Effect of cessation of tobacco use on the incidence of oral mucosal lesions in a 10-yr follow-up study of 12,212 users.
Effect of cessation of tobacco use on the incidence of oral mucosal lesions in a 10-yr follow-up study of 12,212 users.
复制标题
对 12,212 名吸烟者进行的 10 年跟踪研究显示戒烟对口腔粘膜病变发生率的影响。
作者：
PC Gupta;PR Murti;RB Bhonsle;FS Mehta;JJ Pindborg
客观化
目的探讨戒烟对口腔扁平苔藓、白斑等口腔粘膜病变发生率的影响。
设计
一项对印度喀拉拉邦额尔纳库拉姆地区农村人口进行的为期10年的队列研究。
材料和方法
约12212名吸烟者在基线调查中接受了访谈和检查，并在10年内每年重新检查一次。在每一次检查中，他们都接受了健康教育计划，以鼓励他们戒烟。使用人-年方法计算戒烟者和所有其他人的发病率。
结果
男性累计观察77,681人年，女性累计观察32,544人年。在男性中，6.5%的人属于停用类别，在女性中，14.4%的人属于停用类别。口腔扁平苔藓的发生率与戒烟无关(发生率比1.35)，而白斑的发生率在戒烟后显著下降(发生率比0.31)。其他几种与烟草相关的口腔粘膜病变，如口腔扁平苔藓样病变、吸烟者的上颚、白斑前病变、舌中央乳头萎缩和白肿，戒烟后发生率为零或非常低。
结论
已报道的烟草使用和扁平苔藓之间的联系似乎是间接的，但对于所有其他损害来说，这种联系是直接的。停止使用烟草导致白斑和其他病变的发生率大幅下降，这意味着停止使用烟草后患口腔癌的风险降低。
OBJECTIVE
To study the effect of cessation of tobacco use on the incidence of lichen planus, leukoplakia and other oral mucosal lesions.
DESIGN
A 10-yr cohort study in a rural population of Ernakulam district, Kerala, India.
MATERIAL AND METHODS
Some 12,212 tobacco users were interviewed and examined in a baseline survey and re-examined annually for 10 years. At each examination they were exposed to health educational programs to encourage them to quit their tobacco use. The incidence rates were calculated using person-years method among those who stopped their tobacco use and all others.
RESULTS
A total of 77,681 person-years of observation accrued among men and 32,544 among women. Among men 6.5% of these and among women 14.4% were in the stopped category. The incidence of oral lichen planus did not show any consistent association with cessation of tobacco habits (incidence ratio 1.35) but for leukoplakia there was a substantial drop in the incidence after cessation (incidence ratio 0.31). Several other tobacco-associated oral mucosal lesions such as oral lichen planus-like lesion, smoker's palate, preleukoplakia, central papillary atrophy of the tongue and leukoedema showed either zero, or very small incidence, after cessation.
CONCLUSION
The reported association between tobacco use and lichen planus appears to be indirect but for all other lesions it is direct. The cessation of tobacco use led to a substantial fall in the incidence of leukoplakia and other lesions implying a reduced risk for oral cancer after cessation of tobacco use.