Smokeless Tobacco - An Overview

AbstractSmoking, especially cigarette smoking, is the most common form of tobacco consumption world-wide. It is generally accepted that smoking carries health risks for smokers. The combustion and pyrolysis products of tobacco generated during smoking are considered to be responsible for the harmful effects. Smokeless tobacco, another wide-spread form of tobacco use, is not subjected to burning and produces no combustion or pyrolysis products. Therefore, there is an increasingly intense debate about the potential role of smokeless tobacco in reducing the harm of tobacco use.An overview is presented on the different types of smokeless tobaccos consumed around the world. Commercial products differ widely in composition and patterns of use. The smokeless tobaccos of the Western world (Europe and North America) need to be clearly distinguished from those popular in Asia, Africa and South America. The modern smokeless tobaccos used in Europe and North America are reviewed regarding their chemical composition and toxicological properties. Agents of concern found in smokeless tobacco, especially the tobacco specific N-nitrosamines, are dealt with in particular.The epidemiological evidence is summarized concerning a wide range of health outcomes. Published reviews and studies are presented and interpreted regarding non-neoplastic oral diseases, various forms of cancer, circulatory diseases, several other diseases and pregnancy outcome. While many of the epidemiological studies have weaknesses and data are often inconsistent it is quite obvious that smokeless tobacco use is much less risky for consumers than smoking. In fact, for modern forms of European moist snuff such as Swedish snus, which is subject to strict quality standards, there is evidence for - if any - only very limited serious health risk.The ongoing public discussion centers around the influence smokeless tobacco may have on smoking rates (initiation or cessation) and the occurrence of tobacco specific diseases - with Sweden being a revealing example. There is an interesting controversy regarding product and marketing regulations for smokeless tobaccos in the European Union.

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The Progression of the Tobacco Epidemic in India on the National and Regional Levels, 1998-2016

10.21203/rs.3.rs-117370/v1 ◽

2020 ◽

Author(s):

Rufi Shaikh ◽

Fanny Janssen ◽

Tobias Vogt

Keyword(s):

Tobacco Use ◽

Smokeless Tobacco ◽

Family Health ◽

Developed Countries ◽

Tobacco Consumption ◽

Comprehensive Overview ◽

Middle Income ◽

The North ◽

Short Period ◽

Tobacco Epidemic

Abstract Background: According to the smoking epidemic framework, societies undergo successive stages in which the prevalence of tobacco use first increases, and then declines. This pattern was has been extensively documented for developed countries, but evidence that it has occurred in low- and middle-income countries remains fragmented. We assessed the progression of the tobacco epidemic in India on the national and regional levels by gender, including trends in the consumption of smokeless tobacco, to provide a comprehensive overview of tobacco use in India and its states.Methods: We use information on current tobacco consumption among Indians aged 15-49 from three rounds of the National Family Health Survey (NFHS) (1998-99, 2005-06, 2015-16) to estimate the age-standardized smoking and smokeless tobacco prevalence across India and its states.Results: Age-standardized tobacco consumption prevalence in India increased between 1998-99 and 2005-06, and declined from 2005-06 to 2015-2016, simultaneously for men and women. There are substantial spatial differences in the progression of the tobacco epidemic in India. In the north-eastern states in particular, tobacco consumption prevalence remains higher than the national average, and is still increasing. Conclusions: Our results suggest that India and the majority of its states experienced a ‘compressed tobacco epidemic’ in which the prevalence of tobacco consumption increased and decreased simultaneously for women and men over a comparatively short period of time. Despite the overall progress in reducing tobacco use India has made, further lowering tobacco consumption remains a public health priority, as the prevalence of smoking and/or smokeless tobacco use remains high in a number of states. We therefore conclude that tobacco regulations should be expanded with the aim of reducing the overall health burden associated with tobacco consumption across India.

