Smokeless Tobacco Use among Women in Kasama District-Zambia

Background: Smokeless tobacco is defined as a product that contains tobacco, is not smoked or burned at the time of use, and commonly consumed orally or nasally. These products can be placed in the mouth, cheek or the lip and are sucked or chewed. The Zambian government, in the 2019 country report, gave an estimated figure of 4.5% of females aged 15 years and above in 2017 used smokeless tobacco and by 31st December, 2018, there was an increase of smokeless tobacco users to 6.8% women of the same age group. This study aimed to explore the extent of smokeless tobacco use among women in Kasama district-Zambia. Methodology: An analytical cross-sectional quantitative study design was used to collect data using the modified structured interview schedule, adopted from Medicine for Global Health. Simple random sampling method using rotary technique was used to select 430 respondents after meeting the inclusion criteria. Informed consent to participate in the study was obtained. Data was analysed using version 26.0 of the Statistical Package for Social Sciences. Appropriate parametric or non-parametric statistical tests (Chi-squared or Fisher’s exact test) were adopted in testing for associations between variables. Univariable and multivariable binary logistic regression analysis were employed in identifying smokeless tobacco use among women using an investigator-led stepwise approach, guided by various fit statistics and the likelihood ratio test. All statistical analyses adopted a 5% significance level at 95% confidence interval. Results: The results showed that most of the respondents were aged between 18 and 25 years (45.6%), (53.7%) lived in urban settlements and the majority (80%) were unemployed. The majority of respondents (83.5%) had a friend/relative who used smokeless tobacco and over half (53.5%) thought smokeless tobacco was beneficial to them. The commonly mentioned benefits of smokeless tobacco included body warmth (13.6%) and vaginal tightening (7.9%). The results revealed that most of the respondents attained a secondary level of education (38.4%). According to the study, smokeless tobacco use among women of Kasama-Zambia was significantly associated with the following;age (p Conclusion: Based on these findings, the study recommends that efforts should be channeled towards the dissemination of information on the impacts of smokeless tobacco use in order to overcome cultural beliefs attached to smokeless tobacco use.

The effects of oral smokeless tobacco administration on endurance performance

Background： Smokeless tobacco is widely used by athletes to enhance performance. Nicotine is a central nervous system stimulant and acts on cardiocirculatory and metabolic systems, involving tissue blood flow and circulatory vasoreactivity. The aim of this study was to investigate the effects of the oral smokeless tobacco （Swedish snus （SS）） on the perception of fatigue and time to exhaustion （TTE） during moderate-intensity aerobic exercise. Methods： Fourteen healthy non-tobacco male users were recruited for a double-blind, controlled crossover design （SS vs. snus placebo （SP））. Subjects were tested for 3 sessions： experimental session 1 （Exp 1） consisted of an incremental test to determine the maximal aerobic power out-put （Wmax）, whereas Exp2 and Exp3 consisted of exercising at 65%Wmax until exhaustion in SS or SP conditions. During Exp2 and Exp3, muscle and cerebral oxygenation was assessed by means of near-infrared spectroscopy, and the rating of perceived exertion （RPE） was recorded. Results： Comparing SS with SP tests, significant differences （p 〈 0.05） were found in the values of cerebral （-3%） and muscular tissues oxygenation （-4%） in the first 30 min of exercise. The RPE values were not significantly different between the 2 conditions （SS vs. SP）. No significant difference was found in TTE （SS： 54.25 ± 21.84 min; SP： 50.01 ± 17.03 min）. Conclusion： This study showed that muscular and cerebral oxygenation increased significantly with snus administration during an endurance exercise until exhaustion, but this did not affect fatigue perception and TTE. The results showed that snus could not be considered an ergogenic substance in non-tobacco users.2018 Published by Elsevier B.V. on behalf of Shanghai University of Sport. This is an open access article under the CC BY-NC-ND license. （http：//creativecommons.org/licenses/by-nc-nd/4.0/）.

