What is it about?

The use of chewing or oral tobacco (smokeless tobacco) is common in South Asia, putting South Asians at risk for mouth cancers. For people living with HIV (PLHIV), smokeless tobacco use is higher than HIV uninfected individuals. In this study we found the risk of precancerous mouth conditions is increased more than 3-times among PLHIV compared to HIV uninfected persons. Further, precancerous mouth conditions risk is increased 5-times among PLHIV that currently use smokeless tobacco compared to PLHIV that are non-users. We end by recommending screening for precancerous mouth conditions for PLHIV that use smokeless tobacco with a priority for those that are current users.

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Why is it important?

Previous research has shown that relative to HIV-uninfected persons, mouth cancers are more common among PLHIV. One way of improving care for mouth cancers is to detect them early while they are still in their precancerous stage. Checking (screening) of the mouth for precancerous mouth conditions can be done quickly and inexpensively. Prioritizing PLHIV that are current users of smokeless tobacco will further streamline the screening process, by not adding too much burden on an already fragile health system.


There is very little understanding of mouth cancers among PLHIV in South Asia, which is one of the most common types of cancers in the region in the general population. Cancer research in South Asia needs to be contextualized to the region. Most cancer research among PLHIV is dominated by North American or western European, where smokeless tobacco use is rare. We require more cancer studies among PLHIV from diverse geographical regions of the world particularly from the global South, so that our understanding of cancer science is more expansive than it currently is and we are able to deliver the best care to PLHIV in these regions.

Ivan Marbaniang
McGill University

Read the Original

This page is a summary of: Smokeless tobacco use and oral potentially malignant disorders among people living with HIV (PLHIV) in Pune, India: Implications for oral cancer screening in PLHIV, PLoS ONE, July 2022, PLOS, DOI: 10.1371/journal.pone.0270876.
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