Snuff Tobacco Research Articles

Are Tobacco Companies in Nigeria Complying With Health Warning Label Regulations on Cigarettes and Other Tobacco Products?

BACKGROUND: Nigeria has approved 50% coverage of text and images of pictorial health warning labels (PHWLs) on packages of cigarettes and other tobacco products such as cigars, smokeless tobacco, and loose tobacco. While there is knowledge on the extent to which LMICs like Nigeria adopt the WHO Framework Convention of Tobacco Control (FCTC), there is need to examine the compliance with adopted packaging and labeling policies to generate knowledge for strengthening existing policies and efforts at enforcement. We assessed agreement with FCTC regulations as well as compliance with Nigerian requirements which are not adequate and do not effectively capture all FCTC requirements to identify the gaps being explored by these companies in an environment of poor regulation in Lagos, Nigeria. METHODS: This descriptive study was conducted in Lagos State, Nigeria, from October 2022 to January 2023. A multistage random sampling method was utilized. Four local government areas (LGAs) with a combined population of 16 million, accounting for 70% of the population in Lagos, Nigeria were selected while three points‑of‑sale were randomly picked from two selected wards in each LGA. Empty discarded packs of cigarette and other tobacco products were collected from these outlets. The pack dimensions were measured and assessed for PHWLs, health warning manipulations and cessation assistance. Findings were assessed for compliance with the FCTC and national legislation. For each compliance feature, we calculated the frequencies and percentages of the packs that were compliant. RESULTS: 704 packs: 434 packs of 22 cigarette brands and 270 packs of 17 different tobacco products including cigars, snuff and loose tobacco were included in the study. Of 434 cigarette packs assessed, 50.3% were compliant with 9 indicators measured. These ranged from 48.8% to 55.5% for individual brands. For cessation assistance, image variability and image manipulation, compliance was 0% across all cigarette packs. Out of 270 tobacco product packs assessed, 10.6% were compliant with the 9 indicators assessed. Of the 12 multinational parent companies and product distributors assessed, the overall level of compliance among them was 24.9%. Level of compliance was noted to very low for companies involved in marketing other tobacco products, ranging from 0% to 20% but moderate for those marketing cigarettes, ranging from 37% to 55.5%. Companies that had no presence or subsidiaries in Nigeria but only export their products were highly non-compliant. CONCLUSIONS: Tobacco companies had low compliance with PHWL on cigarettes and negligible compliance on other tobacco products like cigars, loose and smokeless tobacco. The government should expand and strictly enforce all regulations applying to health warnings, especially on non-cigarette tobacco products and closely monitor companies that merely export their products to the country.

Are Tobacco Companies in Nigeria Complying With Health Warning Label Regulations on Cigarettes and Other Tobacco Products?

BACKGROUND: Nigeria has approved 50% coverage of text and images of pictorial health warning labels (PHWLs) on packages of cigarettes and other tobacco products such as cigars, smokeless tobacco, and loose tobacco. While there is knowledge on the extent to which LMICs like Nigeria adopt the WHO Framework Convention of Tobacco Control (FCTC), there is need to examine the compliance with adopted packaging and labeling policies to generate knowledge for strengthening existing policies and efforts at enforcement. We assessed agreement with FCTC regulations as well as compliance with Nigerian requirements which are not adequate and do not effectively capture all FCTC requirements to identify the gaps being explored by these companies in an environment of poor regulation in Lagos, Nigeria. METHODS: This descriptive study was conducted in Lagos State, Nigeria, from October 2022 to January 2023. A multistage random sampling method was utilized. Four local government areas (LGAs) with a combined population of 16 million, accounting for 70% of the population in Lagos, Nigeria were selected while three points‑of‑sale were randomly picked from two selected wards in each LGA. Empty discarded packs of cigarette and other tobacco products were collected from these outlets. The pack dimensions were measured and assessed for PHWLs, health warning manipulations and cessation assistance. Findings were assessed for compliance with the FCTC and national legislation. For each compliance feature, we calculated the frequencies and percentages of the packs that were compliant. RESULTS: 704 packs: 434 packs of 22 cigarette brands and 270 packs of 17 different tobacco products including cigars, snuff and loose tobacco were included in the study. Of 434 cigarette packs assessed, 50.3% were compliant with 9 indicators measured. These ranged from 48.8% to 55.5% for individual brands. For cessation assistance, image variability and image manipulation, compliance was 0% across all cigarette packs. Out of 270 tobacco product packs assessed, 10.6% were compliant with the 9 indicators assessed. Of the 12 multinational parent companies and product distributors assessed, the overall level of compliance among them was 24.9%. Level of compliance was noted to very low for companies involved in marketing other tobacco products, ranging from 0% to 20% but moderate for those marketing cigarettes, ranging from 37% to 55.5%. Companies that had no presence or subsidiaries in Nigeria but only export their products were highly non-compliant. CONCLUSIONS: Tobacco companies had low compliance with PHWL on cigarettes and negligible compliance on other tobacco products like cigars, loose and smokeless tobacco. The government should expand and strictly enforce all regulations applying to health warnings, especially on non-cigarette tobacco products and closely monitor companies that merely export their products to the country.

