Tobacco smokeless

There is insufficient evidence to unequivocally link nitrosamine exposure to elevated risk for human cancer (159). There are, however, a number of specific cases, especially with respect to the tobacco-related nitrosamines, in which exposure to V/-nitroso compounds is of concern. The strongest evidence in this context is probably that relating to oral cancer rates among habitual users of smokeless tobacco (snuff). Oral cancer rates among this group are significantly elevated over those of nonusers, and /V-nitrosonornicotine, and 4-(methylnitrosamino)-l-(3-pyridinyl)-l-butanone [64091 -91 both of... 

A new approach to the analysis of the carcinogenic TSNA in moist snuff tobacco is based on SFE with methanol-modified carbon dioxide. Extracted TSNA are trapped across a glass cartridge filled with Tenax GR, from which they are subsequently released by thermal desorption and analyzed by capillary GC-TEA LOD was <2 ng/g. The technique is fast, reproducible, highly selective and sensitive617. SFE with carbon dioxide was also used in the analysis of TSNA in smokeless tobacco. It revealed the presence of higher levels of 4-(methylnitrosamino)-l-(3-pyridyl)-l-butanone (300) than had been determined earlier by conventional methods618. 

Some chemical mixtures Tobacco smoke Smokeless tobacco products Soots, tars, mineral oils ... 

Those in which tobacco is not heated or combusted, i.e., smokeless tobacco, e.g., snuff, snus, betel quid these are used orally predominantly, but some are used nasally. 

Smokeless tobacco products are a major form of tobacco addiction in several countries, notably India and South Africa. The tobacco may be chewed, sucked, or applied to the teeth or gums. The products may be manufactured commercially or at home. 

The predominant form of smokeless tobacco in Uzbekistan is nasway, which is a mixture of dried tobacco leaves, slaked lime, ash from tree bark, and flavoring and coloring agents water is added and the mixture is rolled into balls. In 2002,41% of Uzbek men said they used cigarettes and 38% said they had used nasway less than 1% of the women used nasway. 

In South Africa traditional or home-made products are more commonly used in rural areas while products manufactured by small cottage industries are dominant in urban areas. One of the small smokeless industries was bought by Swedish Match in 1999 and they ve continued to manufacture the same products used for both oral and nasal application. Unlike many other countries, nasal use predominates among the 13.2% of black women in South Africa who use smokeless tobacco, 80% nasally and 20% orally. Overall usage is approximately 10%, but reaches 18.6% among black children (Ayo-Yusuf et al. 2004). Only about 1% of South African men use snuff (Ayo-Yusuf et al. 2008). 

While gender roles and norms in some parts of the world have discouraged women from smoking, smokeless tobacco is more acceptable in some regions (e.g., Africa, India), and waterpipes in others (Middle East). Smokeless tobacco is responsible for four million deaths per year worldwide half of these are among women this is predicted to increase to 10 million deaths per year by 2030 (Christotides 2003). In contrast to India, women in the United States are much more likely to smoke cigarettes than to use smokeless tobacco. 

For all regions of India, 2.4% of women smoke and 12% chew tobacco. In Goa, 19% of women smoke, mostly bidis (4-13% in various districts) cigarette smoking was negligible. In many areas smokeless tobacco use was more common for women (27% in Goa, 35% in Kerala virtually no women smoked in Pune district in Mahrashtra, half of the women used smokeless tobacco and 39% used mishri. 

Similarly, in Mumbai only 0.4% of women smoked, but 57% of women 35 and older used smokeless tobacco). The use of chewing tobacco by women varied greatly by region, with less than 1% in several northern states, 5-10% in Andhra Pradesh and Goa, 20-30% Meghalay and Assam, 30 0% in Orissa and Arunachal Pradesh, and 61% in Mizoram. 

Ayo-Yusuf OA, Swart TJP, Hckworth WB (2004) Nicotine delivery capabilities of smokeless tobacco products and imphcations for control of tobacco dependence in South Africa. Tob Control 13 186-189... 

The primary alkaloid in tobacco is nicotine, but tobacco also contains small amounts of minor alkaloids such as anabasine, anatabine, myosmine, and others. The minor alkaloids are absorbed systemically and can be measured in the urine of smokers and users of smokeless tobacco (Jacob et al. 1999). The measurement of minor alkaloids is a way to quantitate tobacco use when a person is also taking in pure nicotine from a nicotine medication or a nontobacco nicotine delivery system. This method has been used to assess tobacco abstinence in clinical trials of smoking cessation with treatment by nicotine medications (Jacob et al. 2002). 

Jacob P, 3rd, Yu L, Shulgin AT, Benowitz NL (1999) Minor tobacco alkaloids as biomarkers for tobacco use comparison of users of cigarettes, smokeless tobacco, cigars, and pipes. Am J Public Health 89(5) 731-736... 

Since the late 1980s, there has been a proliferation of new potential reduced-exposure products (PREPs), promoted by the industry with the claims of reduced harm, in all the four categories that were summarized earlier (Stratton et al. 2001 Hatsukami et al. 2002, 2005). These include (a) modified tobacco products, such as several denicotinized brands and reduced TSNA emission cigarettes (b) chewing gum impregnated with tobacco (c) smokeless tobacco products with claimed reduced nitrosamine levels and (d) cigarette-like products (carbon-heated smoking devices). 

While cigarette sales in the USA declined 18%, from 21 billion packs in 2000 to 17.4 billion packs in 2007, during the same time period sales of other products, such as moist snuff, increased by 1.10 billion cigarette pack equivalents (Connolly and Alpert 2008). In the USA, the most common smokeless tobacco (ST) products are chewing tobacco (loose leaf, plug, and twist), moist snuff, and dry snuff. Many other forms of smokeless tobacco that are used globally were described in an lARC monograph (lARC 2007). All ST products contain nicotine and other tobacco alkaloids that are inherent to tobacco leaf. 

Table 5 Range of pH and nicotine concentrations in smokeless tobacco sold in Massachusetts (USA) in 2003 (lARC 2004)...

Synthesized conclusions of the lARC monograph on smokeless tobacco (lARC 2007) and the opinion of the Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) on the health effects of smokeless tobacco SCENIHR (2008) can be summarized as follows (a) all forms of ST are potentially addictive (b) all forms of ST are carcinogenic (c) there are probable reproductive health effects (d) there are probable risk factors for myocardial infarction (e) there is limited... 

Alpert HR (2008) Manipulation of free nicotine and its dosing to target high risk groups. Paper presented at the cigarette industry s entry into the smokeless tobacco market. Harvard School of Public Health, Boston, MA, July 10, 2008... 

Henningfield JE, Radzius A, Cone EJ (1995) Estimation of available nicotine content in six smokeless tobacco products. Tob Control 4 57-61... 

SCENIHR (2008) Health effects of smokeless tobacco. Opinion adopted by Scientific Committee on Emerging and Newly Identified Health Risks at the 22nd plenary on February 6, 2008. http //ec.europa.eu/health/ph risk/committees/04 scenihr/scenihr.cons. 06.en.htm... 

---