Histological Features of Parotid Gland of Albino Rats Exposed to. Smokeless Tobacco

Smokeless tobacco is very common personal habit of people living in various areas of Asia which is an alarming sign for the development of different oral diseases in such people. The aim of present study was to investigate effects of smokeless tobacco on parofid glands of the Aalbano rats by using various percentages of the smokeless tobacco. The rats were divided into three different groups, control group （A） no smokeless tobacco, experimental group （B） 5% smokeless tobacco and experimental group （C） 10% of smokeless tobacco with different feeds required according parameters. Weekly weight gain and partid gland were analyzed through student P test and histological structures were recorded through HE stain and Retculin stain. The results showed that as compared to control group body, weight of the rats was decreased in groups B and C having smokeless tobacco percentage in the diet. Weight of parotid gland as compared to control group was decreased in groups B and C with diet of smokeless tobacco. Further, histological observation under HE stain showed that parofid gland of group B showed mild narrowing of ductal lumen, collapse of vessels and stromal was also increased, in group C parenchyrnal tissues with loss of acini found damaged and glandular dystrop and lymphatic infiltration were determined moderate to severe. Meanwhile, reticulin stain showed that vascular collapses were shown because of increasing in stromal glandular atrophy in group C as compared to control group. In conclusion, this study showed that smokeless tobacco caused serious injuries in the tissue level in parotid gland with high percentage of smokeless tobacco which highlight health hazards on its consumption.

Review with meta-analysis relating North American,European and Japanese snus or smokeless tobacco use to major smoking-related diseases

BACKGROUND While extensive information exists relating cigarette smoking to the risk of lung cancer,chronic obstructive pulmonary disease(COPD),ischaemic heart disease(IHD)or acute myocardial infarction(AMI),and stroke,far less information is available on risks from moist snuff(“snus”)or smokeless tobacco(ST)in United States/Canada,Europe or Japan.AIM To summarize data from the selected countries on risks of the four diseases associated with current ST or snus use.METHODS Publications in English in 1990-2020 were considered that,based on epidemiological studies in North America,Europe or Japan,estimated risks of lung cancer,COPD,IHD/AMI,or stroke according to use of ST or snus.The studies should involve at least 100 cases of the disease considered,and not be restricted to those with specific other diseases.Medline literature searches were conducted,selecting papers initially from examination of titles and abstracts,and then from full texts.Further papers were sought from reference lists in selected papers,reviews and meta-analyses.For each disease,relative risk estimates adjusted at least for age were extracted relating ST or snus use to risk,and combined using random-effects meta-analysis.The estimates were mainly for current vs.never or non-current use,but results for ever vs never use were also considered.RESULTS Seven publications reported results for ST use from six United States studies.The most useful results came from four studies which provided results for current vs.never use.Random-effects meta-analyses of these results showed an increased risk for each disease,clearest for lung cancer(relative risk 1.59,95%confidence interval 1.06-2.39,based on 4 estimates)and COPD(1.57,1.09-2.26,n=3),but also significant(at P<0.05)for IHD(1.26,1.10-1.45,n=4)and stroke(1.27,1.03-1.57,n=4).Also including results for ever vs.never use from two other studies increased the lung cancer estimate to 1.80(1.23-2.64,n=6),but had little effect on the other estimates.For snus,16 publications described results from 12 studies,one in Norway and the rest in Sweden.There were no results for COPD,and only three for lung cancer,with these reporting a relative risk of 0.80(0.40-1.30)for current vs never use.More extensive data were available for IHD/AMI and stroke.Using the latest results from each study,combined estimates for current vs.never use were 1.00(0.91-1.11,n=5)for IHD/AMI and 1.05(0.95-1.17,n=2)for stroke,while for current vs.non-current use they were 1.10(0.92-1.33,n=9)for IHD/AMI and 1.12(0.86-1.45,n=9)for stroke.Meta-analyses including earlier results from some studies also showed no significant association between snus use and IHD/AMI or stroke.No relevant results were found for Japan.CONCLUSION Risks of smoking-related diseases from snus use in Scandinavia are not demonstrated,while those from ST use in the United States are less than from smoking.

