DESIGN: This was a population-based, cross-sectional study whereby subjects were adults aged 18 years old and above. A workshop on the identification of OML was held to train and calibrate dental officers prior to data collection in the field. Sociodemographic and risk habits data were collected via face-to-face interview, whilst presence of OML and clinical details of lesions such as type and site were collected following clinical oral examination by the examiners. Data analysis was carried out using the Statistical Package for Social Science (SPSS) version 12.0. The association between risk habits and risk of OPMD was explored using logistic regression analysis.

RESULTS: A total of 1634 subjects were recruited. Prevalence of OML for this population was 54.1%. Linea alba was the most common lesion seen (28.7%). This study showed an overall OPMD prevalence of 5.6%. The most common type of OPMD was leukoplakia (64.8%), followed by lichen planus (30.8%). Subjects who only smoked were found to have an increased risk for OPMD of almost four-fold (RR 3.74, 95%CI 1.89-7.41). The highest risk was found for betel quid chewers, where the increased risk observed was more than six times (RR 6.75, 95%CI 3.32-13.72). Alcohol consumption on its own did not seem to confer an increased risk for OPMD, however when practiced concurrently with smoking, a significant risk of more than five times was noted (RR 5.69 95%CI 3.14-10.29).

METHODS: Data from 45 LMICs were obtained from the Global School-based Student Health Survey (GSHS) between 2009 and 2019. Lifestyle behavior factors were collected through a structured questionnaire. Suicidal ideation, plan, and attempt were ascertained by three single-item questions. Lifestyle risk scores were calculated via a sufficient dimension reduction technique, and lifestyle risk clusters were constructed using a latent class analysis. Generalized linear mixed models with odds ratio (OR) and 95% confidence interval (CI) were used to estimate the lifestyle-STB associations.

RESULTS: A total of 229,041 adolescents were included in the final analysis. The weighted prevalence of suicidal ideation, plan, and attempt was 7.37%, 5.81%, and 4.59%, respectively. Compared with the favorable lifestyle group, the unfavorable group had 1.48-, 1.53-, and 3.11-fold greater odds of suicidal ideation (OR = 1.48, 95%CI: 1.30-1.69), plan (OR = 1.53, 95%CI 1.34-1.75), and attempt (OR = 3.11, 95%CI 2.64-3.65). Four clusters of lifestyle risk behaviors were identified, namely healthy lifestyles (H-L), insufficient intake of vegetables and fruit (V-F), frequent consumption of soft drinks and fast food (D-F), and tobacco smoking and alcohol drinking (S-A) clusters. Compared with H-L cluster, V-F cluster was associated with 43% and 42% higher odds of suicidal ideation and plan, followed by S-A cluster (26% for ideation and 20% for plan), but not significant in D-F cluster (P > 0.05). D-F cluster was associated with 2.85-fold increased odds of suicidal attempt, followed by V-F cluster (2.43-fold) and S-A cluster (1.18-fold).