Smokeless tobacco

Tobacco use is a public health concern worldwide as well as in India. Tobacco consumption is mainly done in two forms: smoked tobacco and smokeless tobacco. The tobacco use without burning is referred to as smokeless tobacco (SLT) use. SLT use has been increased rapidly throughout the world especially among adolescent boys and young men by considering it as safe alternative of smoking. Because of vigorous efforts toward increasing awareness of the adverse effects of tobacco, smoking has been declined and paradoxically the use of SLT has been greatly increased (1). ‘Khaini’, tobacco with slaked lime, is one of the widely used SLT in India (2). Cigarette smoking has extensive effects on respiratory function (3). Like cigarette the most important constituent of ‘khaini is tobacco. This study attempts to f ind out whether ‘khaini ’ causes any unfavorable effects for the lungs by using PFTs. In this study pulmonary function indices of ‘khaini‘sers were compared with those of nonusers con...

The purpose was to examine cigarette smoking, use of snus, alcohol, and performance-enhancing illicit drugs among adolescent elite athletes and controls, and possible gender and sport group differences. First-year students at 16 Norwegian Elite Sport High Schools (n = 677) and two randomly selected high schools (controls, n = 421) were invited to participate. Totally, 602 athletes (89%) and 354 (84%) controls completed the questionnaire. More controls than athletes were smoking, using snus, and drinking alcohol. Competing in team sports was associated with use of snus [odds ratio = 2.8, 95% confidence interval (CI) 1.6 to 4.7] and a similar percentage of male and female handball (22.2% vs 18.8%) and soccer players (15.7% vs 15.0%) reported using snus. For controls, not participating in organized sport was a predictor for smoking (odds ratio = 4.9, 95% CI 2.2 to 10.9). Female athletes were more prone to drink alcohol than males (46.3% vs 31.0%, P < 0.001). Only, 1.2% athletes and 2.8% controls reported use of performance-enhancing illicit drugs. In conclusion, use of legal drugs is less common among athletes, but this relationship depends on type of sport and competition level. The association between team sports and use of snus suggests that sport subcultures play a role.

Smokeless tobacco (SLT) has long been realized as an important component of the fight for global tobacco control. It still remains a major problem in countries like India, Bangladesh and Nepal. The objective of this study was to estimate the trends of SLT use in three countries of the SEARO WHO office. We used data from national surveys in three countries (Bangladesh, India and Nepal) to estimate trends in prevalence of current SLT use. All available nationally representative data sources were used. Estimates were weighted, age standardized and given along with 95% confidence intervals. Significance of linear trend in prevalence over time was tested using the Cochrane-Armitage test for trend. A p value of less than 0.05 was considered statistically significant. We identified three surveys for Bangladesh, three for India and four for Nepal that met the selection criteria (such as Demographic and Health Surveys, WHO-STEPwise approach to Surveillance and Global Adult Tobacco Surveys). ...

Objectives: Tobacco consumption has a significant association with several health problems. Among the eight leading causes of morbidity and mortality, tobacco consumption is the major risk factor for six causes. This study aimed to find out the prevalence and the factors associated with tobacco consumption among the  students at a private university.
Methods: This cross-sectional study was conducted at Daffodil International University from January to May 2017, and data were collected using a structured questionnaire.
Results: A total of 384 students participated in this study. The findings showed that 184 (48.4%) of the students of a private university were smoking any form of tobacco. Age, place of residence, knowledge of the
consequences of tobacco consumption, health problems that the respondents were suffering, an affair of love, the frequency of library had a significant association with tobacco consumption.
Conclusion: Identifying associated risk factors is important to develop a prevention program and mitigate the epidemic situation of tobacco consumption among the students

Bangladesh, for the first time in history, has fulfilled the eligibility criteria set by the United Nations to be recognized as a developing country, crossing over from the list of least developed countries (LDCs). Bangladesh has reached the second phase after meeting the eligibility criteria of CDP – now it is a matter of time for the country to emerge from the LDC list to the list of developing countries. Though having a little development in the industrial sector the tobacco industry with full of modern manufacturing equipment and marketing strategies are growing like a monster and making large profits year after year. Although they pay a large number of taxes and create opportunities to develop a prestigious career there for high professionals, it is also creating various social and economic challenges. This report draws an insight into tobacco industry situation in Bangladesh. There is variety tier of cigarette brands. Along with this smokeless tobacco products are also available. This industry is creating quite a lot of controversies earns a huge proportion of national revenue from Tobacco industry hence, finds it difficult to take an ultimate step against it concerning health hazards. According to various reports, in the developed countries smoking is on the declining trend, but due to the socio-economic condition of the developing countries like Bangladesh, the trend is absent here. Again, it is facing severe difficulties in reducing the number of smokers. The social impact caused by this tobacco industry is controversial. Although a number of anti-smoking, policies are being implemented effectiveness of such campaigns are not sufficient. The socio-economic condition of Bangladesh is also another major factor leading to the growth of the Tobacco Industry and consumers. This report also examines the Social Impact Assessment of Tobacco industry which includes economic, environmental and other variable assessment.

