|  |  | % prevalence (n)a |  | |
---|---|---|---|---|---|
Study | Endpointb | Exposurec | Exposed | Unexposed | Statistical tests and other results and commentsd |
Experimental studies | |||||
Grasser 1977 [21] | Oral leukoplakia | ST ever | 13.3 (4) | 0.5 (1) | OR 28.2 (3.03–262) |
 |  |  |  |  | Lesions in users resolved after 10 days quit |
Payne 1988 [22] | Greer 1–3 | Snuff current | 100.0 (16)e | - | After switching site of snuff placement and to reference snuff, all 16 subjects had new lesions after 7 days of use, evident in 15 subjects by day 2. After 7 days, the original lesions at the habitual sites had resolved by 1 degree |
Martin 1999 [23] | Oral leukoplakia | ST current | 39.4 (119) | 1.5 (42)f | OR 41.9 (28.6–61.4) |
 |  | Snuff current | 41.8 (118) | 1.5 (42)f | OR 46.4 (31.5–68.2) |
 |  | CT current | 5.0 (1) | 1.5 (42)f | OR 3.39 (0.44–25.9) |
 |  |  |  |  | Lesion had completely resolved in 97.2% (106/109) of ST users 6 weeks after tobacco use was prohibited |
Case-control studies | |||||
 |  |  | Cases | Controls |  |
Fisher 2005 [26] | Oral leukoplakia | ST current | 22.5 | 7.2 | OR 9.21 (1.49–57.0)g |
 |  | ST former | 25.7 | 12.3 | OR 2.73 (0.69–10.8)g |
 |  | Snuff current | 19.0 | 2.7 | OR 30.1 (2.67–338)g |
 |  | Snuff former | 11.1 | 6.6 | OR 0.98 (0.17–5.61)g |
 |  | CT current | 4.2 | 4.3 | OR 0.97 (0.19–4.98) |
 |  | CT former | 20.0 | 12.0 | OR 1.83 (0.76–4.40) |
Cross-sectional studies of populations unselected by ST use | |||||
 |  |  | Exposed | Unexposed |  |
Greer 1983 [27] | Greer 1–3 | ST use | 42.7 (50) | - | Only ST users examined |
Poulson 1984 [28] | Greer 1–3 | ST use | 58.9 (33) | - | Only ST users examined |
Offenbacher 1985 [29] | Oral mucosal pathology | ST use | 22.7 (17) | 4.7 (23) | OR 5.95 (3.00–11.8) |
Wolfe 1987 [30] | Greer 1–3 | ST currenth | 25.5 (37) | 3.7 (3)f | OR 8.91 (2.65–29.9) |
Creath 1988 [32] | Oral leukoplakia | Snuff ever | 5.2 (15) | 0.1 (1) | OR 38.6 (5.07–294) |
Cummings 1989 [31] | Soft tissue lesion | ST current | 17.6 (3) | 0.0 (0) | Only 6 never users of ST No differences significant |
 |  | ST former | 100.0 (2) | 0.0 (0) |  |
 |  | Snuff current | 21.4 (3) | 0.0 (0) |  |
 |  | CT current | 11.1 (1) | 0.0 (0) |  |
Stewart 1989 [33] | Greer 1–3 | ST current | 29.0 (9) | - | Prevalence only reported for male current users |
Ernster 1990 [34] | Oral leukoplakia | ST current | 46.3 (196) | 1.4 (7) | OR 59.9 (27.8–129) |
 |  | ST formerj | 1.7 (3) | 1.4 (7) | OR 1.19 (0.30–4.65) |
 |  | Snuff currentk | 58.3 (165) | 1.4 (7) | OR 97.1 (44.4–212) |
 |  | CT currentk | 17.7 (14) | 1.4 (7) | OR 15.0 (5.82–38.4) |
Greene 1992 [35] | Oral leukoplakia | ST current | 51.7 (167) | 2.9 | OR 35.8i |
 |  | ST formerj | 3.5 | 2.9 | OR 1.21i |
 |  | Snuff currentk | 61.3 (157) | 2.9 | OR 53.0i |
 |  | CT currentk | 14.8 (8) | 2.9 | OR 5.82i |
Sinusas 1992 [36] | Greer 1–3 | ST current | 37.1 (23) | 6.0 (5) | OR 9.32 (3.29–26.4) |
 |  | ST formerl | 6.7 (4) | 6.0 (5) | OR 1.13 (0.29–4.39) |
 |  | Snuff currentk | 34.2 (13) | 6.0 (5) | OR 8.22 (2.67–25.3) |
 |  | CT currentk | 16.7 (4) | 6.0 (5) | OR 3.16 (0.78–12.9) |
Daughety 1994 [37] | Oral lesions at placement site | ST current | 33.0 (45) | - | Only ST users asked about oral lesions |
 |  | Snuff current | 43.9 (25) | - |  |
Robertson 1997 [38] | Oral leukoplakia | ST current | ≈50 | < 2 | Approximate estimates based on 1846 baseball players in various studies |
 |  | ST former | < 2 | < 2 |  |
Tomar 1997 [39] | ST lesions | Snuff current | 34.9 (107)m | 1.9 (102)m | OR 18.4 (8.5–39.8)n |
 |  | Snuff former | 5.6 (18)m | 1.9 (102)m | OR 2.4 (1.0–6.1)n |
 |  | CT current | 19.6 (54)m | 3.0 (156)m | OR 2.5 (1.3–5.0)o |
 |  | CT former | 6.0 (32)m | 3.0 (156)m | OR 1.3 (0.7–2.2)o |
Shulman 2004 [42] | Oral mucosal lesions | ST currentp | 60.3 (224) | 23.8 (1939) | OR 3.90 (2.75–5.55)q |
 |  | ST formerp | 12.8 (23) | 23.8 (1939) | OR 0.53 (0.25–1.13)q |
Sinusas 2006 [44] | Greer 1–3 | ST current | 27.9–46.3r | 4.0 | p < 0.001 |
 |  | ST former | 9.5 | 4.0 | p < 0.001 |
Cross-sectional studies of populations selected by ST use and/or presence of oral lesions | |||||
Smith 1970 [45] | Oral mucous membrane change | Snuff current | 11.7 (1751) | - | Only snuff users examined |
Christen 1979 [46] | Clinical leukoplakia | ST current | 64.3 (9) | - | Only ST users examined |
 |  | Snuff current | 69.2 (9) | - |  |
 |  | CT current | 57.1 (4) | - |  |
Kaugars 1992 [47] | Oral lesions | ST currents | 13.0 (45) | - | Only ST users examined |
 |  | Snuff currents | 14.4 (34) | - |  |
 |  | CT currents | 8.4 (18) | - |  |
Little 1992 [48] | Greer 1–3 | ST current | 78.8 (193) | 6.3 (14)t | OR 55.4 (29.8–103) |
Roberts 1997 [49] | Oral lesion | Snuff current | 31.8 (7) | - | Only snuff users examined |