{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T14:24:31Z","timestamp":1783347871915,"version":"3.54.6"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"Abstract<\/jats:title>\n \n Background:<\/jats:title>\n Submucous fibrosis (SMF) is an oral potentially malignant disorder with a high risk of malignant transformation, primarily associated with areca nut use and tobacco consumption.<\/jats:p>\n <\/jats:sec>\n \n Aim:<\/jats:title>\n This study aimed to evaluate the correlation of nicotine dependence and nutritional status with disease severity in patients with SMF.<\/jats:p>\n <\/jats:sec>\n \n Settings and Design:<\/jats:title>\n This observational study was conducted among 70 SMF patients subdivided on clinical and histological classification.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n \n Habit index was calculated and Nicotine dependence was measured using Fagerstrom test for nicotine dependence (FTND). Body mass index (BMI) and mid upper arm circumference (MUAC) was recorded. Haematological assessment, including serum iron, vitamin B\n 12,<\/jats:sub>\n and folate levels was conducted. Malnutritional universal screening tool (MUST) was used to score the risk of malnutrition.\n <\/jats:p>\n <\/jats:sec>\n \n Statistical Analysis:<\/jats:title>\n \n Chi-square, Pearson\u2019s correlation and Spearman\u2019s correlation tests were used for group comparisons of categorical, numerical, and ordinal data, respectively. Level of statistical significance was set at a\n P<\/jats:italic>\n value less than 0.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results and Conclusion:<\/jats:title>\n \n Clinical and histological staging showed a positive correlation with habit index and nicotine dependence (\n P<\/jats:italic>\n value = 0.001). BMI, MUAC and serum iron levels showed inverse correlation with severity of the disease. MUST scores revealed increase (\n P<\/jats:italic>\n value = 0.001) with advancing stages of SMF. FTND showed significant correlation with BMI, MUAC, MUST and serum iron values. Nicotine dependence and nutritional status are important indicators of the severity of the disease in patients with SMF. Routine assessment of these parameters\u2019 aids in the identification of high-risk groups and to plan a targeted treatment strategy.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jomfp.jomfp_353_25","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T18:00:39Z","timestamp":1783101639000},"page":"239-244","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["New insights in submucous fibrosis: Nicotine dependence and nutritional assessment"],"prefix":"10.4103","volume":"30","author":[{"given":"Rishabh","family":"Sachdeva","sequence":"first","affiliation":[{"name":"Department of Oral Pathology, Maulana Azad Institute of Dental Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aadithya B.","family":"Urs","sequence":"additional","affiliation":[{"name":"Department of Oral Pathology, Maulana Azad Institute of Dental Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Oral Pathology, Maulana Azad Institute of Dental Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhawna","family":"Mahajan","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"R1-20260706","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1111\/jop.12924","article-title":"Oral submucous fibrosis in Asian countries","volume":"49","author":"Peng","year":"2020","journal-title":"J Oral Pathol Med"},{"key":"R2-20260706","doi-asserted-by":"crossref","first-page":"35","DOI":"10.4103\/ijmr.IJMR_1793_17","article-title":"Oral health consequences of smokeless tobacco use","volume":"148","author":"Muthukrishnan","year":"2018","journal-title":"Indian J Med Res"},{"key":"R3-20260706","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1111\/j.1360-0443.1991.tb01879.x","article-title":"The Fagerstr\u00f6m test for nicotine dependence: A revision of the Fagerstr\u00f6m tolerance questionnaire","volume":"86","author":"Heatherton","year":"1991","journal-title":"Br J Addict"},{"key":"R4-20260706","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/S1368-8375(00)00133-0","article-title":"Cultural and dietary risk factors of oral cancer and precancer--A brief overview","volume":"37","author":"Zain","year":"2001","journal-title":"Oral Oncol"},{"key":"R5-20260706","first-page":"10","article-title":"Serum levels of folate and vitamin B12 in oral epithelial dysplasia","volume":"1","author":"Jaber","year":"2015","journal-title":"Dent Oral Craniofac Res"},{"key":"R6-20260706","first-page":"i","article-title":"Obesity: Preventing and managing the global epidemic. 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