Genotoxic damage assessment using the micronucleus assay in buccal mucosa of different types of smokers: A cross-sectional study

BACKGROUND Smoking is a leading cause of carcinogenesis in the head and neck region, representing a critical public health issue. Identifying genotoxic damage in smokers can provide valuable insights for developing preventive interventions. AIM To assess genotoxic damage through the micronucleus assay in exfoliated buccal mucosa cells from users of conventional tobacco, reverse smoking, cannabis, electronic cigarettes, and non-smokers. METHODS A cross-sectional study was conducted with 100 participants divided into five groups: 20 conventional tobacco smokers, 20 reverse smokers, 20 electronic cigarette users, 20 cannabis users, and 20 non-smokers. Exfoliated buccal mucosa cells were analyzed using Giemsa and Papanicolaou staining to identify micronuclei (MN) as markers of genotoxic damage. RESULTS MN were present in 86% of the samples. Statistically significant differences were observed in the median micronucleus count between conventional, reverse, and electronic cigarette smokers compared to non-smokers (P < 0.001), while no significant difference was found for cannabis smokers (P = 0.89). A significant correlation was identified between the presence of oral lesions and micronucleus count (P = 0.03). Regression analysis ruled out alcohol as a confounding factor. CONCLUSION This study identified genotoxic damage associated with various smoking habits, except for cannabis use, highlighting the need for public health interventions to reduce smoking and mitigate its genotoxic effects. These findings provide a foundation for future research and the implementation of preventive policies.