Sunday, 29 March 2015

IMA hails smokeless tobacco ban Delhi: Will lead to less heart attacks

IMA hails smokeless tobacco ban Delhi: Will lead to less heart attacks

Banning smokeless tobacco in Delhi has been hailed by IMA. Complementing  Delhi Govt decision, Padma Shri Awardee Dr A. Marthanda Pillai National president and Padma Shri Awardee Dr KK Aggarwal Honorary Secretary General IMA, said that smokeless tobacco comes as chewing tobacco or snuff.

Electronic cigarettes (e-cigarettes) use a liquid nicotine cartridge, rather than tobacco.  In addition to cigarettes, tobacco is smoked in the form of cigars, pipes, and waterpipes.

Nicotine is the principal alkaloid found in smokeless tobacco products. The amount of total and free nicotine varies substantially. The concentrations of nicotine (milligrams per gram of tobacco) are similar in oral snuff and cigarette tobacco and somewhat lower in chewing tobacco.
Most smokeless tobacco products are held in the mouth, cheek, or lip or chewed to allow   absorption of nicotine across the buccal mucosa.Oral snuff is held in the cheek between the gum and tooth area.
1. Snuff is associated with a small but significant increase in the relative risk for hypertension.

2. Some smokeless tobacco products, such as loose snuff and chewing tobacco, contain large amounts of sodium, part of the sodium bicarbonate alkaline buffer, enhancing nicotine absorption. The sodium load (30 to 40 excess mEq per day) could potentially aggravate hypertension and heart failure

3. Some smokeless tobacco products contain significant amounts of licorice. Glycyrrhizinic acid, an active chemical in licorice, has mineralocorticoid activity, which may potentiate hypertension and potassium wasting

4. Among “one-time” users of snuff or chewing tobacco transient (30 to 60 minutes), increases in blood pressure and heart rate have been observed due to effects of nicotine

5. The acute effects of smokeless tobacco products include an increase in heart rate and no change or transient increases in blood pressure.

6. Data from INTERHEART showed that chewing tobacco alone was associated with significantly increased risk for heart attack

7. Most people are poorly informed about the dangers of smokeless tobacco, and some believe that it is a safe substitute for smoking cigarettes.

8. The health effects of smokeless tobacco include oral, pharyngeal, and esophageal cancer, oral leukoplakia (a premalignant lesion) and periodontal disease

9. Use of smokeless tobacco produces levels of nicotine that are similar to those produced by smoking, and are also addictive.

10. Smokeless tobacco use is associated with higher levels of current and subsequent cigarette smoking and lower rates of smoking cessation

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