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Limitations include the small sample size, the lack of a control group, and the inability to test for statistical significance in the changes after intervention

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It has also been shown that smokeless tobacco use is common in this regionfor example in Myanmar more than 50% of men use betel quid. Commenting on the topic, Dr Makoto Tahara, Chief of the Department of Head and Neck Medical Oncology at the National Cancer Centre Hospital East in Chiba in Japan, said: Given the number of health issues associated with chewing betel quid, particularly oral cancer and precancerous conditions such as leukoplakia and oral submucous fibrosis, understanding ways to reduce betel quid chewing is of global public health importance

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