Oral pain after stopping tobacco use : a prospective study on the relationship of predictors of oral pain with paan tobacco chewing and cessation in UK resident Bangladeshi adult women

Abstract

Background: Oral pain has been reported to prevent successful tobacco cessation in Bangladeshi paan tobacco chewers. Aim: to investigate oral pain associated with paan tobacco chewing cessation. Objectives: to identify and assess the impact and association of predictors of oral pain with paan tobacco cessation. Methods: This prospective cohort study recruited UK resident adult Bangladeshi women. Socio-demographic, social capital, general and oral health condition, tobacco use, dependence and cessation data were analysed in four study groups; 1) oral pain at baseline, 2) continued oral pain 3) onset of oral pain during follow-up and 4) at study completion. Results: 150 participants (mean age 51, range 24-84 years) completed the study. Most (92%) were never employed, had no formal education (59%) and chewed both zarda and tobacco leaf (69%). Participants who chewed more paan tobacco (OR 2.270, 95% CI; 1.980-5.258), were anxious when going without paan tobacco (OR 1.908, 95% CI: 1.728-4.995) with dental calculus (OR 3.350, 95% CI; 1.716-15.680) and no completed formal education (OR 3.349, 95% CI; 1.395-8.039) reported baseline oral pain. Oral debris (OR 3.963, 95% CI; 1.045-15.031) and no completed formal education (OR 2.524, 95% CI; 1.866-7.359) predicted continued oral pain. Successful quitters at study completion (OR 4.213, 95% CI; 1.509-13.863) quitting with behavioural support alone (OR 2.932, 95% CI; 1.635-5.873) with tooth erosion (OR 3.880, 95% CI; 1.248-12.061) predicted onset of oral pain. Successful quitters (OR 2.497, 95% CI: 1.603-3.715) quitting with behavioural support alone (OR 2.139, 95% CI; 1.872-5.248) with filled teeth (OR 3.166, 95% CI; 1.826-12.134), tooth erosion (OR 2.849, 95% CI; 1.029-7.892) and living in a low status neighbourhood (OR 4.551, 95% CI; 1.068-19.398) predicted oral pain at study completion. Conclusions: Predictors of oral pain for all four study groups were multi-factorial, including lifestyle and behavioural factors, tobacco dependence and cessation, sociodemographics and oral clinical condition.