Introduction: Oral cancer is one of the 10 most common cancers in the world. Oral habits like smoking, chewing tobacco, gutkha, etc. are documented as initiators of dysplastic changes in the oral mucosa. Aims: To study the buccal mucosa of smokers by exfoliative cytology and to assess the cytological and nuclear changes therein. Objectives: To study the buccal mucosa of smokers for early detection of precancerous lesions of oral cancer thus helping in better treatment and prognosis. Materials & Methods: The study included examination of buccal mucosa followed by scrapping and making smears thereof. The study sample consisted of 100 smokers and 100 controls. The buccal smears thus prepared were stained by Papanicolaous method. The nuclear changes like micronucleation, binucleation, karyorrhexis, karyolysis, pyknosis and condensed chromatin were observed using binocular microscope. Results: A significant increase in micronucleation and binucleation of cells was observed in smokers. Conclusion: We conclude that tobacco smoking produces cellular alterations in the buccal mucosa. These precancerous lesions can be picked up using exfoliative cytology as early as 10-15 years prior to their malignant transformation. Exfoliative cytology is a non-invasive method which can be used for mass screening of the population for early detection of precancerous lesions of the buccal mucosa.

Keywords: Buccal mucosa; Exfoliative cytology; Smoking; Tobacco; Micronuclei.