A medical study has revealed that more than 75 per cent of oral cancer patients in Uganda have a history of tobacco smoking, confirming previous studies suggesting that the use of tobacco is a risk factor for oral cancer.

The study conducted from 1995 to 2001 among cancer patients in Mulago Hospital, Uganda's main referral hospital, shows that of the 141 squamous cell carcinoma cases studied, 91 had a history of tobacco use. The hospital also has a cancer institute.

The study, "Tobacco Use and Oral Cancer Patients in Uganda," is comparable to another carried out at the University of San Francisco in 1998 which reported a history of smoking in 72 per cent of oral cancer patients. It was conducted by independent medical researchers. 

"This confirms the link between cigarette smoking and cancer in Uganda. A tobacco industry executive in the region once said we would not live long enough to suffer the negative health effects of smoking due to our low life expectancy and high infant mortality. This research shows the incidence of cancer of the mouth with as little as two years of smoking," said Phillip Karugaba, spokesman for The Environmental Action Network, a local anti tobacco advocacy group.

The findings of the Ugandan research will be presented to the 4th Negotiating Session on the Framework Convention on Tobacco Control set for March 18-23 in Geneva, Switzerland.

The Framework Convention Alliance, comprising 160 groups from 73 countries dedicated to an effective global tobacco treaty, has also prepared position papers on areas such as advertising, smuggling, trade and packaging of tobacco to be presented during the negotiating sessions. 

The aim of the study was to determine the prevalence and type of tobacco use among patients diagnosed with oral oral cancer and to establish its age and gender distribution among patients.

According to the report, the patients smoked tobacco in different forms, with the commonest use being filtered cigarettes and hand-rolled tobacco. 

The two accounted for about 43 per cent of the cases. Hand-rolled tobacco is the most common form among rural consumers.

The research, co-ordinated by Aisha Bataringaya, found that, out of a total of 141 patients, 47 per cent of those diagnosed with oral cancer were female and 53 per cent male. This finding also confirms the increasing use of tobacco among women. 

Most of the patients with oral cancer conditions associated with tobacco smoking were in the 60-69 age group. 

The other age-group exhibiting high prevalence rates was between 50 and 59 years. Although medical workers say oral cancer is a disease of the elderly, uncommon under the age of 40, the Uganda study has revealed that 15 per cent of all patients were under the age of 40. 

"Perhaps the younger age of development of oral cancer could be as a result of initiation into tobacco use at an early age," says the report.

Most patients were from the central region, which also sheds light on the relationship between urbanisation and the high incidence of tobacco use. 

At least 43 per cent of the patients came from the urbanised central region, 18.7 per cent from the north and 19.5 per cent from the west. 

Both the northern, especially West Nile, and western regions of Uganda are tobacco-growing areas. The eastern parts of the country, which are neither urbanised nor tobacco-growing areas, recorded the least number of patients, accounting for only 11 per cent.

The study recommends that dentists lead the health profession in establishing a protocol for the regulation of tobacco use. 

Dental associations are urged to adopt a policy on tobacco, one of the major causes of preventable deaths in the world.

The World Health Organisation has estimated that, by the year 2030, 10 million people per year will die from tobacco-related diseases, with 70 per cent of them being from developing countries.