Antioxidant Capacity and Cotinine Detection in Saliva Among Smokeless Tobacco Users and Nonusers- A Comparative Pilot Study

Introduction: Salivary diagnostics, based on approaches in omics data, are increasingly applicable in the diagnosis of systemic and oral pathologies. Saliva, an easily analyzable, collectible oral secretion, is evaluated for this purpose and serves as a predictor for multiple disease scenarios. In the decade when nonsmoking forms of tobacco are silent killers in South East Asia, it is the right time to look at the usefulness of saliva in assessing tobacco-associated lesions. This study analyzes parameters such as total antioxidant activity and the presence or absence of cotinine among tobacco chewers and nonchewers. The study aims to assess the salivary cotinine and antioxidant activity in the saliva of nonsmoking tobacco users and normal individuals. Materials and Methods: N  = 50 adults were categorized as Group 1 ( n  = 25), without tobacco chewing habits, and Group 2 ( n  = 25), with tobacco chewing habits, selected based on their tobacco chewing habits. Saliva was passively collected and analyzed for antioxidant levels using the α-diphenyl-β-picrylhydrazyl assay and cotinine levels using commercially available cotinine detection strips. Results: A significant drop in antioxidant activity of tobacco chewers as compared to normal was noted on t -test. Cotinine levels were significantly above the detection limits in all tobacco chewers, confirming the presence of tobacco-associated chemicals in saliva. Their complete absence in the nonchewers makes it a useful marker. Conclusion: The presence of cotinine and a significant decline in antioxidant activity in saliva increase the susceptibility of the oral cavity to tobacco-associated lesions. Habit relapse in reported cases can be monitored for appropriate counseling by using salivary samples.