title: Oral pain before and after smokeless tobacco cessation in U.K.-resident Bangladeshi women: cross-sectional analyses.
abstract: BACKGROUND
  Paan quid with tobacco (PQT) use is common in South Asian populations. Oral pain following a PQT cessation attempt is commonly reported. Factors determining this await full exploration.
  
  
  METHODS
  This prospective study of PQT chewers used a prepiloted interview and clinical examination. Oral pain, socioeconomic position, oral status, health service use, tobacco use and dependency, and psychological distress measures were collected from U.K.-resident Bangladeshi women before and after their quit attempts. Analysis included descriptive and analytic modeling of oral pain determinants, using multiple logistic regressions and a significance value p ≤ .05.
  
  
  RESULTS
  A total of 150 females (mean age 51.2 [SD = 13.7, range = 24-84] years) completed the study. Baseline oral pain prevalence was 39% and 73% at follow-up. Completed education level predicted baseline oral pain (OR = 3.43, 95% CI [1.66, 7.11], p = .001). Follow-up oral pain was predicted by completed education level (OR = 3.74, 95% CI [1.43, 9.79], p = .007), anxiety (OR = 3.52, 95% CI [1.23, 10.07], p = .019), choosing behavioral support alone in the cessation attempt (OR = 3.12, 95% CI [1.26, 8.70], p = .015), failure to stop tobacco chewing during the cessation attempt (OR = 4.16, 95% CI [1.44, 12.04], p = .009), and tooth wear (attrition) (OR = 5.71, 95% CI [1.84, 17.79], p = .003). Lower dependency level (OR = 0.79, 95% CI [0.64, 0.97], p = .023) was protective.
  
  
  CONCLUSIONS
  Dental care access, nicotine replacement therapy, and anxiety management should be incorporated into cessation service delivery protocols to manage oral pain onset and facilitate successful cessation.
authors.affiliation: Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Institute of Dentistry, London, United Kingdom. r.e.croucher@qmul.ac.uk
authors.forename: Ray
authors.initials: R
authors.lastname: Croucher
authors.forename: Mohamed F
authors.initials: MF
authors.lastname: Haque
authors.forename: Saba
authors.initials: S
authors.lastname: Kassim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety; D001459:Bangladesh / Q000208:ethnology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003710:Demography; D003729:Dental Care; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009055:Mouth; D010146:Pain / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012907:Smoking / Q000208:ethnology; D000074606:Smoking Prevention; D012959:Socioeconomic Factors; D020340:Tobacco Use Cessation / Q000208:ethnology* / Q000523:psychology; D061485:Tobacco Use Cessation Devices; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult