • N= 30

  22. Stage II: selection of secondary sampling units (study subjects) • Information regarding total strength of each sampling unit will be collected (N). • formula= a X b N Where a= study subjects from the college b= constant = 2060 N= constant= Total strength of the selected colleges. Example : 600X2060 = 69 subjects per college 18000

  23. Stage III: selection of study population: • Both male and female college students of age 18-24 years will be selected using a simple random sampling technique. • Data Collection Progress: Colleges completed : 13 Study participants : 1070

  24. Proposed work for the study duration

  25. References World Health Organization (2008) WHO report on the Global Tobacco Epidemic, 2008: the MPOWER package. (Geneva, Switzerland). WHO: Tobacco or Health: A Global status report: Country presentations at various Regional Meetings on Tobacco 1997-1998. Geneva; 1997. Kabir MA, Goh KL, Khan MM. Adolescent Tobacco Use and Its Determinants: Evidence from Global Youth Tobacco Survey, Bangladesh 2007. Asia Pac J Public Health. 2013 Jan 28. [Epub ahead of print] Mukherjee A, Sinha A, Taraphadar P, Basu G, Chakrabarty D. Tobacco abuse among school going adolescents in a rural area of West Bengal, India. Indian J Public Health. 2012 Oct-Dec;56(4):286-9. Muttappallymyalil J, Divakaran B, Thomas T, Sreedharan J, Haran JC, Thanzeel M Prevalence of tobacco use among adolescents in north kerala, India. Asian Pac J Cancer Prev. 2012;13(11):5883-6.

  26. Manimunda SP, Benegal V, Sugunan AP, Jeemon P,  Balakrishna N, Thennarusu K, Pandian D, Pesala KS. Tobacco use and nicotine dependency in a cross-sectional representative sample of 18,018 individuals in Andaman and Nicobar Islands, India. BMC Public Health. 2012 Jul 10;12:515. doi: 10.1186/1471-2458-12-515. MbatchouNgahane BH, Luma H, Mapoure YN, Fotso ZM, AfaneZe E. Correlates of cigarette smoking among university students in Cameroon. Int J Tuberc Lung Dis. 2013 Feb;17(2):270-4. doi: 10.5588/ijtld.12.0377. Agrawal M, Pandey S, Jain S, Maitin S. Oral cancer awareness of the general public in gorakhpur city, India Asian Pac J Cancer Prev. 2012;13(10):5195-9 International Institute for Population Sciences (IIPS) and Macro International. 2008. National Family Health Survey (NFHS-3), India, 2005-06: Karnataka. Mumbai: IIPS. Page 99 Global Adult Tobacco Survey Collaborative Group. Global Adult Tobacco Survey (GATS): Core Questionnaire with Optional Questions, Version 2.0. Atlanta, GA: Centers for Disease Control and Prevention, 2010

  27. Peretti- Watel P, L’haridon O, Seror V. Time preferences, socioeconomic status and smokers' behaviour, attitudes and risk awareness. Eur J Public Health. 2013 Jan 23. [Epub ahead of print] Sikorska- Jaroszynska MH, Mielnik- Blaszczak M, Krawczyl D, Nasilowska-Barud A. Smoking and the level of nicotine addiction in relation to the state of hard dental tissues in young adults. Ann Agric Environ Med. 2011 Dec;18(2):415-9. Sachs-Ericsson N, Collins N, Schmidt B, Zvolensky M Older adults and smoking: Characteristics, nicotine dependence and prevalence of DSM-IV 12-month disorders. Aging Ment Health. 2011 Jan;15(1):132-41. Fernandez D, Martin V, Molina AJ, De Luis JM. Smoking habits of students of nursing: a questionnaire survey (2004-2006). Nurse Educ Today. 2010 Jul;30(5):480-4. TidsskrNorLaegeforen. [Smoking and nicotine dependence]. 2009 Aug 27;129(16):1628-30.

  28. Auf RA, Radwan GN, Loffredo CA, EI Setouchy M, Israel E, Mohamed MK. Assessment of tobacco dependence in waterpipe smokers in Egypt. Int J Tuberec Lung Dis. 2012 Jan;16(1):132-7. Molina AJ, Fernandez D, Delgado M, Martin V. Sensitivity and specificity of a self-administered questionnaire of tobacco use; including the Fagerström test. Int J Nurs Stud. 2010 Feb;47(2):181-9 Cummings KM, Fong GT, Borland R. Environmental influences on tobacco use: evidence from societal and community influences on tobacco use and dependence. Annu Rev Clin Psychol. 2009;5:433-58. Kaneita Y, Sakurai H, Tsuchiya T, Ohida T. Changes in smoking prevalence and attitudes to smoking among Japanese physicians between 2000 and 2004. Public Health. 2008 Sep;122(9):882-90. doi: 10.1016/j.puhe.2007.12.009. Epub 2008 Jun 18. Panday S, Reddy SP, Ruiter RA, Bergstrom E, de Vries H. Nicotine dependence and withdrawal symptoms among occasional smokers. J Adolesc Health. 2007 Feb;40(2):144-50. Epub 2006 Nov 29.

