Alcohol, tobacco and paan use and understanding of oral cancer risk among Asian males in Leicester

Objectives To determine use of alcohol, tobacco and paan among males from the various Asian communities in Leicester; and assess their knowledge and attitudes towards oral cancer risk factors and prevention. Also, to determine any differences regarding habits and attitudes between first and second generation Asians. Design Volunteers completed a confidential, bilingual questionnaire regarding alcohol, tobacco and paan use and also knowledge about oral cancer risk factors and preventive measures. Setting Participants were recruited from sources that included GPs' surgeries, sixth form colleges and places of worship. Subjects Asian males, i.e. those of Indian, Pakistani, Bangladeshi or Sri Lankan origin; over the age of 16 years and resident in Leicester. Main outcome measures Quantitative figures were obtained from the questionnaires as to the frequency of alcohol, tobacco and paan use and responses regarding oral cancer knowledge, risk factors and preventive measures. Results The principal Asian community groups in Leicester were Hindu, Sikh, Muslim and Jain. Significant differences were found in males from these groups with regards to habits and oral cancer awareness. Muslim males use tobacco and paan more than the other groups but avoid alcohol. Sikh males drink more alcohol (especially spirits) than the other groups but their use of tobacco and paan is low. Habits of Hindu and Jain males are variable. However, approximately 10% of both 1st and 2nd generation Hindu males combine all three habits of alcohol, tobacco and paan; and are thus considered to be at high risk of developing oral cancer.Seven percent of 1st generation Hindu males were found to chew paans containing tobacco which are strongly associated with oral cancer. More 2nd generation Jains drank alcohol than the 1st generation, and a greater proportion of Hindu, Sikh and Jain 2nd generation males drink spirits than their older counterparts. Knowledge of oral cancer risk factors and preventive measures were variable, the lowest level of knowledge being among the 1st generation Sikh group. Few volunteers realised the risk of alcohol drinking in the aetiology of oral cancer. Conclusion The'Asian'community in Leicester is not homogeneous, but consists of distinct community groups; each with their own cultural beliefs, habits and attitudes. Knowledge of these differences can be used to provide appropriate health education programmes suitably targeted to reduce the use of the known risk factors for oral cancer.