Non-cigarette Tobacco Use and Stroke Among West Africans: Evidence From the SIREN Study.

Non-cigarette tobacco (NCT) represents a form of tobacco use with a misperceived significance in chronic disease events. Whether NCT use is sufficient to promote stroke events, especially among Africans, is yet to be understood. This study assessed the relationship between NCT use and stroke among indigenous Africans. A total of 7617 respondents (NCT users: 41 vs. non-NCT: 7576) from the Stroke Investigative Research and Educational Network (SIREN) study were included in the current analysis. NCT use was defined as self-reported use of smoked (cigars or piper) or smokeless (snuff or chewed) tobacco in the past year preceding stroke events. Stroke was defined based on clinical presentation and confirmed with a cranial computed tomography/magnetic resonance imaging. Multivariable-adjusted logistic regression was applied to estimate the odds ratio (OR) and 95% confidence interval (CI) for the relationship of NCT with stroke at a two-sided p < .05. Out of the 41 (0.54%) who reported NCT use, 27 (65.9%) reported using smokeless NCT. NCT users were older than non-NCT users (62.8 ± 15.7 vs. 57.7 ± 14.8 years). Overall, NCT use was associated with first-ever stroke (OR: 2.08; 95% CI: 1.02, 4.23) in the entire sample. Notably, smokeless NCT use was independently associated with higher odds of stroke (OR: 2.74; 95% CI: 1.15, 6.54), but smoked NCT use (OR: 0.16; 95% CI: 0.02, 1.63) presented a statistically insignificant association after adjusting for hypertension and other covariates. NCT use was associated with higher odds of stroke, and public health interventions targeting NCT use might be promising in reducing the burden of stroke among indigenous Africans. A detailed understanding of the relationship between NCT use and stroke will likely inform well-articulated policy guidance and evidence-based recommendations for public health prevention and management of stroke on the African continent.

Tobacco use in diabetes mellitus: a retrospective cohort study to determine the effect of snuff tobacco use on diabetes mellitus complications over a period of nine years

Tobacco use in diabetes mellitus: a retrospective cohort study to determine the effect of snuff tobacco use on diabetes mellitus complications over a period of nine years

Kinetics and the Mechanism of Reduction of Hexacholoroiridate (IV) by Carcinogenic Nicotine as an Alkaloid in Aqueous Solutions with the Determination of Ionization Constant of Nicotine

