title: Demystifying the Enigma of Smoking - An Observational Comparative Study on Tobacco Smoking.
abstract: BACKGROUND
  Smoking is a hazardous habit which causes definite changes in the oral cavity, consequently there exist changes in the mucosa when subjected to smoking. Palatal mucosa is first to be affected. The present study determines the palatal status in reverse smokers and conventional smokers.
  
  
  OBJECTIVE
  To study and compare the clinical, cytological and histopathological changes in palatal mucosa among reverse and conventional smokers.
  
  
  METHODS
  Study sample was categorized into two groups. Group 1 comprised of 20 subjects with the habit of reverse smoking and Group 2 comprised of 20 subjects with the habit of conventional smoking. Initially, clinical appearance of the palatal mucosa was recorded, followed by a cytological smear and biopsy of the involved area among all the subjects. The findings were studied clinically, the specimens were analysed cytologically and histopathologically, and compared among the two groups.
  
  
  RESULTS
  The severity of clinical changes of the palatal mucosa among reverse smokers was statistically significant when compared to those of conventional smokers. There was no statistically significant difference observed in cytological staging between the groups with a p-value of 0.35. The histopathological changes in both the groups showed a significant difference with a p-value of 0.02. A significant positive correlation was observed between the clinical appearance, and cytological, histopathological changes.
  
  
  CONCLUSIONS
  Profound clinically aggressive changes were observed in group I compared to group II. Severity of dysplastic changes have been detected in few subjects through histopathological examination irrespective of no prominent clinical and cytological changes observed among the two groups.
authors.affiliation: Assistant Professor, Department of Oral Medicine and Radiology, DrsSudha and Nageswara Rao Siddhartha Institute of Dental Sciences , Gannavaram Mandal, Krishna District, Andhra Pradesh, India .
authors.forename: Ayesha Thabusum
authors.initials: AT
authors.lastname: Dharmavaram
authors.affiliation: Assistant Professor, Department of Oral Medicine and Radiology, Vishnu Dental College , Bhimavaram, West Godavari District, Andhra Pradesh, India .
authors.forename: Rajesh
authors.initials: R
authors.lastname: Nallakunta
authors.affiliation: Professor and Head, Department of Oral Medicine and Radiology, Vishnu Dental College , Bhimavaram, West Godavari District, Andhra Pradesh, India .
authors.forename: Sudhakara Reddy
authors.initials: SR
authors.lastname: Reddy
authors.affiliation: Assistant Professor, Department of Oral Medicine and Radiology, GSL Dental College , Rajamundry, Andhra Pradesh, India .
authors.forename: Sai Kiran
authors.initials: SK
authors.lastname: Chennoju
keywords: Conventional smoking; Palatal mucosa; Reverse smoking