title: The effects of chewing areca/betel quid with and without cigarette smoking on oral submucous fibrosis and oral mucosal lesions.
abstract: OBJECTIVE
  The purpose of this study was to investigate the risk of areca/betel quid chewing with or without cigarette smoking on oral submucous fibrosis (OSF) and other oral mucosal lesions.
  
  
  METHODS
  A stratified case-control study was designed. There were in total 102 patients with oral mucosal lesions or OSF (confirmed pathologically) in the case group. OSF (n = 62) and oral mucosal lesions (n = 62) in 102 subjects were separately analyzed for men and women investigating their risks.
  
  
  RESULTS
  For OSF, people with both smoking and chewing habits had a statistically significant odds ratio (OR) 8.68 (95% CI = 1.87, 40.23). For the group of people with chewing habit only and without any lifetime cigarette smoking habit, the OR was 4.51 (95% CI = 1.20, 16.94). For other oral mucosal lesions, people with mixed habits and chewing only had also significant risks (OR = 8.37 and 3.95, respectively). For both OSF and other oral lesions, the ORs of mixed habits and chewing only were both higher in women than in men.
  
  
  CONCLUSIONS
  The areca/betel quid used in Taiwan does not contain any tobacco product. The only way of areca/betel quid could synergize with any tobacco product is through cigarette smoking. A statistically significant association with oral mucosal lesions and OSF was still found in the group of areca/betel quid chewing only.
authors.affiliation: Graduate Health Sciences, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
authors.forename: Y-H
authors.initials: YH
authors.lastname: Yang
authors.forename: Y-C
authors.initials: YC
authors.lastname: Lien
authors.forename: P-S
authors.initials: PS
authors.lastname: Ho
authors.forename: C-H
authors.initials: CH
authors.lastname: Chen
authors.forename: J S F
authors.initials: JS
authors.lastname: Chang
authors.forename: T-C
authors.initials: TC
authors.lastname: Cheng
authors.forename: T-Y
authors.initials: TY
authors.lastname: Shieh
mesh_terms: D000328:Adult; D000368:Aged; D001114:Areca / Q000009:adverse effects*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000209:etiology; D007642:Keratosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000187:drug effects*; D009062:Mouth Neoplasms / Q000209:etiology; D016017:Odds Ratio; D009914:Oral Submucous Fibrosis / Q000209:etiology*; D012907:Smoking / Q000009:adverse effects*; D013624:Taiwan