Toxicology of Ngirimbo Samples across Chitipa District

Abstract Introduction: Smokeless tobacco describes a wide variety of tobacco products that do not require combustion, and is typically used either orally or nasally. Ngirimbo is a form of oral smokeless tobacco used by smokers in Malawi for tobacco harm reduction. The aim of this study was to determine the acidity (pH), nicotine content, mineral content (iron, zinc, calcium, magnesium and copper), heavy metal content (lead, chromium and cadmium), and presence of other volatile compounds in ngirimbo across Chitipa District in Malawi . Methods: Atomic absorption spectrophotometry and gas chromatography-mass spectrometry were used to estimate nicotine content, concentration of toxic heavy metals, minerals of potential toxicity and other harmful chemicals in the samples. Results: Samples were found to contain harmful chemicals, high pH and nicotine [2-(1-methyl-2-pyrolidinyl)-pyridine, (S)- and (S)-3-(1-methyl-2-pyrolidinyl)-pyridine] levels. Mineral concentrations were found to be much higher than typical safety limits. Conversely, samples were not found to contain lead, and had low concentrations of chromium and cadmium. Conclusions: These findings suggest that prolonged use of ngirimbo is a significant health risk to people with chronic diseases. Nonetheless, ngirimbo provides a valid method of tobacco harm reduction and a potential smoking cessation tool. Therefore, further analytical toxicological studies are needed to fully characterize variations in the quality of the product. Implications : Consumers of ngirimbo are susceptible to acute toxic effects of oral and dermal exposure to the product, as well as addiction. Some individuals would suffer from convulsions or seizures following ngirimbo use, and other clinical consequences depending on the amount ingested. However, understanding the amount of nicotine, and other volatile constituents, consumed through ngirimbo use will help to generate recommendations for quantity and frequency of use. Further, establishing the threshold of harm for nicotine consumption will contribute to the extraction, isolation, and use of nicotine as a smoking-cessation agent, and for treating psychiatric disorders such as schizophrenia and neurodegenerative diseases such as Alzheimer’s.

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Smokeless tobacco: harm reduction or nicotine overload?

European Journal of Cancer Prevention ◽

10.1097/00008469-200304000-00001 ◽

2003 ◽

Vol 12 (2) ◽

pp. 89-92 ◽

Cited By ~ 7

Author(s):

H Vainio ◽

E Weiderpass

Keyword(s):

Harm Reduction ◽

Smokeless Tobacco ◽

Tobacco Harm Reduction

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Australian mental health care practitioners’ practices and attitudes for encouraging smoking cessation and tobacco harm reduction in smokers with severe mental illness

International Journal of Mental Health Nursing ◽

10.1111/inm.12314 ◽

2017 ◽

Vol 27 (1) ◽

pp. 247-257 ◽

Cited By ~ 11

Author(s):

Ratika Sharma ◽

Carla Meurk ◽

Stephanie Bell ◽

Pauline Ford ◽

Coral Gartner

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Illness ◽

Smoking Cessation ◽

Mental Health Care ◽

Harm Reduction ◽

Severe Mental Illness ◽

Tobacco Harm Reduction ◽

Health Care Practitioners

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Assessing the Knowledge, Attitude, and Practices of Cigarette Smokers and Use of Alternative Nicotine Delivery Systems in Pakistan: A Cross-Sectional Study

Advances in Public Health ◽

10.1155/2021/5555190 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Abdul Hameed ◽

Daud Malik

Keyword(s):

Smoking Cessation ◽

Harm Reduction ◽

Large Scale ◽

Weak Link ◽

Principal Component ◽

Delivery Systems ◽

Tobacco Harm Reduction ◽

Cross Sectional ◽

Quit Smoking ◽

Nicotine Delivery

Background. This research has been conducted to assess smokers’ knowledge and behavior vis-à-vis combustible smoking cessation, prevalence, and risk, and the use of alternative nicotine delivery systems to quit smoking. Methods. A mixed-method approach utilizing cross section primary survey data and comprising descriptive and s-KAP index analysis has been adopted to ascertain the relationship between dependent and independent s-KAP variables; the principal component analysis methodology has been used to determine the use of alternative nicotine delivery systems. Results. Most of the smokers were aged between 15 and 35 years. A predominant 69.8% of the smokers came from middle-class background. Moreover, 71.3% were unaware of any alternative Tobacco Harm Reduction product. A majority of the respondents (68.2%) were keen to quit smoking. However, when asked why they had not succeeded, 52.9% reported addiction to nicotine as the main impediment. In Pakistan, lack of smoking cessation services is the weak link in the fight against the tobacco epidemic. Smokers are generally unaware of the Tobacco Harm Reduction products available in Pakistan; moreover, only 10.9% of the respondents were willing to spend more than Rs. 4000 per month on Tobacco Harm Reduction products. The average s-KAP score for young adults below the age of 20 was much lower than the national average but improved with the level of education. Interestingly, the score of smokers who had ever tried to quit smoking was slightly higher than that of those who had never tried to quit. Conclusion. There is intent to quit combustible smoking but the policy and infrastructure necessary for successful quitting are missing. Pakistan needs to concentrate on two fronts: a large scale awareness campaign against the use and harms of combustible smoking and simultaneously providing affordable and accessible smoking services across the country. Pakistan should look at the use and regulation of safer nicotine products in the UK. The country should carefully weigh the options of ensuring how to incorporate the use of safer nicotine delivery systems in its tobacco control efforts.

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