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The relative risk of developing OSMF in PM users as compared to nonusers is 498.[] As compared to users of tobacco without any visible oral lesion, the relative risk of oral cancer in a subject with OMSF is 397.3.[] The rate of transformation of OSMF to oral cancer varies from 4.5% to 7.6%, and this is mainly responsible for an increase in oral cancer in young subjects.[] The duration was also shorter in the subjects who have higher frequency of use per day and daily consumption was more important than the total duration for development of OSMF.[] The abrasive nature of areca nut is responsible for local trauma and injury to the oral mucosa which is more severe with the use of PM due to the granular nature.[] In vivo study in albino rats had shown that PM use lead to increased keratoses, parakeratoses, inflammatory cell infiltrate with loss of nuclear polarity leading to increased sub mucosal collagen deposition.[] Copper which is found in PM in large quantity up-regulates collagen synthesis and increased cross-linkage of elastins and collagens.[] OSMF is caused by decreased fibroblastic phagocytosis of collagen, interference with lysyl oxidase, matrix metalloproteinases and increased secretion of growth factors, inflammatory cytokines.[] Effect of Pan Masala on Gastrointestinal System PM users often ingest the juice obtained from chewing it leading to multiple effects on the gastrointestinal system

Kin Nik Nik contains the following herbs: Red Raspberry Mullein Damiana Lavendar Mugwort Uva Ursi (Bearberry) Lobelia Motherwort Passion Flower Uva Ursi, also known as Bearberry, is a plant that grows berries bears consider to be a delicacy