Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Exp Med. Sep 20, 2025; 15(3): 108025
Published online Sep 20, 2025. doi: 10.5493/wjem.v15.i3.108025
Genotoxic damage assessment using the micronucleus assay in buccal mucosa of different types of smokers: A cross-sectional study
Efraín Álvarez-Martínez, Iván E Porto-Puerta, Carlos M Ardila
Efraín Álvarez-Martínez, Iván E Porto-Puerta, Maxillofacial Surgery, Universidad de Antioquia, Medellín 050010, Antioquia, Colombia
Carlos M Ardila, Department of Basic Sciences, Biomedical Stomatology Research Group, Faculty of Dentistry, Universidad de Antioquia, Medellín 050010, Antioquia, Colombia
Author contributions: Álvarez-Martínez E performed the conceptualization, data curation, data analysis, manuscript writing, and revision of the manuscript; Porto-Puerta IE performed the conceptualization, data curation, data analysis, manuscript writing, and revision of the manuscript; Ardila CM performed the conceptualization, data curation, data analysis, manuscript writing, and revision of the manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Ethics Committee of the Faculty of Dentistry at the University of Antioquia, ensuring compliance with all applicable ethical guidelines and standards.
Informed consent statement: All participants signed an informed consent form detailing the study's objectives, procedures, potential risks and benefits, and guarantees of data anonymity and confidentiality. This ensured that participants were fully informed and voluntarily participated.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at martin.ardila@udea.edu.co.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Carlos M Ardila, Postdoctoral Fellow, Professor, Senior Researcher, Department of Basic Sciences, Biomedical Stomatology Research Group, Faculty of Dentistry, Universidad de Antioquia, Calle 70 No. 52-21, Medellin 050010, Antioquia, Colombia. martin.ardila@udea.edu.co
Received: April 3, 2025
Revised: May 16, 2025
Accepted: July 16, 2025
Published online: September 20, 2025
Processing time: 131 Days and 17.9 Hours
Abstract
BACKGROUND

Smoking is a leading cause of carcinogenesis in the head and neck region, representing a critical public health issue. Identifying genotoxic damage in smokers can provide valuable insights for developing preventive interventions.

AIM

To assess genotoxic damage through the micronucleus assay in exfoliated buccal mucosa cells from users of conventional tobacco, reverse smoking, cannabis, electronic cigarettes, and non-smokers.

METHODS

A cross-sectional study was conducted with 100 participants divided into five groups: 20 conventional tobacco smokers, 20 reverse smokers, 20 electronic cigarette users, 20 cannabis users, and 20 non-smokers. Exfoliated buccal mucosa cells were analyzed using Giemsa and Papanicolaou staining to identify micronuclei (MN) as markers of genotoxic damage.

RESULTS

MN were present in 86% of the samples. Statistically significant differences were observed in the median micronucleus count between conventional, reverse, and electronic cigarette smokers compared to non-smokers (P < 0.001), while no significant difference was found for cannabis smokers (P = 0.89). A significant correlation was identified between the presence of oral lesions and micronucleus count (P = 0.03). Regression analysis ruled out alcohol as a confounding factor.

CONCLUSION

This study identified genotoxic damage associated with various smoking habits, except for cannabis use, highlighting the need for public health interventions to reduce smoking and mitigate its genotoxic effects. These findings provide a foundation for future research and the implementation of preventive policies.

Keywords: Oral neoplasms; Smoking; Genotoxicity; Micronucleus; Oral cancer

Core Tip: This study reveals significant genotoxic damage in buccal mucosa cells among conventional, reverse, and electronic cigarette smokers, but not cannabis users, using the micronucleus assay. A strong correlation was found between smoking-related oral lesions and micronucleus frequency, independent of alcohol use. These findings underscore the urgent need for targeted public health strategies to reduce smoking-induced DNA damage and prevent oral carcinogenesis. The results provide critical evidence for policymakers and future research on tobacco-related harm.