Health Promotion in Oral Cancer
Health promotion may be defined as the process by which patients are given the power to gain control over their health thereby improving it. It also includes providing skills to patients to enable them to develop healthy habits and also improving their social and physical environments to support these habits (Sharma & Romas, 2012). Health promotion does not only focus on the disease but empowers the patient to improve his or her overall health. Therefore, health care in oral cancer is involved in creating a conducive environment for patients to improve their health. Oral cancer is a type of cancer that affects the inner parts of the mouth including the throat. It is mainly caused by smoking cigarettes and chewing smokeless tobacco. It mostly appears as painless sores and growth within the mouth including the lips, tongue, gums and inner cheek. It may be confused for ulcers or cold sores (Sharma & Romas, 2012). Oral cancer has a very high mortality rate i.e. patients affected only live for up to 5 years after infection. This may be due to the fact that cancer cells in the mouth are usually not detected until they are developed. Survival and treatment of oral cancer depends on early detection. If it is diagnosed in the early stages, an oral cancer patient is more likely to survive than persons affected by other cancers (Sharma & Romas, 2012).

Health education with health promotion and the situation in Saudi Arabia
Health education is any learning experience combination formulated to assist people alongside communities in enhancing their health through increasing their knowledge and/or impelling their attitude (Sharma & Romas, 2012). In recent decades, Kingdom of Saudi Arabia (KSA) has prioritized in health education and promotion to enhance the delivery of health care in all levels; primary, secondary and tertiary. Nonetheless, regardless of these enhancements, health education and promotion has received an immense challenge of language barriers between providers of healthcare and the public. Most of the healthcare providers in KSA are not from that country and they also do not speak Arabic (International Conference on Informatics, Management, and Technology in Healthcare et al, 2014). Apparently, bridging the language gap is essential for enhancing health education and promotion. Previously, health care providers have tried numerous tactics to connect with public including the use of the internet alongside social media, promotional items such as leaflets and posters, and information conveyed through text-messaging services. Since addressing the barrier has had numerous challenges alternative tactics have been proposed by numerous experts, to enhance health education and promotion. One of the approaches is through the use of promotional items and gifts to escalate awareness. Ideally, the utilization of gifts with printed public health message has been proposed as an option since it assists in delivering essential healthcare messages to the community.

Oral cancer situation in Saudi Arabia (prevalence & incidence) In reference to the Cancer Incidence Report Saudi Arabia 2004, the total cancer incidences were about 9,300 with men being affected more than women (50.9% and 49.1% respectively (Radosevich, 2013). Further, males between the ages of 60 and 74 years had the highest incidence of colo-rectal cancer, whereas women of between 45 years and 59 years had breast cancer. In regards to Oral Cancer in Saudi Arabia, some regions have a higher incidence than other such as the northern region where tongue cancer in males is said to be at 6.1%. Similarly, oral cancer in Jazan is said to be at 9.4% in males (Radosevich, 2013). In females, tongue cancer is at 9.2% and oral cancer is 5.5%. In Najran, tongue cancer in males is estimated at 3.4% while in Baha region it is estimated at 6.9% in males and 2.7% in females (Radosevich, 2013).
Chew tobacco (Shammah) in KSA
Prolonged period of tobacco chewing or the so commonly referred to as the utilization of snuff is linked with oral gums, cavity, and oropharynx cancer. As mentioned earlier, oral cancer is among the most frequent cancers globally. The behavior of using snuff in the KSA has led to oral cancer becoming the third most prevalent malignancy after leukemia alongside Lymphoma. Apparently, tumors for malignant oral cavity represent about 25% of all neck and head cancers recorded annually in KSA (Scully, 2013). Most of the incidences are advanced, as well as palliatively treated. Ideally, the high prevalence oral cancer prevalence in KSA is ascribed to the utilization of Shammah. Accordingly, numerous authors have conveyed their clinical imprint that the escalated regularity of oral cancer is KSA’s southwestern region and largely in Jazan province, was linked to the utilization of chew tobacco. According to one of the reports, 90% of oral cancer patients availed a past of chew tobacco routine. In another study, 50% of them confessed to utilizing it (Scully, 2013).
An oral cancer epidemiological appraisal from the entire KSA over twenty years established JAZA as the cause of 35.4% of the oral cancer sites in the propinquity of the characteristic intraoral shammah placement (Saraf, 2008). Accordingly, this information implies that there exist a connotation between Jazan region, oral cancer and chew tobacco since oral cancer seems to abit prevalent in this province where shammah is also extremely common. A research carried out on Maxillofacial Surgery Unit of the Armed Forces Hospital, Riyadh, KSA, to evaluate the approach to remedy and ensuing results of 228 patients of oral cancer. According to this research, oral cavity tumors are the most prevalent neoplasms in KSA’s Jazan region. Apparently, they represent 13% of all types of cancers, as well as, 72% of neck and head cancers diagnosed yearly in this region (Saraf, 2008). According to the authors, this escalated oral cancer incidence is attributed to chew tobacco utilizing habit.

Health literacy
Health literacy is the level to which persons have the capability to acquire, process, as well as comprehend fundamental health information required to make apposite decisions alongside services required to avert or treat diseases (Pleasant eta l.,2013). Succinctly, KSA has made tremendous achievements in its inexorable efforts on health literacy, scaling down the rate of illiteracy form 60% in 1972 down to only 4% currently (International Conference on Informatics, Management, and Technology in Healthcare et al.,2015). This has been mainly attributed to the introduction of an adult education syllabus and the fact that about 99% of its children are now schooling.
Locus of Control
Locus of Control denotes the degree to which people believe they can control events impacting them (Abraham, 2008). Accordingly, in relation to health, it is the level at which individuals believe that their health is controlled by external, as well as, internal aspects. Apparently external beliefs are premised on the perception that an individual’s health is controlled by powerful other such as medical professional or is dogged by luck, chance or fate. Conversely, internal beliefs characterize an individual’s health situation as being the direct outcome of an individual’s action. Apparently, in KSA, internal belief has dominated due to the high health literacy. High health literacy has enable many people in KSA to have knowledge regarding diseases and thus are able to make immediate actions (Abraham, 2008).
Conclusion
Oral cancer is a type of cancer that affects the inner parts of the mouth including the throat. It is mainly caused by smoking cigarettes and chewing smokeless tobacco. Accordingly, in recent decades, Kingdom of Saudi Arabia (KSA) has prioritized in health education and promotion to enhance the delivery of health care in all levels; primary, secondary and tertiary. Nonetheless, regardless of these enhancements, health education and promotion has received an immense challenge of language barriers between providers of healthcare and the public In reference to the Cancer Incidence Report Saudi Arabia 2004, the total cancer incidences were about 9,300 with men being affected more than women (50.9% and 49.1% respectively. One habit contributing to oral cancer in this region is the use of chew tobacco. On another note, KSA has made tremendous achievements in its inexorable efforts on health literacy, scaling down the rate of illiteracy form 60% in 1972 down to only 4% currently. Further the Health Locus of Control (HLC) in KSA is dominated by internal belief due to the high health literacy

References
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