Background Screening and monitoring in pregnancy are strategies used by healthcare providers to identify high-risk pregnancies so that they can provide more targeted and appropriate treatment and follow-up care, and to monitor fetal well-being in both low- and high-risk pregnancies. The use of many of these techniques is controversial and their ability to detect fetal compromise often unknown. Theoretically, appropriate management of maternal and fetal risk factors and complications that are detected in pregnancy and labour could prevent a large proportion of the world's 3.2 million estimated annual stillbirths, as well as minimise maternal and neonatal morbidity and mortality. Methods The fourth in a series of papers assessing the evidence base for prevention of stillbirths, this paper reviews available published evidence for the impact of 14 screening and monitoring interventions in pregnancy on stillbirth, including identification and management of high-risk pregnancies, advanced monitoring techniques, and monitoring of labour. Using broad and specific strategies to search PubMed and the Cochrane Library, we identified 221 relevant reviews and studies testing screening and monitoring interventions during the antenatal and intrapartum periods and reporting stillbirth or perinatal mortality as an outcome. Results We found a dearth of rigorous evidence of direct impact of any of these screening procedures and interventions on stillbirth incidence. Observational studies testing some interventions, including fetal movement monitoring and Doppler monitoring, showed some evidence of impact on stillbirths in selected high-risk populations, but require larger rigourous trials to confirm impact. Other interventions, such as amniotic fluid assessment for oligohydramnios, appear predictive of stillbirth risk, but studies are lacking which assess the impact on perinatal mortality of subsequent intervention based on test findings. Few rigorous studies of cardiotocography have reported stillbirth outcomes, but steep declines in stillbirth rates have been observed in high-income settings such as the U.S., where cardiotocography is used in conjunction with Caesarean section for fetal distress. Conclusion There are numerous research gaps and large, adequately controlled trials are still needed for most of the interventions we considered. The impact of monitoring interventions on stillbirth relies on use of effective and timely intervention should problems be detected. Numerous studies indicated that positive tests were associated with increased perinatal mortality, but while some tests had good sensitivity in detecting distress, false-positive rates were high for most tests, and questions remain about optimal timing, frequency, and implications of testing. Few studies included assessments of impact of subsequent intervention needed before recommending particular monitoring strategies as a means to decrease stillbirth incidence. In high-income countries such as the US, observational evidence suggests that widespread use of cardiotocography with Caesarean section for fetal distress has led to significant declines in stillbirth rates. Efforts to increase availability of Caesarean section in low-/middle-income countries should be coupled with intrapartum monitoring technologies where resources and provider skills permit.

Smoking is the primary cause of avoidable deaths in developing countries; it is the principal cause of many illnesses and is risk factor or aggravated cause. Cigarettes or smokeless tobacco have a direct or indirect toxicity effect on practically every organ. The induced diseases are cardiovascular, cancers, respiratory complaints and many consequences less well known but often serious. There is no smoking without risk; however, stopping smoking at any age is beneficial.

This paper includes an update of a Cochrane systematic review on tobacco use cessation (TUC) in dental settings as well as narrative reviews of possible approaches to TUC and a more detailed discussion of referral for specialist TUC services. On the basis of these reviews we conclude that interventions for tobacco users in the dental setting increase the odds of quitting tobacco. However, the evidence is derived largely from patients using smokeless tobacco. Pharmacotherapy (such as nicotine replacements, bupropion and varenicline) is recommended for TUC in medical settings but has received little assessment in dental applications, although such evidence to date is promising. Whether the dental setting or referral to specialist TUC services is the most effective strategy to help people to quit tobacco use is unclear. An effective specialist service providing best available TUC care alone may not be the answer. Clearly, such services should be both accessible and convenient for tobac...