  29. Loyha K, Vatanasapt P, Promthet S, Parkin DM. Risk factors for oral cancer in northeast Thailand. Asian Pac J Cancer Prev. 2012;13(10):5087-90. Bhoopathi V, Mascarenhas AK. Utility of oral cancer diagnostic adjuncts in the adult US populations J Oral Pathol Med. 2012 Dec 1.[Epub ahead of print] Moore CE, Warren R, Maclin SD Jr. Head and neck cancer disparity in underserved communities: probable causes and the ethics involved. J Health Care Poor Underserved. 2012 Nov;23(4 Suppl):88-103 Vastanasapt P, Thanaviratananich S, Ratanaanekchai T, Thepsuthammarat K. The burden of head and neck cancers in Thailand. J Med Assoc Thai. 2012 Jul;95Suppl 7:S182-9.

  30. Coelho KR. Challenges of the oral cancer burden in India. J Cancer Epidemiol. 2012 Epub 2012 Oct 4. Halboub ES, Abdulhuq M, Al-Mandili A. Oral and pharyngeal cancers in Yemen: a retrospective study. East Mediterr Health J. 2012 Sep;18(9):985-91. Bascones-Martinez A, Rodriguez- Gutierrez C, Rodriguez- Gomez E, Bascones-Iiundain J,  Bascones-Iiundain C, Gil-Montoya JA, Gonzalez-Moles MA. ExpTher Med. Epidemiological study of oral cancer patients in Alava province, Spain.2011 Sep;2(5):937-940. Epub 2011 Jun 17. Radoil L, Paget-Bailly S, Cyr D, Papadopoulos A, Guida F, Schmaus A, Cenee S, Menviella G, Carton M, Lapotre-Ledoux B, Delafosse P, Stucker I, Luce D. Eur J Cancer Prev. Tobacco smoking, alcohol drinking and risk of oral cavity cancer by subsite: results of a French population-based case-control study, the ICARE study. 2012 Sep 12.

  31. Deneo-Pellegrini H, De Stefani E, Boffetta P, Ronco AL, Acosta G, Correa P, Mendilaharsu M. Maté consumption and risk of oral cancer: Case-control study in Uruguay. Head Neck. 2012 Aug 23. Sartori LC, Frazao P. Accuracy of screening for potentially malignant disorders of the oral mucosa by dentists in primary care. Oral Health Prev Dent. 2012;10(1):53-8. KulchayaLoyha, PatravootVatanasapt, SupanneePromthet, Donald Maxwell Parkin. Risk Factors for Oral Cancer in Northeast Thailand. Asian Pacific J Cancer Prev,2012, 13 (10), 5087-5090 Ebbert OJ, Christi PA,and Darrell SR. The Fagerström Test for Nicotine Dependence-Smokeless Tobacco (FTND-ST). Addict Behav. 2006 September ; 31(9): 1716–1721. Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO. The Fagerstrom Test for Nicotine Dependence: A revision of the Fagerstrom Tolerance Questionnaire. British Journal of Addictions 1991;86:1119-27

  32. Egbe CO, Petersen I, Meyer-Weitz A, Oppong Asante K An exploratory study of the socio-cultural risk influences for cigarette smoking among Southern Nigerian youth. BMC Public health 2014 Nov 22;14:1204. Haller DM, Meynard A, Lefebvre D, Hasselgård-Rowe J, Broers B, Narring F Excessive substance use among young people consulting family doctors: a cross-sectional studyFamily Practice first published online August 5, 2015 Al-Bedah AM, Qureshi NA. The Global Youth Tobacco Survey: 2001-2002 in Riyadh region, the Kingdom of Saudi Arabia. Subst Abuse Rehabil. 2011 Nov 16;2:197-204. Mukherjee A, Sinha A, Taraphdar P, Basu G, Chakrabarty D. Tobacco abuse among school going adolescents in a rural area of West Bengal, India. Indian J Public Health. 2012 Oct-Dec;56(4):286-9. Bhojani UM, Chander SJ, Devadasan N. Tobacco use and related factors among pre-university students in a college in Bangalore, India. Natl Med J India. 2009 Nov-Dec;22(6):294-7.