Background: Nicotine (NIC) is a lipid-soluble alkaloid found predominantly in tobacco products, including cigarettes, cigars, and oral tobacco products such as snuff and chewing tobacco. Since nicotine substrate is the major constituent of tobacco smoke, it may cause negatively impacted problems for human healthcare, which keeps many users hooked. Method: A spectrophotometric technique has been applied to investigate the kinetics of reductoin hexachloroiridate (IV) as an inert one-equivalent oxidant by carcinogenic nicotine (NIC) in aqueous perchlorate solutions. Results: First-order in [IrCl6]2- and fractional-first-order concerning the nicotine concentration has been revealed. Kinetic evidence for forming a 1:1 intermediate complex between the NIC and [IrCl6]2- before the rate-determining step was confirmed. Conclusion: The ionization constants of nicotine were evaluated from the kinetic data and are 8.57x10-4 and 4.57 x 10-4 moldm-3 at an ionic strength of 0.5 moldm-3 and 30°C and 40°C, respectively. The activation parameters have been deduced from the kinetic results of the temperature dependence of rate constants. A plausible reaction mechanism for the redox reaction is suggested and discussed. Nicotinic acid (Vitamin B3) was formed as an oxidation product of nicotine oxidation.

Effect of Chronic Consumption of Smokeless Tobacco (Snuff) on Liver Enzymes of Males in Maiduguri, Northeast Nigeria

Smokeless tobacco snuff consumption is as dangerous as cigarette smoking. It is now considered a significant source of morbidity and mortality owing to the effect of the numerous chemical constituents. Thus, this study was designed to investigate the effect of chronic consumption of Smokeless Tobacco (Snuff) on Liver Enzymes of males in Maiduguri and its environs, Northeast Nigeria. In this study we recruited 109 individuals who were smokeless tobacco snuffers and 97 healthy controls. It was a prospective case control study performed in adult males (30-50 years and 23 – 48 years for case and control respectively) with mean age of the case and control subjects of 37.12 ± 10.21and 33.64 ± 3.29 respectively. Serum Alanine amino transferase (ALT), Serum Aspartate amino transferase (AST) and serum Alkaline phosphatase (ALP) were estimated using kinetic methods by Cobas C311(Roche/Hitachi) chemistry auto analyzer. The estimated Serum AST, ALT, and ALP, levels were compared using un-paired student's t test between the two groups. Also, the liver enzyme levels were evaluated based on the duration of the smokeless tobacco consumption and correlation was determined. The age range of the study subjects was between 30 and 50 years and the mean age of the Case and control subjects were 37.12 ± 10.21and 33.64 ± 3.29 respectively. The mean(average) of the duration of tobacco snuff intake was 10.52 ± 7.02 years. The mean Serum level of AST, ALT, and ALP of tobacco snuffers were found to be higher (15.45 ± 3.32, 22.00 ± 5.10 and 22.00 ± 5.10 respectively) as compared to controls (10.42 ± 2.36, 8.88 ± 3.14 and 31.14 ± 4.60 for AST, ALT and ALP respectively) and the differences were statistically significant at p&lt; 0.05. Also, the serum levels of the liver enzymes (AST, ALT, and ALP) were evaluated according to duration of snuff intake and the liver enzymes were found to be higher in people who uses the tobacco snuff for 11-20 years. However, the duration of the snuff intake was correlated with the serum levels of the liver enzymes. There was strong correlation between duration of snuff intake and serum levels of AST and ALT (r=0.648 and r=0.741 respectively) and the relationship were statistically significant at p&lt;0.05. But the serum level of ALP was weekly correlated with the duration of snuff intake and the relationship was not statistically significant at p&gt;0.05. From the results of the current study and the literature reviewed it is evident that tobacco snuff may likely be one of the causes of several liver diseases. Therefore, our study might be helpful in creating awareness on the hazards of using smokeless tobacco products (Snuff), among our population who are using smokeless tobacco.

