erythroplakia, erythroleukoplakia, oral leukoplakia, submucous fibrosis of the oral cavity, squamous cell carcinoma of the oral cavity, and other soft tissue lesions. 10,11Smokeless tobacco is sorted as a group I carcinogen (IARC), having proven connections to oral and oropharyngeal cancers. 12,13obacco use is not only an individual choice but also a complex behavior shaped by sociocultural, environmental, and occupational determinants. 14Occupational stress, irregular work IntroductIonAlmost 8 million people die from tobacco use each year, making it a significant worldwide public health concern.Approximately 1.3 million of these are caused by secondhand smoke exposure, but tobacco usage is directly linked to nearly 7 million. 1,2Beyond second-hand smoke, the dangers of third-hand smokeresidual tobacco toxins that persist on surfaces for extended periods-pose an additional risk, particularly to vulnerable groups such as children. 3These findings reinforce that no form or level of tobacco exposure is safe, and all types of tobacco products, including cigarettes, bidis, cigars, waterpipe, heated tobacco, and smokeless tobacco products, carry serious health risks. 4,5lobally, around 80% of tobacco users come under lowand middle-income countries, with India being among the highest contributors to the tobacco burden. 6,728.6% of Indian people use tobacco in some capacity, with smokeless tobacco usage (21.4%) outpacing smoking (10.7%), according to the GATS (2016-2017). 2,8,9One of the main risk factors for early death and morbidity associated with chronic illnesses such as diabetes, cancer, heart disease, and respiratory disorders is tobacco use.Within the oral cavity, smoking and smokeless tobacco are strongly implicated in the development of oral potentially malignant disorders (OPMDs), verrucous carcinoma,
Senapati et al. (Mon,) studied this question.