  33. Zaman MM, Rahman MM, Rahman MR, Bhuiyan MR, Karim MN, Chowdhury MA .Prevalence of risk factors for non-communicable diseases in Bangladesh: Results from STEPS survey 2010.Indian J Public Health. 2016 Jan-Mar;60(1):17-25. Higgins ST, Kurti AN, Redner R, White, Keith DR, Gaalema DE, Sprague BL, Stanton CA, Roberts ME, DooganNJ,Priest JS. Co-Occurring Risk Factors for Current Cigarette Smoking in a U.S. NationallyRepresentative Sample. Prev Med. 2016 Feb 19. pii: S0091-7435(16)30004-4. Agaku IT, Singh T, Rolle IV, Ayo-Yusuf. Exposure and response to current text-only smokeless tobacco health warnings among smokeless tobacco users aged ≥18years, United States, 2012-2013. OA. Prev Med. 2016 . pii: S0091-7435(16)00061-X. Ramaswamy AT, Toll BA, Chagpar AB, Judson BL. Smoking, cessation, and cessation counseling in patients with cancer: Apopulation-based analysis. Cancer. 2016 Feb 16. doi: 10.1002/cncr.29851. Cheng HG, Chen S, McBride O, Phillips MR. Prospective relationship of depressive symptoms, drinking, and tobacco smokingamong middle-aged and elderly community-dwelling adults: Results from the ChinaHealth and Retirement Longitudinal Study (CHARLS). J Affect Disord. 2016 Feb 11;195:136-143.

  34. 39. International Institute for Population Sciences. National family health survey (NFHS-3), 2005–06: India. V. I. Mumbai: International Institute for Population Sciences, 2007. 588 p. 40. Turhan E, Inandi T, Col M, Bugdayci R, Eker O, Ilhan M. Smoking Cessation and Attitudes, Belief, Observation, and Education of Medical Students, in Turkey. JNMA J Nepal Med Assoc. 2016 Apr-Jun; 54(202):55-62. 41. Sreeramareddy CT, Harper S, Ernstsen L. Educational and wealth inequalities intobaccouse among men and women in 54 low-income and middle-income countries.Tob Control. 2016 Nov 24. [Epub ahead of print] 42. Tobacco Use and Utilization of Medical Services in Adolescence: An Analysis of the KiGGS Data. Gesundheitswesen. 2016 Nov 17. [Epub ahead of print] 43. Australia's plain tobacco packs: anticipated and actual responses among adolescents and young adults 2010-2013. Tob Control. 2016 Nov 15. pii: tobaccocontrol-2016-053166. [Epub ahead of print] 44. Smoking cessation practice among family doctors in Lithuania: a Survey. Everatt R1, Zolubiene E2, Grassi MC3. Clin Ter. 2016 Sep-Oct;167(5):161-167 45. Current Cigarette Smoking Among Adults - United States, 2005-2015. Jamal A1, King BA1, Neff LJ1, Whitmill J1, Babb SD1, Graffunder CM1. MMWR Morb Mortal Wkly Rep. 2016 Nov 11;65(44):1205-1211.

  35. 46. Bidi smoking: an underestimated issue of Indian society. J Exp TherOncol. 2017 May;12(1):73-81. JitenderS,SarikaG,Sharma P,MishraP. 47. Use of moist oral snuff (snus) and pancreatic cancer: Pooled analysis of nine prospective observational studies. Int J Cancer. 2017 May 9.Araghi M,Rosaria GalantiM,Lundberg M,Lager A,EngströmG,AlfredssonL,KnutssonA,NorbergM,SundM,WennbergP,TrolleLagerrosY,BelloccoR,Pedersen NL,ÖstergrenPO,Magnusson C. 48. Characteristics and predictors of oral cancer knowledge in a predominantly African American community. PLoS One. 2017 May 17;12(5):e0177787. Osazuwa-Peters N,AdjeiBoakyeE,HussainiAS,SujijantaratN,GaneshRN,Snider M,Thompson D,VarvaresMA. 49. Association of Smoking, Alcohol Use, and Betel Quid Chewing with Epigenetic Aberrations in Cancers. Int J Mol Sci. 2017 Jun 6;18(6). pii: E1210. doi: 10.3390/ijms18061210. Wang TH,Hsia SM,Shih YH,ShiehTM.

  36. Thank You