Impact of Tobacco Use in the Etiology of Chronic Renal Failure Among Sudanese Patients

Background: Chronic renal failure (CRF) is a clinical syndrome that occurs when there is gradual decline in renal operation overtime. Objective: This study aims to investigate the prevalence of depression among medical students at university of Baghdad, college of medicine in Iraq and the association between some variables and depression. Aim: This study aimed to identify the impact of tobacco use in the etiology of chronic renal failure among Sudanese patients in Omdurman Military Hospital and Omdurman Kidney Dialysis Center Materials and methods: This descriptive community-based study was conducted in Khartoum State. A random sample of 100 cases with chronic renal failure and 100 control subjects were selected. Demographic, socioeconomic characteristics, prevalence of tobacco use among the respondents and incidence of acute and chronic illnesses associated with renal failure were statically tested to find its correlation to renal failure Results: Findings showed that there was no significant statistical association between educational level and occupational status, to chronic renal failure (P-value &gt; 0.05). Use of tobacco including cigarettes, snuff and water pipe, indicated significant association (P-value ≤ 0.05). Conclusion: From the above findings the followings could be concluded that educational level showed significant statistical correlation to chronic renal failure. Use of tobacco (smoking, snuff and water pipe) is one of the most important remediable renal risk factors. Further studies focusing on controlled information on the success of a modem smoking cessation strategy in renal patients is highly recommended.

The State Tobacco Trade in Russia during the Petrine Era: Kursk and Vyazma

Referring to two tobacco books stored in the Russian State Archive of Ancient Acts for Kursk (1720) and Vyazma (1725), the author examines the legal trade in tobacco in these cities. The article provides general information about the total legislative ban on tobacco trade in the seventeenth century and the measures taken in the 1690s to legalise the spread and use of tobacco. The history of the tobacco trade in Russia at the initial stage of its existence remains very poorly studied. The author emphasises the importance of tobacco books of the eighteenth century in the study of domestic tobacco trade. The article presents data on the quantitative and geographical composition of documents found in various funds of the Russian State Archive of Ancient Acts, providing a detailed source characterisation of the Kursk and Vyazma tobacco books (including their volume, structure, and forms of individual articles). The author analyses the volume and turnover of the state-owned tobacco trade in Kursk and Vyazma, determines the assortment of tobacco products sold, traces seasonal fluctuations in the sale of tobacco, and makes conclusions about the amount of income received by the treasury. Additionally, the author carries out a comparative analysis of retail prices for tobacco sold in Kursk and Vyazma, demonstrating the dependence of this indicator on the distance from the main areas of wholesale purchases. Furthermore, he considers the manufacture of snuff, providing information on the ratio of smoking and snuff tobacco in the Russian tobacco market in different historical periods. Based on information about the number of the townspeople of Kursk and Vyazma according to the first revision of 1719 and data on the volume of state tobacco trade in these cities, an attempt is made to determine the level of tobacco consumption among the local population. The article provides information on the structure of state expenditures made over the year to ensure the tobacco trade in Vyazma and demonstrates the share of state tobacco profits in the general structure of state revenues (customs, liquor, etc.) in Kursk. Finally, the article provides information on the personnel and social status of the officials responsible for the receipt of state tobacco revenues in Kursk and Vyazma in the indicated years.

The Concept of Harm Reduction from Tobacco: Past, Present, Future

The concept of tobacco harm reduction (THR) is a speculative and controversial topic in the context of the international battle against the use of all types of tobacco. This concept involves providing tobacco users who are unable or unwilling to quit smoking or using other types of tobacco (snuff, chewing), with modified risk tobacco product (MRTP) for continued use. Skepticism about THR is huge and is associated with the negative experience of tobacco companies to produce cigarettes with a low content of tobacco tar/nicotine, which should have had significantly lower health risks than conventional cigarettes. Paradoxically, such an experience served as a springboard to an increase in the number of tobacco products that potentially have the properties of MRTP. Moreover, some members of the anti-smoking coalition, including WHO, consider the transition of tobacco smokers to MRTP as a strategy with great potential. However, the European Group of Experts believes that the MRTP strategy does not work and will lead to another generation of young people getting used to tobacco. In this article, we have critically analyzed the history of the past and present of tobacco products, myths and contradictions around them. We have tried to evaluate the modern concept of S THR as objectively as possible, which has a high potential for a real reduction in the number of deaths associated with smoking.

The application value of contrast-enhanced computed tomography in cervical lymph node metastasis of oral carcinomas: A protocol for systematic review and meta-analysis.

Background:Oral carcinomas is a concerning condition around the world. Globally, it is the 11th most common form of cancer. Over 90% of oral carcinomas are squamous cell carcinomas. Smoking, tobacco intake, smokeless tobacco (snuff or chewing tobacco), excessive sunlight exposure, alcohol, betel nut consumption, human papillomavirus, and reverse end smoking are the most common causes of oral carcinomas. Oral carcinomas are prone to neck lymph mode metastasis, which has an impact on the prognosis of patients and the five-year survival rate. Thus, precise lymph node metastasis and staging of oral carcinomas are critical. With the development of nuclear medicine and molecular imaging, an increasing number of studies have found that Contrast-Enhanced Computed Tomography (CECT) has high diagnostic value for tumors.Methods and analyses:The reviewers will conduct a thorough search for related literature in 6 online databases, including The Cochrane Library, PubMed, WanFang database, Web of Science, Chinese biomedical literature database, and the China National Knowledge Infrastructure. The authors will obtain full text of studies deemed to be eligible to extract and synthesize data. The present systematic review will be reported in accordance with the Preferred Reporting Project (PRISMA-P) of the 2015 System Review and Meta-Analysis Protocol.Results:The present systematic analysis will pool the results of individual studies to assess the value of CECT in cervical lymph node metastasis of oral carcinomas.Conclusion:The results in the proposed research will determine whether CECT is an efficient diagnostic method for cervical lymph node metastasis of oral carcinomas.Ethics and dissemination:This study will utilize secondary data from pre-published studies. Therefore, an ethical clearance is not required. The research outcomes shall be disseminated in conference reports and peer-reviewed publications.OSF registration number:Oct 13, 2021.osf.io/k5nr9. (https://osf.io/k5nr9/).

Tobacco Snuff Induced Comparative Weight Changes and Notable Physical Observations in Adults Albino Wistar Rats

In Nigeria, tobacco snuff is the powdered form of smokeless tobacco blended with potash as its main additive. It has been discovered to have several adverse health effects, though perceived by many as safe. In this eight-week study, the effect of tobacco snuff consumption on body weight, physical observation and growth performance of Wistar rats were investigated. This study involved (42) Adult Wistar rats weighing 150-300g. They were divided into groups of tests and control, group A serving as control, while groups B, C and D of 12 Wister rats each served as the test groups. The test groups were further divided into subgroups (1, 2, 3 and 4) representing four experimental phases of 2, 4, 6 and 8 weeks respectively. The rats were fed with varying doses of tobacco snuff, while the control group (A) received feed pallets and water ad libitum. Throughout the study, serial physical and behavioural changes of the rats were recorded as well as the body weights of the rats before sacrifice. Results showed statistically significant weight changes in the test groups throughout the study period as compared with the control. On growth performance, there was an average daily growths increase in the control but decreased in the test groups in a dosage and duration dependent manner. Our findings however, indicate that tobacco snuff has the potentials of body weight reduction and could induce severe growth retardation with adversities.

Inhalation Bioaccessibility of Potentially Toxic Metals in Tobacco Snuff and Related Exposure Risks

This study determined the concentrations and inhalation bioaccessibility of cadmium, chromium, nickel and zinc in some foreign and locally available tobacco snuff and leaves. For the determination of the heavy metals concentration, the samples were ashed and washed with hydrochloric acid according to standard method. The bioaccessibility test employed the Stimulated Epithelial Lung Fluid (SELF). The total concentration of heavy metals in the four samples investigated ranged between 9.7 - 14.9 μg/g, 24.1 - 37.0 μg/g, 41 - 69 μg/g and 153 - 183 μg/g for cadmium, chromium, nickel and zinc respectively. The percentage inhalation bioaccessibility fraction of the four samples investigated ranged between 20.8% - 59.8%, 3.3% - 8.1%, 21.7% - 48.8% and 7.6% - 12.5% for cadmium, chromium, nickel, and zinc respectively. Statistical analyses using SPSS 21, revealed significant differences in the total concentration of heavy metals in the samples investigated except for Zinc. Risk assessment based on daily consumption of 10 g of the tobacco snuff employing total concentration of the heavy metals suggests that excluding nickel, all other metals investigated indicated daily intake values above WHO permissible levels. However, with the bioaccessible fractions, only cadmium, a known carcinogen indicated levels above WHO limits. From the results of this study, it can be deduced that consumption of tobacco snuff may induce negative health effects such as cancer and its attendant complications, the risk analysis based on bioaccessible concentration suggests lower health risk than analysis based on total heavy metal concentration; hence the assumption that snuff is a safe alternative to tobacco smoking may be erroneous.

