Aims and Objectives: Exfoliative cytology is a minimally invasive procedure that has been used for the detection of early changes in clinically normal oral mucosa of tobacco users. This study highlights the cause‑effect relationship between tobacco usage in varied forms and the structural cellular and nuclear alterations in different age groups. Materials and Methods: This study was conducted with different age groups who were tobacco users as a planned, cross‑sectional study.

Results: The results of the study revealed that the mean nuclear diameter (ND) and cytoplasmic diameter (CD) showed a statistically significant difference in the control group and in smokers and tobacco chewers. Conclusion: Increase in ND and decreased CD, as well as an altered nucleo‑cytoplasmic ratio, appear to be due to chronic tobacco usage and cytomorphometric analysis can be used to detect these cellular and…