Oral malignant and potentially malignant lesions associated with tobacco-related risks in the Nicobarese tribe of car Nicobar Island

Tobacco use and alcohol consumption are significantly high among the Nicobarese tribe, which may contribute to increased oral health risks. The primary objective of this study was to evaluate the prevalence and characteristics of oral malignant and potentially malignant lesions within this tribal population. A cross-sectional study was conducted to assess the health status and potential risk factors within the Nicobarese tribal population. A predesigned proforma to systematically document demographics and followed the World Health Organization (WHO) guidelines for clinical examination. Sample size was 2600, selected using population proportionate to size from 10 villages, with systematic household sampling and random recruitment of eligible adults. The prevalence of oral potentially malignant lesions, including oral malignant lesions, was 9.92%, with oral malignant lesions alone accounting for 0.19%. Out of 274 who have oral lesions, 271 (98.9%) were smokeless tobacco users. Tobacco use, whether through smoking cigarettes or using smokeless tobacco such as sukka alone or in combination with other smokeless tobacco forms, was significantly associated with these lesions. The majority of oral lesions were observed in individuals aged 26–45 years, with a higher prevalence in males. This study provides the first data on the prevalence of oral malignant and potentially malignant lesions among the indigenous Nicobarese tribe of Car Nicobar Island. We found a high prevalence of oral potentially malignant lesions, despite the low prevalence of oral malignant lesions. Early screening and community-based oral examination programs are urgently needed to catch lesions before they progress to cancer. Immediate public health action is required to reduce smokeless tobacco use through culturally sensitive cessation programs and behavioral change communication. Community-based awareness drives, improve healthcare accessibility and oral health literacy in underserved populations.