Salivary and serum acetaldehyde levels in betel quid chewers, pan masala chewers with or without tobacco and tobacco smokers: A comparative study using head space gas chromatography.

Background: Acetaldehyde, a natural by-product of combustion and photo-oxidation, has been detected at low levels in cigarette smoke. Various literature studies have shown increased salivary acetaldehyde production among smokers and heavy drinkers. Aim: The present investigation was performed to estimate the salivary and serum acetaldehyde levels in pan masala chewers (with or without tobacco), betel quid chewers and tobacco smokers. Methodology: Blood and Saliva samples were collected from 40 participants. The study participants were categorized into 4 groups of 10 individuals each. Subjects with no habits, betel quid chewing habit, pan masala chewing habit with or without tobacco and tobacco smoking habit. All the samples were centrifuged and subjected to gas chromatography (GC) analysis as per standard protocols provided by the manufacturer. Results and Discussion: No statistically significant difference in either serum or salivary acetaldehyde levels between Pan Masala chewers (with or without tobacco) and smokers was noted. However, higher mean serum and salivary acetaldehyde levels than the normal subjects and betel quid chewers was observed. It may be speculated that natural acetaldehyde, may not be released in estimated quantity of acetaldehyde by head space GC. Nevertheless, it is possible that addition of acetaldehyde as flavoring agents or preservatives for improving acceptability of the product can be a possible cause for these observations. Conclusion: Owing to various socio, economic and political reasons, implementation of the ban remains to be a formidable challenge. With these observations, we believe that absolute ban of all pan masala product is the ideal solution for minimizing the oral cancer burden in India.