Potential Application of USP Paddle and Basket Dissolution Methods in Discriminating for Portioned Moist Snuff and Snus Smokeless Tobacco Products.

The focus of the study was to develop discriminatory dissolution methods for portioned snus and moist snuff sub-categories of smokeless tobacco products (STPs) using USP basket and paddle apparatuses. Skoal Classic Wintergreen (SCW) and CORESTA CRP1.1 pouches were used as test products. The dissolution was performed at 10, 20, 30, 40, and 50rpm basket or paddle speed in 500ml artificial saliva pH6.8. The products were also characterized for assay, pH, particle size, and loss on drying. The dissolution profiles were evaluated for amount/% of nicotine dissolved, time to reach plateau, and profiles comparison by f2 and f1 factors. The nicotine assay was 13.3 ± 0.2 and 7.6 ± 0.1mg/pouch for SCW and CRP1.1, respectively. The nicotine dissolved in 30min from SCW and CRP1.1 were 38.4-81.8 and 37.6-88.1, and 50.5-64.9 and 72.3-92.1% by paddle and basket methods, respectively. The f2 and f1 values were ≤ 39.2 and ≥42.1 and ≤ 43.2 and ≥34.1 for basket methods and paddle methods. RSD were less than 20% at all points of dissolution profiles, and dissolution plateau were achieved in 30min at some of the tested conditions. In summary, dissolution methods based on basket and paddle can be used as a performance test for STPs.

Changes in Cardiovascular system among smokeless tobacco users attending tertiary care hospital in Andhra Pradesh, India

Background: Tobacco can be consumed as cigarettes and also as smokeless tobacco. Smokeless tobacco is a harmful tobacco product that contains over 3,000 chemicals, 7 including 28 known carcinogens (cancer-causing agents). Various forms of smokeless tobacco (mainly snuff and chewing tobacco) cause an immediate increase in heart rate and blood pressure. However, the relationship between smokeless tobacco uses on blood pressure remains unknown, especially in tertiary level hospitals. Our aim is to find out the smokeless tobacco use influence on cardiovascular parameters, for instance, pulse rate and blood pressure. Methods: This cross-sectional study was carried out to assess cardiovascular changes among adult male smokeless tobacco (ST) users. For this purpose, 50 male respondents were selected. The participants were selected from the medicine outpatient department of Great Eastern Medical School and Hospital, Srikakulam, Andhra Pradesh. Pulse rate and blood pressure were measured and ST uses behavior was assessed using self-reports. Statistical analysis was done by SPSS20. Results: In this study, the mean (±SD) of pulse rate was 83.2±12.3 beats/min. The mean (±SD) of systolic blood pressure was 158.72±24.84 mm of Hg and the mean (±SD) of diastolic blood pressure was 98.78±9.87 mm of Hg in smokeless tobacco users. Conclusion: Mean systolic and diastolic blood pressures were higher in smokeless tobacco users in the tertiary level hospital. However, the mean pulse rate was within the normal range.