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An Intertemporal Analysis of Post-FCTC Era Household Tobacco Consumption in Pakistan

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16142532 ◽

2019 ◽

Vol 16 (14) ◽

pp. 2532

Author(s):

Biplab Kumar Datta ◽

Muhammad Jami Husain ◽

Nigar Nargis

Keyword(s):

Tobacco Control ◽

Tobacco Use ◽

Smokeless Tobacco ◽

National Level ◽

Tobacco Consumption ◽

Smoking Rate ◽

Middle Income ◽

Household Level ◽

The Poor ◽

Smokeless Tobacco Use

Since the ratification of the WHO Framework Convention on Tobacco Control (FCTC) in 2004, Pakistan has taken various measures of tobacco control. This study examines how these tobacco control measures are associated with change in household-level tobacco consumption patterns in Pakistan over the decade (2005 to 2016) after FCTC ratification. We used multiple waves of the household survey data of Pakistan from 2004–2005 to 2015–2016 for analyzing household-level tobacco use. We find that tobacco consumption remains at a significantly high level (45.5%) in Pakistan despite the recent declining trend in the post-FCTC era. During the preparatory phase of FCTC implementation between 2005 and 2008, the smoking rate was on the rise, and smokeless tobacco use was declining. Over the implementation phase of FCTC policies between 2008 and 2016, the pattern of change in tobacco use reversed—the smoking rate started to decrease while smokeless tobacco use started to rise. However, the decrease in the smoking rate was slower and the increase in smokeless tobacco use at the national level was driven by an increase among the poor and middle-income households. These trends resulted in the growing burden of tobacco expenditure among the poor and middle-income households relative to the wealthier households.

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Tobacco Use and Orofacial Pain: A Meta-analysis

Nicotine & Tobacco Research ◽

10.1093/ntr/ntaa074 ◽

2020 ◽

Vol 22 (11) ◽

pp. 1957-1963

Author(s):

Abdulwahab H Alamir ◽

Mir Faeq Ali Quadri

Keyword(s):

Tobacco Use ◽

Orofacial Pain ◽

Meta Analysis ◽

Tobacco Consumption ◽

Oral Diseases ◽

Tobacco Exposure ◽

General Body ◽

Specific Association ◽

The Relationship ◽

Body Ache

Abstract Introduction The relationship between smoking and general body ache has been shown to be bidirectional. The specific association between tobacco consumption and orofacial pain remains unclear, however. Aim and Methods The aim of this systematic review was to explore the association between pain related to diseases of the oral cavity and use of tobacco. A systematic search of PubMed, Embase, Web of Science, and Cochrane databases was carried out in September 2019. Tobacco exposure was included irrespective of the method of consumption (smokeless and smoked tobacco), and frequency of the habit. The outcome was defined as clinically diagnosed or self-reported pain in the orofacial region, with no limitation in the duration of the condition or the site of the pain. Results Altogether, eight studies were selected, with three of them demonstrating good methodology and none of them being of poor quality. Meta-analysis of six studies showed that orofacial pain was significantly worse in tobacco (smoked and smokeless) users (odds ratio [OR] = 3.55, 95% confidence interval [CI]: 1.92, 6.58) in comparison to nonusers. Subgroup analysis showed that the odds of orofacial pain was three times (OR = 3.13, 95% CI: 1.16, 8.46) higher among smokers, but was not associated with smokeless tobacco. Conclusions The odds of experiencing orofacial pain among patients with oral diseases increase for patients who are also smokers. The findings could help dentists and other health specialists more effectively manage patients with orofacial pain who are tobacco consumers. Implications This study shows that the odds of orofacial pain among patients with oral diseases increase for patients who are smokers. The results are a significant contribution to the literature because, while the relationship between smoking and general body ache has been shown to be bidirectional, the specific association between tobacco use and orofacial pain warranted further study. The findings could help dentists and other specialists more effectively manage patients with orofacial pain who are also tobacco consumers.

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Trend in the affordability of tobacco products in Bangladesh: findings from the ITC Bangladesh Surveys

Tobacco Control ◽

10.1136/tobaccocontrol-2017-054035 ◽

2018 ◽

Vol 28 (Suppl 1) ◽

pp. s20-s30 ◽

Cited By ~ 7

Author(s):

Nigar Nargis ◽

Michal Stoklosa ◽

Jeffrey Drope ◽

Geoffrey T Fong ◽

Anne C K Quah ◽

...

Keyword(s):

