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Updated: Jul 17, 2026

Methods to Evaluate Cytotoxicity and Immunosuppression of Combustible Tobacco Product Preparations
Published on: January 10, 2015
Clinical, pathological, cellular and molecular lesions caused by oral smokeless tobacco--a review
K A A S Warnakulasuriya1, R Ralhan
1Department of Oral Medicine and Pathology, WHO Collaborating Centre for Oral Cancer and Precancer, King's College Dental Institute at Guy's, King's and St Thomas' Hospitals, London, UK. s.warne@kcl.ac.uk
Abstract:
While carcinogenicity of smokeless tobacco (ST) to humans is well established the oral lesions that precede development of cancer are less well characterized. The clinical appearances of ST-associated lesions are variable. Epidemiological studies show a strong significant association of risk with chronic daily use but population differences are noted because of various commercial products in use. Morphological features observed are some what different to oral lesions caused by smoking and oral dysplasia in ST-associated lesions is less common. Effects of ST on oral keratinocytes observed in vitro include alterations in cell proliferation, apoptosis and activation of inflammatory markers. Genetic aberrations caused by ST include activation of ras, uncommon in smokers but mutational hot spots in p53 encountered are similar to those in smokers.
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