Defining the socio-economic and environmental determinants for high tobacco consumption behaviors among interstate migrant construction workers in Chennai: an observational analysis

Background: Global Adult Tobacco Survey-2 (GATS) reveals significant improvements in the decline of tobacco consumption in the past decades, however vulnerable population groups such as migrant construction workers tobacco consumption behaviors in Chennai remain understudied, thus the study was planned to estimate the socio-economic and environmental determinants for high tobacco consumption behaviors among interstate migrant construction workers in Chennai.Methods: A cross sectional survey was undertaken using a pre-tested structured questionnaire adapted from GATS survey questionnaire assessing the socio-demographic and environmental determinants for tobacco use among study population across 13 construction sites in Chennai during May-September 2019. Data was entered in MS-Excel and analysed using SPSS.Results: Among 345 migrant construction workers, mean age of the subjects was 28.42±8.7 years, 338 (98%) were current tobacco users by smoking, chewing, snuffing, of whom 198 (58.6%) used smokeless forms of tobacco like gutkha, khaini, chewing tobacco leaves, betel quid, tobacco snuff, 98 (29%) were smokers and 42 (12.4%) were dual users i.e. both cigarettes and beedis. Khaini (57%) is the dominant form of tobacco used among migrant construction workers. Mean age of initiation of tobacco use was 21.58 years and 21.17, and 22.73 and 19.5 years for smoking, SLT and dual users respectively. The migrant construction workers with no formal literacy(p=0.000), monthly income of more than 10000 (p=0.020) Indian rupees and migrants for less than one year duration (p=0.05)were more likely using the smokeless tobacco than any other socio demographic group.Conclusions: Tobacco prevalence especially smokeless tobacco use is alarmingly high among interstate migrant construction workers to Chennai.

Prevalence and social determinants of tobacco use in Afghanistan.

BackgroundLimited evidence exists on the prevalence and social determinants of tobacco use in Afghanistan—a fragile post-war context where the tobacco epidemic is on the rise. This study aimed to estimate the prevalence and social determinants of tobacco use in Afghan men and women.MethodsData from the 2015 Afghanistan Demographic and Health Survey of 10 760 men and 29 461 women were used to generate weighted prevalence estimates for smoking, smokeless tobacco (SLT) products including chew and snuff tobacco, ‘any tobacco use’ and ‘dual tobacco use’. We also modelled associations with tobacco outcomes using binary logistic regressions.ResultsWe found that for men, smoking cigarettes was the most prevalent form of tobacco use (21.9% [95% confidence interval {CI} 21.2–22.7]). Prevalence rates were far lower for women, with cigarette/pipe smoking at 3.4% (95% CI 3.2–3.7). For both sexes, tobacco use was inversely associated with education and positively associated with agricultural and skilled and unskilled manual labour occupations. Wealth increased the odds of smoking for men but decreased the odds for women. Media exposure had little influence on tobacco use among women; however, the effects were more varied for men.ConclusionsOur results demonstrate social inequalities in tobacco use among Afghan men and women, which calls for stronger tobacco control measures and continued monitoring of this growing epidemic.

Educational Status and Risks of Cardiovascular Disease in Awka, Southeast Nigeria

Background and Objectives: All over the world, cardiovascular risks constitute a heavy healthcare burden, affecting people with different levels of education, across economies in both the developed and the developing ones. Differences in educational levels in cardiovascular risks have not been completely defined. This study was set out to evaluate the influence of levels of education on the risks of cardiovascular disease in an urban community in Awka, southeast Nigeria. Methodology: In this cross sectional study of 294 subjects conducted in Awka in 2017, biodata, anthropometric and demographic data were obtained. A questionnaire was used to extract information on smoking, alcohol use, tobacco snuff use, diabetes mellitus status, time spent at work > 10 hours daily and night sleep duration 10 hours daily 29.3%, obesity 33.3%, hypertension 58.5%, night sleep 10 hours daily (p 10 hours daily, hypertension and obesity increased in prevalence with increasing levels of education but declined with tertiary education.