Athletes are not a typical at-risk group for smoking combustible tobacco products, because they are generally health conscious and desire to remain fit and optimize athletic performance (1). In contrast, smokeless tobacco use historically has been associated with certain sports, such as baseball (2). Athletes might be more likely to use certain tobacco products, such as smokeless tobacco, if they perceive them to be harmless (3); however, smokeless tobacco use is not safe and is associated with increased risk for pancreatic, esophageal, and oral cancers (4). Tobacco use among youth athletes is of particular concern, because most adult tobacco users first try tobacco before age 18 years (5). To examine prevalence and trends in current (≥1 day during the past 30 days) use of combustible tobacco (cigarettes, cigars) and smokeless tobacco (chewing tobacco, snuff, or dip [moist snuff]) products among athlete and nonathlete high school students, CDC analyzed data from the 2001–2013 Nation...

Nicotine, at the dosage levels smokers seek, is a relatively innocuous drug commonly delivered by a highly harmful device, cigarette smoke. An intensifying pandemic of disease caused or exacerbated by smoking demands more effective policy responses than the current one: demanding that nicotine users abstain. A pragmatic response to the smoking problem is blocked by moralistic campaigns masquerading as public health, by divisions within the community of opponents to present policy, and by the public-health professions antipathy to any tobacco-control endeavours other than smoking cessation. Yet, numerous alternative systems for nicotine delivery exist, many of them far safer than smoking. A pragmatic, public-health approach to tobacco control would recognize a continuum of risk and encourage nicotine users to move themselves down the risk spectrum by choosing safer alternatives to smoking--without demanding abstinence.

Human papillomavirus (HPV) infects the squamous epithelial cells of oral cavity and cervix leading to formation of warts that develops into the cancer. Human papillomavirus (HPV)-16 and 18 encode E6 oncoprotein, which binds to and induces degradation of the tumour suppressor protein p53. A common polymorphism of p53, encoding either proline (Pro) or arginine (Arg) at position 72, affects the susceptibility of p53 to E6 mediated degradation in vivo. Oral cancer is a pressing problem in India due to the widespread habit of chewing betel quid, which plays an important role in etiology of this disease. In the present study an attempt has been made to analyze the genetic predisposition of the Indian population to HPV infection and oral carcinogenesis. In our study a total of 110 cases of Oral Cancer highly addicted to betel quid and tobacco chewing are analyzed for HPV 16/18 infection and its association with polymorphism at p53 codon 72. Of these a total number of 37 patients (33.6%) have shown the presence of HPV, among which the presence of HPV-16, 18 and 16/18 coinfection is 22.7%, 14.5% and 10%, respectively. Our results also indicate that the p53 codon 72 genotype frequencies in Indian Oral Cancer patients are 0.55 (Arg) and 0.45 (Pro) as per Hardy-Weinberg equilibrium. In our study, striking reduction in Pro/Pro allele frequency has been found in HPV positive cases, indicating Arg/Arg genotype to be more susceptible to HPV infection and oral carcinogenesis. © 2001 Wiley-Liss, Inc.

In a retrospective study, interviews were obtained with 3,716 patients with histologically proven cancer of the lung (Kreyberg types I and II), mouth, larynx, esophagus, or bladder and with over 18,000 controls. For each of these cancers, the relative risk of both male and female present smokers increased with the quantity smoked and the duration of the habit. The strongest increase occurred for cancer of the lung and larynx, and the least increase occurred for cancer of the esophagus and bladder. For exsmokers the risk decreased with years of cessation. The risk for mouth cancer of pipe and cigar smokers who inhaled much less than cigarette smokers was less than that of the latter and increased with the quantity smoked. The risk of mouth, larynx, and esophagus cancer among smokers increased with the quantity of alcohol consumed. Greater smoking habits and lesser cessation rates were noted among lower socioeconomic groups, suggesting that these groups will bear an ever increasing pr...

Globally, India accounts for the highest number of oral cancer cases. The survival rates are about 30% lower than those in developing countries. The main reason for these dismal figures is the late presentation of patients. In order to downstage oral cancer in such a scenario, screening and diagnosis at an early stage is warranted. A pragmatic approach is needed for an oral cancer screening program, hence a mobile health (mHealth) approach was used. In this approach, health workers were empowered with mobile phones with decision-based algorithm. Risk stratification of tobacco habit enables us to identify lesions associated with particular habits. A specific cohort of factory employees who predominantly had pure tobacco chewing habit was chosen to examine the effect of pure tobacco on oral mucosa. One thousand three hundred and fifty-seven subjects were screened in two phases. In the first phase, habits and oral lesions were identified and photographed. The photographs were remotely ...