Tobacco products oral snuff

Table I lists the concentrations of nitrosodimethylamine (NDMA) and nitrosodiethylamine (NDEA) in some of the tobacco products which had greater than 0.5% nitrate content. Tobacco with less than 0.5% nitrate content, such as Bright tobaccos, yielded NDMA, NDEA and nitrosopyrrolidine (NPYR) generally below 5 ppb. The relatively high concentrations of NDMA in fine cut tobaccos and in snuff are possibly of significance in the increased risk for oral cancer among snuff dippers who use these tobacco types repeatedly each day by placing a pinch of the product directly into the gingival buccal fold (6,7).

Chronic snuff dipping has been associated with oral cancer in experimental animals and humans. Oral pharyngeal cancer accounts for 3% of these cancers and is the seventh most common form of cancer.The oral use of moist smokeless tobacco products (chewing tobacco) has increased in recent years, resulting in leukoplakia, which is a clinical white patch or plaque on the oral mucus membrane that cannot be removed by scrapping. Most of these lesions can occur in all areas of the oral cavity. Water-soluble smokeless tobacco extract has been shown to suppress lymphokine activated killer (LAK) cell activity by inhibiting DNA synthesis, and altered LAK function in the oral mucosa... 

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). 

---