Introductory Note:

This bibliography is an attempt to compile a list of 'all' tobacco and areca nut related research conducted in India since 1985, providing references and abstracts. Most of the abstracts were those originally prepared by the authors. The purpose of creating this database is to form a pool of information, which can be drawn upon by tobacco control researchers, advocates for tobacco control and those specializing in public health policy.

This compilation contains abstracts on reports of tobacco use surveys, tobacco related mortality, tobacco related diseases both cancerous and non-cancerous, according to body system and site, and other health problems associated with tobacco use and environmental tobacco smoke. Other topics include the toxicity of tobacco products, behavioural interventions and the psychology of tobacco use, tobacco control measures and policies, reports on tobacco advertising and sponsorship. Also included are the tobacco health hazards faced by tobacco workers, tobacco employment studies, tobacco agriculture and technology, and the economics of tobacco. There are many more studies on the health problems caused by tobacco use than on other topics, reflecting perhaps the seriousness of the health impact of tobacco use

The following databases were searched: Pub Med, Medline, and J-Gate (a new Indian database). The keywords used for the searches were '(Tobacco OR smoking) AND India', and the databases were also searched using terms for diseases known from international research findings to be associated with tobacco, 'AND India'. Proceedings of meetings on tobacco control related research provided additional sources. We are grateful to the librarians who helped with the literature searches, and to those who contributed articles and other publications from their own collections

Some judgment was used in selecting material for this database, both according to its quality and to the usefulness of the information for framing tobacco control policies or interventions. Some papers were excluded because they duplicated another paper by the same author/s, or because the methodology or statistics were unclear. Apart from abstracts of research studies, some editorials, letters and news articles containing fresh viewpoints, interesting ideas, useful summaries or information were also included.

A table of contents has been given for quick location of abstracts and references, in which articles are categorised by topic area. Within each topic the abstracts are listed in reverse chronological order. Codes have been given for each article, designating the topic category, the year of publication (or of preparation), and the first three letters of the first author's last name. The table of contents shows the topic codes. In addition, there is a full alphabetical listing by last name of the first author. A CD ROM is included with each hard copy of this publication, so that users can search and sort the articles. The files are also available on-line at the ACT-India website and through the World Bank website: www.worldbank.org/tobacco.

The following types of reports are included: analytical reports, case series studies and case reports, case-control studies, cohort studies, comparative studies, cross-sectional studies and cross-sectional follow-up studies, detection camp reports, descriptive reports, incidence studies, intervention studies, histological studies, news reports, overviews of research results, predictive reports, proceedings, reviews of studies, recommendations, and tobacco use surveys. There are also a few clinical, and biophysical and biochemical studies.

A tremendous amount of biological research on the effects of tobacco on the cells of the oral mucosa is being done in India. Researchers in cancer cytogenetics have mostly been studying changes in the oral mucosa leading to cancer or the abnormalities in the DNA structure of oral cancer cells. Broadly, the main findings are that tobacco acts on cells as a mutagen, disrupting the inherited regulation mechanisms for repair and reproduction, putting them on the road to cancer. Individuals who have inherited defective DNA repair genes are more likely than people with normal DNA to developcancer within their lifetime, but even persons with normal cell DNA from birth can develop cancer. The main message from cytogenetic research is that tobacco in all forms is carcinogenic and poses health risks to everyone exposed to it. Similarly, experiments with extracts of areca nut (sometimes erroneously referred to as betel nut), have demonstrated that substances it contains interact with and damage DNA, eventually making cells unhealthy and potentially cancerous.

Abstracts and references on biological research have not been given in this compilation due to the highly technical and specialized nature of the topic Tobacco or areca nut research involving animal subjects was largely omitted also.

Several health problems, which have been found through various studies conducted in the West to occur more frequently in smokers, have not been studied in India, or at least not after 1985. These topics include periodontal disease (studied prior to 1985 in India), peptic ulcer and oesophageal reflux, impotence, osteoporosis, cervical and breast cancers. These areas might be worthwhile investigating from the tobacco perspective in India.It should be noted that results on the association of diabetes with tobacco use are found in studies under the topic of circulatory diseases with other related indicators, as diabetes is a risk factor for circulatory diseases.

This is perhaps the first attempt of its kind. There may be shortcomings and unintended omissions. We shall be most grateful to the readers for pointing those out and contributing new as well as missed papers. We urge those working in any fields under-represented here to contribute further articles. This would improve this database and make future versions more useful and comprehensive. The database will be expanded and updated periodically.

Cecily Stewart Ray (e-mail - cecily_s_ray@hotmail.com)

Prakash C. Gupta (e-mail - pcgupta@tifr.res.in)

Joy de Beyer (e-mail - Jdebeyer@worldbank.org)