Tobacco Use ◽

Smokeless Tobacco ◽

Linear Regression Analysis ◽

Tobacco Consumption ◽

Tobacco Product ◽

Price Increase ◽

Income Growth ◽

Multivariate Linear Regression Analysis ◽

Tobacco Products ◽

Individual Level

BackgroundThe price of tobacco products in relation to the income of tobacco users—affordability—is recognised as a key determinant of tobacco use behaviour. The effectiveness of a price increase as a deterrent to tobacco use depends on how much price increases in relation to the income of the potential users. The aim of this paper is to examine the distribution of and trends in the affordability of tobacco products in Bangladesh.MethodUsing four waves of International Tobacco Control Survey data on Bangladesh, this study measures affordability of tobacco products at the individual level as the ratio of self-reported price and self-reported income. The trends in affordability by brand categories of cigarettes and of bidi and smokeless tobacco are estimated using multivariate linear regression analysis.ResultsDespite significant increase in price, the affordability of cigarettes increased between 2009 and 2014–2015 due to income growth outpacing price increase. The increase was disproportionately larger for more expensive brands. The affordability of bidis increased over this period as well. The affordability of smokeless tobacco products remained unchanged between 2011–2012 and 2014–2015.ConclusionThe tax increases that were implemented during 2009–2015 were not enough to increase tobacco product prices sufficiently to outweigh the effect of income growth, and to reduce tobacco consumption. The findings from this research inform policymakers that in countries experiencing rapid economic growth, significant tax increases are needed to counteract the effect of income growth, in order for the tax increases to be effective in reducing tobacco use.

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Adults' Addictive Behavior Can be Prevented if Parents are Aware.

10.21203/rs.3.rs-576923/v1 ◽

2021 ◽

Author(s):

sabapathi v ◽

Selvin paul peter J

Keyword(s):

Parental Care ◽

Tobacco Use ◽

Smokeless Tobacco ◽

Tobacco Consumption ◽

Addictive Behavior ◽

Mode Behavior ◽

Raising Awareness ◽

Motivating Factor ◽

First Time ◽

Virtual Mode

Abstract Addiction is characterized as the inability to avoid using a physical drug or engaging in virtual mode behavior. Due to the influence of the situation and surrounding factors, every person performs or engages in some action. This type of behaviour could become addictive if it becomes habit forming. If an action is carried out by unconscious actions, it has the potential to become addictive. A method of calculating operation in relation to an object. If an action is carried out by unconscious actions, it has the potential to become addictive. A method of evaluating behaviour related to an addictive concern that can help determine the presence of addiction. Since the decision to confess to the addiction is unclear. In this regard, tobacco use analysis is an important part of preventing addiction and raising awareness. Tobacco consumption assessment studies in India are urgently needed, and parental care, especially in adults, must be improved to protect them from tobacco and other drug inducing substances. The motivating factor for first-time tobacco use, as well as the effects of smoking, were discovered in this research. The first tobacco, whether smoking or smokeless tobacco, is stimulated by smoking motive influences both directly and indirectly (orally consume).

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Global Study on Tobacco Use among Youth in the Kyrgyz Republic Republic (GYTS, 2019)

Russian Pulmonology ◽

10.18093/0869-0189-2020-30-3-270-277 ◽

2020 ◽

Vol 30 (3) ◽

pp. 270-277

Author(s):

A. G. Polupanov ◽

A. A. Tolebaeva ◽

I. S. Sabirov ◽

A. T. Altymysheva ◽

A. I. Sabirova ◽

...

Keyword(s):

Tobacco Use ◽

Smokeless Tobacco ◽

Electronic Cigarettes ◽

Statistical Processing ◽

Tobacco Consumption ◽

Kyrgyz Republic ◽

Street Vendor ◽

Global Youth Tobacco Survey ◽

Tobacco Products ◽

Passive Smoker

The aim of the study was to assess the situation related to tobacco consumption among adolescents aged 13 – 15 in the Kyrgyz Republic.Materials and Methods. The study used a two-stage selection of schoolchildren in grades 7 – 9 (teenagers 13 – 15 years old) to conduct the survey. At the 1st stage, information was collected about all schools of the republic, where children of the target group study. the schools in which the survey was subsequently conducted were selected by the statistical sampling method according to the number of students in grades 7 – 9. The grades whose students participated in the questionnaire were set at stage 2 by random sampling in each school The survey includes 43 questions from the Standard main Questionnaire of the Global Youth Tobacco Survey (GYTS) and 30 supplementary questions (73 in total) with multiple choice of answers. The statistical processing was performed using the SUDAAN software package (US Centers for Disease Control and Prevention); a 95% confidence interval was calculated to calculate weighted prevalence estimates and standard errors (SE).Results. The survey found that 6.0% of schoolchildren (9.5% of boys and 2.4% of girls) currently use various types of tobacco; 4.4% of schoolchildren currently use tobacco (6.8% of boys and 2.0% of girls); 2.4% of schoolchildren smoke cigarettes; 2.4% use smokeless tobacco, 2.8% use other tobacco products (hookah); 2.8% of schoolchildren smoke electronic cigarettes (3.9% of boys and 1.7% of girls). Tobacco use most often begins before age 7 or after age 12. 16.8% of schoolchildren are exposed to tobacco smoke at home, of which 14.2% are in closed places and 14.8% in open public places. 87.2% of schoolchildren purchase cigarettes in a shop, kiosk, from a street vendor, and in the market. During the visit to the point of sale 26.7% noticed tobacco advertising and promotions; 49.7% saw anti-tobacco messages in the mass media. Definitely think that smoking tobacco by other people is bad for them, 71.2% of schoolchildren.Conclusion. A high percentage of teenagers consuming e-cigarettes, hookah, and smokeless tobacco products has been noted, although > 50% of them are aware of the dangers of tobacco use. Every 6th student is a passive smoker. The vast majority of schoolchildren aged 13 – 15 who try to quit smoking do not receive professional help in quitting tobacco use, and are exposed to protobacco media marketing campaigns.

