Prisoners' perception of tobacco use and cessation in Chhatisgarh, India--the truth from behind the bars.

BACKGROUND: Prisoners represent a population group that is disadvantaged, socially deprived and underprivileged, needing particular attention with regard to provision of necessary oral health care, health promotion and motivation and tobacco cessation. Considering the situation in prisons, smoking and tobacco chewing are burning issues related to health deterioration and economic loss that seem to be overlooked by the public health sectors. AIM: To assess prisoners' perception of tobacco use and cessation in Chhatisgarh, India. MATERIALS AND METHODS: A pre-tested, close ended questionnaire was administered in the form of extensive face to face interviews, to assess perceptions regarding tobacco use and cessation in the central jail of Durg District of Chhattisgarh state, India. RESULTS: Prevalence of tobacco usage amongst the prisoners was found to be 61%. Some 27% reported smoking, 44% used tobacco in the chewable form and 29% indulged in consuming tobacco in both forms i.e. smoked as well as chewed. Results suggest several recommendations for policy relevance such as provision of a prison dentist, a tobacco cessation counseling program and targeted eradication of oral cancer by educating the prisoners. CONCLUSIONS: Health is a fundamental human "right of everyone to the enjoyment of the highest attainable standard of physical and mental well-being". This applies to prisoners just as it does to every other human being. The alarming findings in the study suggest the need for dental treatment facilities and tobacco cessation counseling in prisons.

Knowledge, attitude and practice of tobacco use and its impact on oral health status of 12 and 15 year-old school children of Chhattisgarh, India.

BACKGROUND: Tobacco is a leading preventable cause of deaths worldwide; the situation is particularly serious in the developing countries. Tobacco use amongst the children and adolescents is already a pandemic and they are vulnerable targets of tobacco industry. This is also the case in India. OBJECTIVES: 1) Document and monitor the prevalence of tobacco use including smoked, smokeless and other forms of tobacco; 2) Understand studentknowledge and attitudes related to tobacco use and its health impact; 3) Assess the impact of tobacco on the oral health status of school-going children in India. MATERIALS AND METHODS: The sample was 1,500 school children of the age group 12-15 years age. A pretested, close ended questionnaire was administered in the form of extensive face to face interview to understand student knowledge, attitudes and behavior related to tobacco use and its health impact and to assess the prevalence of tobacco use including smoked, smokeless and other forms of tobacco. Oral health status was assessed using the Community Periodontal Index (CPI). Frequency distribution, Chi-square tests and Odd's ratio was calculated. RESULTS: Prevalence of tobacco usage amongst the prevalence was 20.4%: 9.2% reported smoking, 15.8% used tobacco in the chewable form and 25.3% children were involved in consuming betel nut/areca nuts. The OR (Odd's ratio) for calculus formation was highest for guthka chewers (OR=14.322), paan masala chewers had the highest odds of developing bleeding on probing when compared to the others. CONCLUSIONS: There is an urgent need to launch school-based tobacco prevention programs for community awareness of children and the public, as preventing the initiation of a habit is far easier than stopping it.

Dental practitioners self reported performance of tobacco cessation counseling interventions: a cross sectional study.

BACKGROUND: The objective of the study was to determine the knowledge, attitude and behaviors of the practicing dentists regarding tobacco cessation counseling (TCC) in Chhattisgarh state and also the barriers that prevent them from doing so. MATERIALS AND METHODS: The study was conducted among dental practitioners of Raipur district, Chhattisgarh state (India). The sampling frame was registration with the State Dental Council and practicing in Raipur district. A questionnaire was personally administered and the practitioners were given explanations regarding how to complete it. Only descriptive statistics were calculated (SPSS version 16 for Windows). RESULTS: Based on the responding dentists' self reports, 76% were not confident in TCC, 48% did not assume TCC to be their responsibility, 17% considered that it might have a negative impact on their clinical practice, whereas 24% considered it might take away precious time from their practice, 25% considered TCC by dentists to be effective to a considerable extent and 80% considered TCC activities are not effective due to lack of formal training, 69% considered dental clinics as an appropriate place for TCC but 82% thought there must be separate TCC centre and 100% of the dentists wanted TCC training to be a part of practice and that it should be included in dental curriculum. Some 95% of them were of the view that tobacco products should be banned in India and 86% responded that health professionals must refrain from tobacco habits so to act as role models for society. CONCLUSIONS: Dental professionals must expand their armamentarium to include TCC strategies in their clinical practice. The dental institutions should include TCC in the curriculum and the dental professionals at the primary and the community health care level should also be trained in TCC to treat tobacco dependence.

Periodontal health status among permanent residents of low, optimum and high fluoride areas in Kolar District, India.

PURPOSE: To assess and compare the periodontal health status among permanent residents of low, optimum and high fluoride areas in Kolar District, India. MATERIALS AND METHODS: A house-to-house survey was conducted in a population consisting of 925 permanent residents aged 35 to 44 years in three villages having different levels of fluoride concentrations in the drinking water. The fluoride concentrations in selected villages were 0.48 ppm (low), 1.03 ppm (optimum) and 3.21 ppm (high). The ion selective electrode method was used to estimate the fluoride concentration in the drinking water. Periodontal status was assessed using the Community Periodontal Index (CPI) and loss of attachment (LOA). Results were analysed using the chi-square test and logistic regression. The chi-square test was used to find the group differences and logistic regression to find association between the variables. RESULTS: The overall prevalence of periodontitis was 72.9%; specifically, prevalences were 95.4%, 76.3% and 45.7% in low, optimum and high fluoride areas, respectively. The number of sextants with shallow or deep pockets decreased (shallow pockets: 525, 438, 217; deep pockets: 183, 81, 34) from low to high fluoride areas (odds ratio: 71.3). The low fluoride area had a 7.9-fold higher risk of periodontitis than the optimum fluoride area and a 30-fold higher risk than the high fluoride area, which was highly significant (χ2 = 53.5, P < 0.0001 and χ2 = 192.8, P < 0.001, respectively). CONCLUSIONS: The severity of periodontal disease is inversely associated with the fluoride concentrations in drinking water. This relation can provide an approach to fluoride treatments to reduce the prevalence or incidence of this disease.