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  1. Hedin CA, Axéll T
    J Oral Pathol Med, 1991 Jan;20(1):8-12.
    PMID: 2002444
    At the faculties of dentistry in Chiang Mai, Thailand (CM), and Kuala Lumpur, Malaysia (KL), 234 and 233 consecutive out-patients were interviewed concerning tobacco and chewing habits and examined for the presence of oral melanin pigmentation. Tobacco was regularly used by 32% and 28% of the studied populations in CM and KL. Cigarette smoking was the predominant habit, but the chewing of betel and tea leaves (miang) and the smoking of banana leaf cigars (khi yo) was also registered. The genetically acquired pigmentation dominated. Although nearly all non-tobacco users in the Malay and Indian populations had oral melanin pigmentation, it was found that tobacco smokers had significantly more oral surfaces pigmented than non-tobacco users. Among Thais, the percentage of pigmented individuals was significantly higher among tobacco smokers. It was concluded that tobacco smoking stimulates oral melanocytes to a higher melanin production also in dark-skinned ethnic groups.
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