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Research on Oral Diseases and Its Impact On Dental Education and Practice

Advances in Dental Research ◽

10.1177/08959374880020020101 ◽

1988 ◽

Vol 2 (2) ◽

pp. 199-203 ◽

Cited By ~ 4

Author(s):

H. Löe

Keyword(s):

Oral Health ◽

Recombinant Dna ◽

Dental Education ◽

Periodontal Diseases ◽

Epidemiological Studies ◽

Oral Bacteria ◽

Oral Diseases ◽

Dental Research ◽

Tissue Repair And Regeneration ◽

Wide Range

In recent years advances in dental research have marked the integration of dental science into the mainstream of biomedical research, with dental investigators employing the same cell and molecular biology techniques that have revolutionized the biosciences. Examples include the isolation and cloning of genes essential to the development of teeth and bones, discoveries of numerous extracellular factors that guide the growth and differentiation of cells and aid in tissue repair and regeneration, the development of a technique for producing human monoclonal antibodies, and the use of recombinant DNA techniques to generate mutant forms of oral bacteria. At the same time, dental research continues to make strides in more traditional pursuits. Thus, we are seeing continued advances in dental diagnostics, in the generation of new materials and methods for restorations and replacements of natural teeth, and an increase in approaches aimed at preventing or reversing the major dental diseases: dental caries and the periodontal diseases. Recent epidemiological studies highlight the gains that have been made in the oral health status of Americans and are helping shape the research agenda of the National Institute of Dental Research in the years ahead. Greater emphasis will be put on the oral health problems of adults and older Americans and those of any age who are at high risk for oral problems. Advances in research, evident in changing patterns of disease, have become the major force for change in dental education and practice. Future practitioners will need a broader intellectual preparation that will enable them to diagnose and treat a wide range of oral tissue conditions. Many dental schools are showing their willingness and ability to rise to the challenge of changing demands, assuring a promising future for the "new dentistry".

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Declining trend of smoking and smokeless tobacco in India: A decomposition analysis

PLoS ONE ◽

10.1371/journal.pone.0247226 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0247226

Author(s):

Supriya Lahoti ◽

Priyanka Dixit

Keyword(s):

Health Policy ◽

Tobacco Use ◽

Smokeless Tobacco ◽

Decomposition Analysis ◽

Tobacco Consumption ◽

Relative Reduction ◽

National Health Policy ◽

Logistic Regressions ◽

Smokeless Tobacco Use ◽

Specific Contribution

There has been a relative reduction of tobacco consumption between Global Adult Tobacco Survey-India (GATS-India) 2009–10 and GATS-India 2016–17. However, in terms of absolute numbers, India still has the highest number of tobacco consumers. Therefore, this paper aims to examine the socioeconomic correlates and delineate the factors contributing to a change in smoking and smokeless tobacco use from GATS (2009–10) to GATS (2016–17) in India. We used multivariable binary logistic regressions to examine the demographic and socioeconomic correlates of smoking and smokeless tobacco use for both the rounds of the survey. Further decomposition analysis has been applied to examine the specific contribution of factors in the decline of tobacco consumption over a period from 2009 to 2016. Results indicated that the propensity component was primarily responsible for major tobacco consumption decline (smoking- 41%, smokeless tobacco use- 81%). Most of the decrease in propensity to smoke has been explained by residential type and occupation of the respondent. Age of the respondent contribute significantly in reducing the prevalence of smokeless tobacco consumption during the seven-year period, regardless of change in the composition of population. To achieve the National Health Policy, 2017 aim of reducing tobacco use up to 15% by 2020 and up to 30% by 2025, targeted policies and interventions addressing the inequalities identified in this study, must be developed and implemented.

