Reverse smoking in Andhra Pradesh, India: variability of clinical and histologic appearances of palatal changes

In Srikakulam, India, 101 patients with palatal lesions due to reverse smoking were followed for 1 year at monthly intervals to analyze the behavior of the various components of their palatal lesions. Of these patients, 24% stopped the habit completely and 27% changed to the conventional type of smoking. Palatal keratosis was very stable, whereas red areas changed into nonpigmented areas. Epithelial dysplasia was found in 23% of the 101 biopsies, the highest being in the red areas. Mild inflammation was seen in about half of the biopsies.