Objective: To evaluate the association between different lifestyle/social habits and oral premalignant conditions/lesions.
Study design: Descriptive Study
Place and Duration: This study was carried out at the Department of Oral and Maxillofacial Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad from 1991 to 1994.
Materials and Methods: A total of 100 patients visiting the outpatient clinic of Oral and Maxillofacial Surgery department with different lifestyle oral habits were included in this study. Initial assessment and diagnosis was made by history and clinical examination which was subsequently confirmed histopathologically. The sociodemographic profile of the patients, type of habit and nature of lesion were all recorded. The collected data were then evaluated for its statistical significance.
Results: Out of 100 patients, 60% (n=59) were female while 40% (n=41) were males. The mean age was 40.1 years and 47% of the patients were in the 21-40 year age group. Ingestion of spicy food was the most prevalent lifestyle habit (84%) followed by sopari (63%) and pan (41%). Oral submucous fibrosis was the most frequent lesion to be observed (45%) followed by oral lichen planus (39%).
Conclusion: The habit of pan chewing showed a statistically significant association to the development of oral precancerous lesions and conditions.
Key Words: Oral precancerous lesions, Lifestyle habits, pan, sopari.

Introduction

Oral lesion constitute major public problem in Pakistan and South Asian countries. Public of these areas are habitual of taking spicy food, pan (Quid: defined as substance or group of substances remaining in contact with the oral mucosa containing one or both of the two basic ingredients i.e. tobacco and areca nut ), sopari (areca nut), smoking and naswar (snuff). These are the common social habits in this region. Research has found that these habits are risk factors for producing oral lesion.1 A change in colour of the normal reddish oral mucosa to white constitutes one of the most frequently encountered oral abnormalities.2 A variety of malignant and pre malignant lesion of oral cavity appear white, like leukoplakia, oral submucous fibrosis, oral lichen planus, erythroplakia, chronic hyperplastic candidiasis, sub-lingual-keratosis, tobacco-induced keratosis, syphilitic keratosis and carcinoma in situ.3
The initiation of these precancerous conditions may depend upon extrinsic local factors. The more frequently blamed factor is tobacco used in different ways i.e. smoking and chewing that causes local irritation.4 Pindborg and Renstrup (1963)5 found that, smoking, chewing tobacco alone or included in pan are the causative factors for leukoplakia. They further reported that habit of keeping naswar (snuff) in the vestibule of mouth produces oral precancerous lesions.5
Canniff (1986) reported that there is general agreement in the literature that the areca nut chewing is another significant causative factor for oral lesions.6Malik (1971) pointed out in his study in Pakistan that eating spicy food and chewing areca nut are the causative factors of oral lesions.7
In our study we have examined the patients having oral mucosal lesions with chewing habits of pan sopari, smoking tobacco, taking spicy food and using naswar and evaluated the association of these risk factors in causing oral precancerous lesion.

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