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Pattern of tobacco use among adolescents in urban slums of Jorhat, Assam

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20174835 ◽

2017 ◽

Vol 4 (11) ◽

pp. 4232

Author(s):

Netri Das ◽

Anadi S. Tasa ◽

Anuradha H. Medhi

Keyword(s):

Tobacco Use ◽

Smokeless Tobacco ◽

Tobacco Consumption ◽

Cross Sectional Study ◽

Tobacco Product ◽

Urban Slums ◽

Community Based ◽

Cross Sectional ◽

Change Communication ◽

Smokeless Tobacco Use

Background: Tobacco use is a leading cause of preventable death worldwide and an estimated 250 million children and adolescents in developing countries die prematurely because of tobacco consumption. The objectives of the study were to determine the pattern of tobacco use among the adolescents and assess the factors associated with its use in urban slums of Jorhat, Assam.Methods: A community-based cross-sectional study was conducted in two randomly selected urban slums of Jorhat district from September 2015 to February 2016 among 110 adolescents using predesigned pretested proforma. Data were analyzed using SPSS - trial version 16; risk analysis was done using odds ratios with 95% confidence intervals.Results: 106 (96.36%) adolescents had ever used a tobacco product and 97 (88.18%) were current users. 57.73% consumed smokeless form and 3.1% used smoking form exclusively while 39.17% used both smoking and smokeless tobacco. Exclusive smokeless tobacco use was more common among girls. Smoking as well as combined smoking and smokeless tobacco was more common among boys. Gutkha was most common smokeless product (94.84%) and cigarette was commonest smoking form (34.02%) used. Awareness regarding its harmful effects was high (77.28%). Tobacco use in family is significantly associated with current use of tobacco (OR 5.88).Conclusions: Tobacco consumption is an emerging threat to health of adolescents in urban slums. Smokeless tobacco use is high in our study, especially among girls. Tobacco use by family is a major reason behind using tobacco indicating an urgent need to carry out behaviour change communication (BCC) activities among adolescents and their family members.

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The predictors of cigarette smoking, smokeless tobacco consumption and use of both forms in adolescents in South Asia: a secondary analysis of the Global Youth Tobacco Surveys (GYTS)

Nicotine & Tobacco Research ◽

10.1093/ntr/ntaa202 ◽

2020 ◽

Author(s):

Masuma Pervin Mishu ◽

Faraz Siddiqui ◽

Radha Shukla ◽

Mona Kanaan ◽

Omara Dogar ◽

...

Keyword(s):

Cigarette Smoking ◽

Tobacco Use ◽

Smokeless Tobacco ◽

Secondary Analysis ◽

Tobacco Consumption ◽

Multinomial Regression ◽

Public Places ◽

Media Messages ◽

Study Population ◽

Harmful Effects

Abstract Background Tobacco uptake in adolescents is associated with a range of predictors. We examined the predictors of cigarette smoking, smokeless tobacco (ST) consumption and use of both ST and cigarettes among adolescents in four South Asian countries. Methods We analysed the Global Youth Tobacco Surveys (GYTS) data for Bangladesh (2013), India (2009), Pakistan (2013), and Sri-Lanka (2015), using multinomial regression to examine associations between several predictors and tobacco use. Results Data from 23,681 adolescents were analyzed. Overall, 82.8% of the study population were between 13 and 15 years and 52.7% were girls, 2% were cigarette smokers, 6.5% were ST users and 1.1% used both ST and cigarettes, in the past 30-days. Exposure to smoking in public places was associated with past 30-days smoking (RRR 5.59, 95%CI 4.28-7.28), ST use (RRR 2.07, 95%CI 1.84-2.32) and use of both ST and cigarettes (RRR 11.42, 95%CI 7.44-17.54). Exposure to tobacco use in electronic media and being offered free tobacco products were associated with all forms of tobacco use. Shopkeepers’ refusal to sell cigarettes protected adolescents from smoking (RRR 0.47, 95%CI 0.36-0.63) and ST use (RRR 0.65, 95%CI 0.45-0.95). However, exposure to anti-tobacco mass media messages was not protective for any form of tobacco use. Adolescents taught at school about harmful effects of tobacco were less likely to use ST; no evidence of this association was observed for smoking. Conclusion The associations between tobacco use and pro-tobacco factors were strong but the associations with anti-tobacco factors lacked strength and consistency in this study population.

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