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Community Dent Oral Epidemiol. 2015 Aug;43(4):289-97. doi: 10.1111/cdoe.12153. Epub 2015 Feb 12.

Maternal and paternal contribution to intergenerational psychosocial transmission of paan chewing.

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Division of Oral Health and Society, Faculty of Dentistry, McGill University, 2001, McGill College Avenue, Suite 500, Montreal, QC, H3A 1G1, Canada.
Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, 531 boul. des Prairies, Laval, QC, H7V 1B7, Canada.
Institute of Health and Human Development, University of East London, UH250 Startford Campus, Water Lane, London, E154LZ, UK.
School of Medicine, North Haugh, University of St Andrews, Fife, KY16 9TF, UK.
Kerala University of Health Sciences, Medical college PO, Thrissur, Kerala, 680596, India.
Oral pathology, Government Dental College, Medical College Campus, Kozhikode 8, Kerala, India.



Paan chewing is a recognized risk factor for oral cancer in the Asian population. However, there is currently little evidence about the intergenerational psychosocial transmission of paan chewing in South Indian families. We investigated the association between parental and participant's paan chewing in a South Indian population.


A subset of data was drawn from a hospital-based case-control study on oral cancer, the HeNCe Life study, conducted at Government Dental and Medical Colleges of Kozhikode, South India. Analyses were based on 371 noncancer control participants having diseases unrelated to known risk factors for oral cancer. Demographics, behavioral habits (e.g., paan chewing, smoking), and indicators of socioeconomic position (SEP) of both participants and their parents were collected with the use of a questionnaire-based interview and a life grid technique. Unconditional logistic regression assessed odds ratios (OR) and 95% confidence intervals (95% CI) for the associations between parental and participant's paan chewing, adjusted for confounders.


Over half of the participants were males (55.2%), and the mean age of participants was 59 (SD = 12) years. After adjusting for age, religion, parents' SEP, parents' education, smoking and alcohol consumption, and perceived parenting behavior, we observed that maternal paan chewing and paternal paan chewing were significantly associated with the participant's paan chewing ([OR = 2.40, 95% CI = 1.11-5.21] and [OR = 3.05, 95% CI = 1.48-6.27], respectively).


Intergenerational psychosocial transmission of the habit of paan chewing could occur through shared sociocultural or environmental factors.


betel quid chewing; intergenerational relation; life course

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