Chewing tobacco may cause?

ESIC Nursing Officer 2016 (shift-1)

Medical Surgical Nursing

Easy

Appeared in: ESIC Nursing Officer 2016 (shift-1)

Explanation

Chewing tobacco, a form of smokeless tobacco, contains at least 28 cancer-causing agents (carcinogens), with tobacco-specific nitrosamines (TSNAs) being the most potent.
Approximately 90% of oral cancers in regions like South East Asia are directly linked to tobacco use, including chewing.
The disease process often begins with precancerous lesions like leukoplakia (white patches) or erythroplakia (red patches), which can transform into invasive oral cancer over time.
Studies show that the cancer almost always occurs on the side of the mouth where the tobacco quid is habitually kept, demonstrating a direct causal link.

Option A: This is not a recognized direct complication of smokeless tobacco use. Vision problems are more commonly associated with smoking due to an increased risk of cataracts and macular degeneration.
Option C: This is not a primary or common symptom. While nicotine can affect the gastrointestinal tract, it is more likely to cause nausea or indigestion, especially in new users. Diarrhea is not a characteristic long-term effect.
Option D: While chewing tobacco does cause mouth sores and non-healing ulcers, this is often a symptom or a precursor to oral cancer. Oral cancer is the ultimate, more severe pathology.

Visual 1: Image: Photograph showing leukoplakia (a white, thickened patch) on the inner cheek or gum, a common precancerous lesion from chewing tobacco.
Visual 2: Image: Photograph of advanced oral squamous cell carcinoma in a patient's mouth to illustrate the severe outcome.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Health risks associated with smokeless tobacco use as background academic context rather than a clinical decision trigger.
Nurses have a crucial role in screening for smokeless tobacco use during routine patient history taking.
Performing a thorough oral cavity examination (Oral Visual Examination - OVE) is a key nursing assessment for the early detection of precancerous or cancerous lesions in high-risk individuals.
Patient education on the risks of all forms of tobacco and providing resources for cessation are vital nursing interventions to prevent oral cancer.

How to Approach the Question

First, identify the core subject of the question: the consequences of 'chewing tobacco'.
This is a factual recall question. Access your knowledge about the major health risks associated with smokeless tobacco.
Evaluate each option. 'Impaired vision' and 'Diarrhea' are not commonly associated with chewing tobacco and can be eliminated.
Compare the remaining options: 'Oral cancer' and 'Ulcer'. Recognize that an ulcer can be a symptom or a precursor to cancer, but oral cancer is the most severe and definitive long-term disease caused by chewing tobacco.
Select 'Oral cancer' as the most significant and definitive consequence among the choices.

Concept Tested & Keywords

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