ArticlePloS one2017
Oral cancer via the bargain bin: The risk of oral cancer associated with a smokeless tobacco product (Naswar).
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 3 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- The health impact of smokeless tobacco products: a systematic review.Harm reduction journal · 2021Pooled it
- Association between smokeless tobacco use and oral cavity cancer risk in women compared with men: a systematic review and meta-analysis.BMC cancer · 2021Pooled it
- Relationship between type of smokeless tobacco & risk of cancer: A systematic review.The Indian journal of medical research · 2018Pooled it
- Behavior Change Intervention for Smokeless Tobacco Cessation Delivered Through Dentists in Dental Settings: A Pragmatic Pilot Trial.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2024Trial
- Nicotiana tabacum: From a Beneficial Plant to Harmful Products-A Comprehensive Review of Smokeless Tobacco and Its Adverse Health Effects.TheScientificWorldJournal · 2026Review
- Evidence of mutations in tumour suppressor genes among oral cancer in Naswar, smokeless tobacco users.Acta odontologica Scandinavica · 2025Article
- Smokeless tobacco: knowledge, attitudes and usage in Pakistan.Journal of health, population, and nutrition · 2025Article
- Unveiling Oral Cancer Epidemiology in Pakistan: Insights From a Case-Control Study.Global health, epidemiology and genomics · 2025Article
- The Relationship Between Smokeless Tobacco and the Incidence of Oral Cancer: A Systematic Review Study.Addiction & health · 2025Review
- Burden of lip and oral cavity cancer among young people across South, East, and Southeast Asia: trends from 1990 to 2021 and predictions to 2030.Frontiers in oncology · 2025Article
- Smokeless Tobacco Usage and Oral Cancer Risk: A Hospital-Based Case-Control Study From Bangladesh.Tobacco use insights · 2025Article
- Associations of tobacco use, physical activity and diet with hypertension in the city of Kandahar, Afghanistan: a community-based cross-sectional study.BMC research notes · 2024Article
- Molecular and cell phenotype programs in oral epithelial cells directed by co-exposure to arsenic and smokeless tobacco.bioRxiv : the preprint server for biology · 2024Article
- Exploring the Risk Factors for Oral Cancer in Pakistan: A Systematic Literature Review.Dentistry journal · 2024Review
- Ursolic acid-loaded chitosan nanoparticles suppress 7,12-dimethylbenz(a)anthracene-induced oral tumor formation through their antilipid peroxidative potential in golden Syrian hamsters.Naunyn-Schmiedeberg's archives of pharmacology · 2023Article
- Cancer incidence in Khyber Pakhtunkhwa, Pakistan, 2020.BMC public health · 2023Article
- Metabolic syndrome and periodontitis among adults: The 2018 Indonesia National Health Survey.Journal of clinical periodontology · 2022Article
- Association of salivary Cathepsin B in different histological grades among patients presenting with oral squamous cell carcinoma.BMC oral health · 2022Article
- Comparison of severity of periodontal clinical parameters among naswar/snuff users: Cross sectional study.PloS one · 2022Article
- Implementing smokeless tobacco control policy in Pakistan: a qualitative study among Naswar supply chain actors.Tobacco control · 2021Article
Corrections and comments
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Authors and funding
8 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In the wake of smokeless tobacco (SLT) being advocated as a mean of tobacco harm reduction, it is pertinent to establish individual health risks associated with each SLT product. This case-control study was aimed at assessing the risk of oral cancer associated with a smokeless tobacco product (Naswar). The study was conducted from September 2014 till May 2015 in Khyber Pakhtunkhwa, Pakistan. Exposure and covariate information was collected through a structured questionnaire. Conditional logistic regression was used to calculate odds ratios (OR) along with their 95% confidence intervals (CI). 84 oral cancer cases (62% males) and 174 age- and sex-matched controls were recruited. Ever users of Naswar had more than a 20-fold higher risk of oral cancer compared to never-users (OR 21.2, 95% CI 8.4-53.8). Females had a higher risk of oral cancer with the use of Naswar (OR 29.0, 95% CI 5.4-153.9) as compared to males (OR 21.0, 95% CI 6.1-72.1). Based on this result, 68% (men) and 38% (women) of the oral cancer burden in Pakistan is attributable to Naswar. The risk estimates observed in this study are comparable to risk estimates reported by previous studies on other forms of SLT use and the risk of oral cancer in Pakistan. The exposure-response relationship also supports a strong role of Naswar in the etiology of oral cancer in Pakistan. Although still requiring further validation through independent studies, these findings may be used for smokeless tobacco control in countries where Naswar use is common.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.