A study of the short-term cardiopulmonary effect of mawa chewing in rural India

Abstract

Background: Tobacco is consumed in smoking and smokeless forms all over the world. Smokeless tobacco has been advocated as a substitute for cigarette smoking. On the contrary, the use of smokeless tobacco is fraught with health risk and needs to be discouraged. Previous reports have described long-term harmful effects of nicotine on various body parameters, little is known about the acute effect of smokeless tobacco, such as mawa, consumed very rampantly in rural India, on cardiopulmonary parameters. Use of smokeless tobacco indeed represents a health concern of growing magnitude among these groups. As a consequence of its addictive qualities, the consumption of smokeless tobacco often becomes a lifelong habit with cumulative and deleterious effects on health. Very few studies have been undertaken on the acute effect of use of mawa, a common form of tobacco used in India, on cardiopulmonary parameters of youngsters. Materials and Methods: Treadmill Exercise Testing and Pulmonary Function Tests were done before and after maximal exercise testing to assess cardiopulmonary efficiency in two groups, namely, healthy sedentary controls and healthy mawa chewers. Results: On studying the differences in cardiopulmonary efficiency in the two groups, the resting heart rate was found to be statistically significantly higher in the study group and the delta heart rate was found to be statistically significantly lower among mawa chewers. There was no significant difference seen in parameters such as VO 2max , maximum oxygen pulse, MVV, VE max as an acute effect of mawa. Conclusion: In this study, it appears that mawa chewers are physically fit similar to the controls, but immediately after smoking a lesser delta HR suggests a higher risk for cardiovascular mortality. Stopping mawa at this juncture can be helpful in reverting back the risk, and parameters such as resting HR, recovery HR, and delta HR can be used as prognostic assessment tools for any intervention therapy to stop mawa chewing in asymptomatic individuals.