title: The Insight for Initiation and Maintenance of Areca nut chewing Habit and its Effects on Oral Health Status among School Age Population in Western Rajasthan, India.
abstract: BACKGROUND
  Areca nut is highly carcinogenic according to International Agency for Research on Cancer (IARC). Its usage is continuously increasing in children and adolescents in India.
  
  
  OBJECTIVE
  The aim of the study was to understand the reasons for the development of the areca nut chewing habit at early age.
  
  
  METHODS
  A total of 2846 subjects were surveyed from rural government schools between ages of 4 to18 years in Western Rajasthan, India. A structured questionnaire was designed to record the factors associated with initiation and continuation of areca nut chewing habits. A systemic oral examination was done to access current oral health status in these users. Students were divided into two groups viz. Group 1 and 2, comprising of students from 4 to 10 years and 11 to18 years respectively.
  
  
  RESULTS
  Total 34.5% children in Group 1 and 72.8% in Group 2, were indulged with the habit of chewing areca nut. Study revealed that social environment and secondarily stimulating effect of areca nut have association with initiation and maintenance of habits. A total of 55 subjects were diagnosed at various clinical stages of Oral Submucous Fibrosis (OSMF).
  
  
  CONCLUSIONS
  Areca nut cessation programs should be initiated on the primary education level for the prevention of this habit in Western Rajasthan, India.
authors.affiliation: Reader, Department of Oral and Maxillofacial Pathology, Vyas Dental College and Hospital , Jodhpur, Rajasthan, India .
authors.forename: Abhishek
authors.initials: A
authors.lastname: Singhvi
authors.affiliation: Postgraduate Student, Department of Oral and Maxillofacial Pathology, Vyas Dental College and Hospital , Jodhpur, Rajasthan, India .
authors.forename: Ashish
authors.initials: A
authors.lastname: Joshi
authors.affiliation: Professor and Head, Department of Oral and Maxillofacial Pathology, Vyas Dental College and Hospital , Jodhpur, Rajasthan, India .
authors.forename: Neeta
authors.initials: N
authors.lastname: Bagul
authors.affiliation: Senior Lecturer, Department of Oral and Maxillofacial Pathology, Vyas Dental College and Hospital , Jodhpur, Rajasthan, India .
authors.forename: Sanya
authors.initials: S
authors.lastname: Bhatia
authors.affiliation: Postgraduate Student, Department of Oral and Maxillofacial Pathology, Vyas Dental College and Hospital , Jodhpur, Rajasthan, India .
authors.forename: Gurdeep
authors.initials: G
authors.lastname: Singh
authors.affiliation: Postgraduate Student, Department of Oral and Maxillofacial Pathology, Vyas Dental College and Hospital , Jodhpur, Rajasthan, India .
authors.forename: Rajkumari
authors.initials: R
authors.lastname: Gupta
keywords: Areca catechu; Prevalence; School age; Submucous fibrosis