|Year : 2020 | Volume
| Issue : 3 | Page : 321-322
MCQs on “Prevalence, patterns, and sociocultural factors associated with use of tobacco-based dentifrices (Gul) in India”
HS Darling1, S Jayalakshmi2, Pradeep Jaiswal3
1 Department of Medical Oncology and Hemato-oncology, Command Hospital, Bangalore, Karnataka, India
2 Department of Radiation Oncology, Artemis Hospital, Gurugram, Haryana, India
3 Department of Surgical Oncology, Command Hospital, Bangalore, Karnataka, India
|Date of Submission||21-Jul-2020|
|Date of Decision||22-Jul-2020|
|Date of Acceptance||22-Jul-2020|
|Date of Web Publication||10-Aug-2020|
H S Darling
Department of Medical Oncology and Hemato-oncology, Command Hospital, Bangalore, Karnataka
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Darling H S, Jayalakshmi S, Jaiswal P. MCQs on “Prevalence, patterns, and sociocultural factors associated with use of tobacco-based dentifrices (Gul) in India”. Indian J Cancer 2020;57:321-2
|How to cite this URL:|
Darling H S, Jayalakshmi S, Jaiswal P. MCQs on “Prevalence, patterns, and sociocultural factors associated with use of tobacco-based dentifrices (Gul) in India”. Indian J Cancer [serial online] 2020 [cited 2020 Oct 1];57:321-2. Available from: http://www.indianjcancer.com/text.asp?2020/57/3/321/291782
Q 1. Characteristics of smokeless tobacco (ST) include all, except
- it causes more head and neck cancers than lung cancer
- it is more common in India than smoked tobacco
- it is helpful in smoking cessation programs
- its use is more common in Indian women
Q 2. Dentifrices are essentially
- used for dental cleaning
- tobacco-containing dental care products
- ST preparations
- oral pain-killers
Q 3. Global Adult Tobacco Survey-2 (GATS-2, 2016–2017) has given the prevalent forms of usage of ST in the Indian population. Choose the correct sequence.
- Paan > Gutkha > Khaini > Gul
- Khaini > Gutkha > Paan > Gul
- Gul > Paan > Gutkha > Khaini
- Gutkha > Paan > Gul > Khaini
Q 4. Gul is harmful in its own way as
- it is very expensive
- it can cause sudden death
- most consumers are unaware of its tobacco content
- it is only available in the black market
Q 5. Find the incorrect option. In this study, most of the Gul consumers
- started using it as a dental pain-killer
- did not use a toothpaste
- had never received dental care
- started using it as a substitute to smoked tobacco
Q 6. Which of the following statements about Gul is false?
- It is used as dentifrice
- It contains tobacco with sugar or molasses
- Predominantly used in southern part of India
- It is registered as tobacco product in India
Q 7. Which of the following statements is false about Gul usage in Indian population?
- Its usage is more common in females as compared to males
- Under existing Indian laws, usage is allowed as a dentifrice
- Commonly used to alleviate dental pain
- More commonly available in grocery shops then tobacco shops
Q 8. The most likely reasons for Gul usage being more common in females are all, except
- It has very pleasant odor
- It is readily available
- it is cheap
- it is considered a safe dentifrice
Q 9. Choose the incorrect statement
- The chances of lung cancer are less with Gul consumption as compared to bidi smoking
- Gul usage is more common in nuclear families
- Most of the Gul users have most of their other family members using Gul
- Gul is used as a substitute to toothpaste by Gul consumers
Q 10. Choose the correct statement
- As per the Drugs and Cosmetics Act 1940, nicotine can be used in food products
- As per the Food Safety and Standards Authority of India, tobacco is allowed as a food component
- As per Indian law, tobacco cannot be used as an ingredient in dental care products
- Under the regulation of Cigarette and Other Tobacco Products Act 2003, Gul can be used as a dentifrice
Answers & explanations:
1 (c). It is helpful in smoking cessation programs
ST in its various forms has been implicated in many life-threatening and debilitating diseases including cancer of the mouth. It was seen in our study that a lower proportion of males used Gul than females. ST is more prevalent than the smoked form of tobacco in India as assessed by various studies.
2 (a). Used for dental cleaning
Dentifrice: a powder, paste, or liquid for cleaning the teeth Definition of Dentifrice by Merriam-Webster [Internet]. [cited 2020 Jul 21].
3 (b). Khaini > Gutkha > Paan > Gul
According to the GATS-2 (2016–2017), 28.6% (267 million) of adults in India use some form of tobacco with the majority of the tobacco users consuming smokeless form of tobacco (21.4%). Every fifth adult in India uses ST, out of which Khaini is the most commonly used ST product (12.5%), followed by Gutkha used by 8% of adults. Six percent of adults use betel quid with tobacco and 5% (3% male and 6% females) use tobacco products like Mishri, Gul, and Gudakhu by oral application.
4 (c). Most consumers are unaware of its tobacco content
About 60.7% of users denied knowing that Gul contained tobacco.
5 (d). Started using it as a substitute to smoked tobacco
Majority (68%) of Gul users did not use toothpaste to clean their teeth and most of them (45.16%, n = 28) had never received dental care. It was observed that 97.8% (n = 46) of Gul users who initiated the habit to alleviate dental pain reported that they experienced pain relief on using it.
6 (c). Predominantly used in southern part of India
Gul (tobacco-containing dentifrice) is a pyrolyzed tobacco product mixed with sugar or molasses, alkaline modifiers, and other unknown ingredients which are marketed under different brand names in small tin cans and used as a dentifrice in the eastern part of India across the states of Assam, Arunachal Pradesh, Uttar Pradesh (UP), and Bihar.
7 (b). Under existing Indian laws usage is allowed as a dentifrice
Several judicial rulings have implied that Gul is not included as a dentifrice but as a tobacco product under the regulation of Cigarette and Other Tobacco Products Act (COTPA, 2003).
8 (a). It has very pleasant odor
The taboo has been less stringent for ST in comparison to smoked form, perhaps because it is relatively odorless and less perceptible, less stigmatized for women, and easier to conceal.
9 (c). Most of the Gul users have most of their other family members using Gul
Most of the Gul users (70.5%) reported that none of their other family members used Gul.
The role of ST use in the occurrence of cancers such as colorectal, lung, breast, and cervix has not been established beyond doubt as yet and needs further exploration by well-controlled studies. (Gupta S, Gupta R, Sinha DN, Mehrotra R. Relationship between the type of smokeless tobacco & risk of cancer: A systematic review. Indian J Med Res. 2018 Jul; 148 (1):56–76.)
10 (c) As per Indian law, tobacco cannot be used as an ingredient in dental care products
The use of tobacco as an ingredient in dental care products is prohibited by law in India.