Rhinologic signs associated with snuff taking

ObjectiveTo study rhinologic signs associated with nasal tobacco (snuff) intake in Parakou, northern Benin. Materials and methodsA cross-sectional descriptive comparative study included 300 tobacco snuff takers and 300 subjects who did not use tobacco at all. The sampling technique was a stratified 4-stage random sample for non-users and a convenience non-random sample for snuff takers. ResultsThe sex-ratio was 0.92 in non-users and 41.9 in snuff takers. Duration of snuff taking was more than 20 years in 24.3% of cases. The symptoms studied were significantly more frequent in snuff takers than non-users (P<0.05). Snoring was reported by 58.3% of snuff takers, versus 5.7% of non-users (P=0.000). Nasal obstruction and rhinorrhea were reported by respectively 26.3% and 22.7% of snuff takers, versus 6.3% and 5.3% of non-users (P=0.000). Hyposmia was reported by 14% of snuff takers, versus 1.3% of non-users (P=0.000). Anterior rhinoscopy found abnormalities in 81.7% of snuff takers, compared to 10.67% of non-users. Nasal hypertrichosis was more frequent in snuff takers than non-users: 40% versus 5% (P=0.000). ConclusionNasal intake of tobacco is responsible for morbidity in snuff takers compared to non-users of tobacco.

Correlates of Tobacco and Marijuana Use among Urban Dwellers in Enugu, Nigeria

Introduction: Tobacco and marijuana use is a public health challenge all over the world and especially in Sub Saharan Africa. The combination of low socioeconomic status and substance use can be described as a social and economic disaster for many poor families of Africa. While majority of studies concentrated on cigarette smoking, few studies in Nigeria has been conducted on non-smoke forms of tobacco. The burden of marijuana abuse is also rising in the Nigeria. Similar to cigarette smoking, cannabis use is more common among males. Knowledge of the pattern of tobacco and cannabis use in the community is important considering the public health implications. The aim of this study was to determine the prevalence of tobacco (cigarette smoking and snuff) and cannabis use among adults in an urban communities Enugu, southeast Nigeria. Methods: This was a cross-sectional descriptive study conducted in urban slum settlements in Enugu, the capital of Enugu State, southeast Nigeria. Using a semi structured questionnaire, we collected data selected socio-demographic characteristics, including tobacco use and cannabis use in the last 30 days. The study was conducted between August and December 2013. For database management and statistical analyses, we used the SPSS version 23. Results: The total number of individuals recruited in the study was 1572; 844 (52.8%) females and 728 (45.5%) males with a male to female ratio of 0.9:1. Tobacco was used by a total of 270 (17.2%) individuals within the last 4 weeks and marijuana by 23 (1.5%) of the population. Overall, 280 (17.8%) used either one or both tobacco and marijuana. While snuff was predominately used from 60 years and above, cigarette smoking peaked at 30 - 39 years and marijuana use peaked at a younger age of 20 - 29 years. Cigarette smoking positively correlated with male gender (male 1, female 0) and alcohol use (Yes 1, No 0). P < 0.01 in both cases. Snuff use in addition to positively correlating with gender and alcohol use, it also positively correlated with history of diabetes (Yes 1, No 0). Marijuana use correlated with male gender and use of alcohol. Conclusion: The prevalence of cigarette smoking (5.5%), snuff (11.6%) and marijuana use (1.6%) was found in an urban settlement in Enugu. Predictors of tobacco use were older age, male gender and alcohol use. Public health intervention programs should reemphasize the health-related issues associated with these substances and the need to quit using them.

Acute Effect of Tobacco Snuff Consumption on Plasma Total Protein, Albumin, Globulin and Fasting Blood Sugar Level in Rats

This study was designed to investigate the effect of tobacco snuff consumption on total protein, albumin, globulin and fasting blood sugar level. Adult Wistar rats (12) weighing 150-300g were involved. They were divided into four groups; group A serving as control, while groups B, C and D served as the test groups. The rats were fed with varying doses of tobacco dust mixed with potash (tobacco snuff). At the end of the experiment, the animals were sacrificed and blood sample collected into lithium heparin container. Total protein (24.34 ± 4.10 g/dl), albumin (13.80 ± 4.66 g/dl), and fasting blood sugar were assayed and the results obtained showed statistically significant changes. However, fasting blood sugar (117.33 ± 38.50mg/dl) showed decrease that was not statistically significant in all the groups throughout the experiment. The results of this study suggest that tobacco snuff is toxic to the synthetic capacity of the liver and the observed changes were dose dependent.