Comparative Evaluation of Salivary Sialic Acid Levels Among Beedi Rollers and Tobacco Users in Mangalore, South India

Introduction: According to World Health Organization, the global cancer burden is estimated to have risen to 18.1 million new cases and 9.6 million deaths in 2018. Tobacco use is a leading cause of cancer and of death from cancer. Beedis are the most popular smoking form of tobacco in India. Thirty-four percent of the tobacco produced in India is used for making beedis. The beedi sector is agroforestry-based and the second largest industry in India with approximately 4.4 million full-time beedi workers in India. Toxic constituents present in tobacco are released into the ambient air during the processing of beedis. Methods: A descriptive cross-sectional study was conducted to assess and compare salivary sialic acid levels among beedi rollers, tobacco smokers, smokeless tobacco users and individuals with no tobacco exposure. The study sample comprised of 140 individuals who were 30 to 60 years old, who attended dental screening and treatment camps in rural and urban areas in Mangalore, conducted by the Department of Public Health Dentistry, Yenepoya Dental College and patients who visited the Department of Oral Medicine and Radiology of Yenepoya Dental College. Saliva was collected by passive drool method into a sterile container. Biochemical analysis of salivary sialic acid was done using the acidic ninhydrin method. Continuous variables are expressed in terms of mean and standard deviation. Categorical variables are expressed in terms of frequencies and percentages. To compare salivary sialic acid levels between the groups ANOVA was used. The Chi-square test was used to compare categorical variables between the groups. Results: A total of 140 participants, 35 beedi rollers, 35 smokers, 35 smokeless tobacco users and 35 individuals with no tobacco exposure participated in the study. Among the 140 participants, 90 participants were males and 50 participants were females. There was a statistically significant difference in the mean salivary sialic acid level between the different groups (p<0.001) with smokeless tobacco users having the highest (10.60 mg/dL) mean salivary sialic acid level. It was found that the mean salivary sialic acid level reduced as the age progressed, even though there was no statistically significant difference. There was a statistically significant difference in the mean salivary sialic acid level between the different groups (p=0.010) with participants with 11 to 20 years of exposure to tobacco having the highest (8.67 mg/dL) mean salivary sialic acid level and participants with no tobacco exposure having least (3.06 mg/dL) mean salivary sialic acid level. Conclusion: The salivary sialic acid level was more in beedi rollers than individuals with no tobacco exposure, even though the difference was not statistically significant. The results showed elevated levels of salivary sialic acid in smokeless tobacco users followed by tobacco smokers. This may be an indication that smokeless tobacco use has harmful effects similar to or more than tobacco smoking since salivary sialic acid levels in smokeless tobacco users were higher than those in smokers.