Gene Expression Changes and Signal Transduction Pathway Alterations in Primary Human Oral Epithelial Cells Exposed to Smokeless Tobacco Extracts

Smokeless tobacco (ST), an alternative to smoking, has gained wide popularity among tobacco users. This study is conducted to determine the time course of gene expression associated with specific signaling pathways in human oral epithelial cells after exposure to smokeless tobacco extract (STE). A differentiated layer of epithelial cell is created as a way to mimic reasonably similar physiological atmosphere. A dose and time dependent response is observed for cell viability and cell proliferation assays indicating that this model system is responsive to the treatment. Expressions of 84 genes representing 18 different signal transduction pathways are quantitated. This is accomplished by using real-time polymerase chain reaction arrays at 1 h, 3 h, 6 h and 24 h time points following exposure to STE. Changes in gene expression are observed on many cellular processes including cell cycle regulation, cell adhesion, inflammation, apoptosis, and DNA breaks-down including Akt pathway activation. Short time exposure (1 h) leads more genes to down regulate whereas longer incubation time results in more genes up regulation. Most notable differences in the expression of genes during the course of treatment are BCL2A1, BIRC3, CCL20, CDK2, EGR1, FOXA2, HOXA1, IGFBP3, IL1A, IL-8, MMP10, NOS2, NRIP1, PTGS2, SELPLG and TNF-a. This study provides an insight on gene expression on oral epithelial cells as a result of STE exposure. This may also postulate greater understanding on biological effects and the mechanism of action of STE particularly at the transcriptional level.

Pregnancy Outcomes in Smokeless Tobacco Users Cohort Study in a Tertiary Care Hospital

There is a dearth of literature regarding the pregnancy outcomes in antenatal women using smokeless tobacco products (STP). Objective: To compare maternal and neonatal pregnancy outcomes in antenatal women using smokeless tobacco products with those not using tobacco products. Method: Pregnant women attending antenatal clinic at Guru Teg Bahadur hospital, Delhi received brief information about smokeless tobacco products. Antenatal women using STP and matched controls, 92 in each group (total 184) were recruited for the study. After obtaining consent, the urinary cotinine level was measured in both groups at first contact. Antenatal, labour and postpartum events were recorded in both groups. Urinary cotinine levels were again measured at 6 months in the user group. Results: Average age of antenatal women under study was 24.8 yrs and 25.21 yrs in user and non-user groups respectively. More women in the user group were illiterate (P ? 20.39 μg/ml and 24.37 +/? 20.14 μg/ml respectively (p < 0.0001). Women using STPs for more than 5 yrs recorded higher urinary cotinine levels. There was no significant difference in urinary cotinine levels with the type of tobacco product consumed. Pregnancy outcomes of 39 women are known. There was no significant difference in antenatal, intra-natal and postpartum complications in the two groups. Neonatal weight difference was 20 gms.Conclusion: Smokeless tobacco products are the most common forms used by women in low and middle income countries. Larger studies are required to understand their effects on pregnancy outcomes.

无烟气烟草制品的发展现状和趋势

综述了国外无烟气烟草制品的发展历史、产品类型、生产工艺、主要生产厂商和品牌以及相关监管法规等内容,旨在为国内无烟气烟草制品的研制和监管提供参考。

无烟气烟草制品技术发展现状及趋势研究

为把握国外无烟气烟草制品研发的技术特点和发展趋势,借助Thomson Innovation专利分析工具对1985-2014年间无烟气烟草制品技术专利进行分析,系统揭示近30年来无烟气烟草制品的研发现状与态势、研发热点以及技术分布。分析结果表明：专利申请变化趋势受政策影响较大;中国和美国是无烟气烟草制品技术专利申请的主要国家;3类无烟气烟草制品技术研发热点各有不同;以跨国烟草公司为代表的企业通过收购与并购成为无烟气烟草制品技术研发的主导力量。

加热型无烟气烟草制品专利技术统计分析

为使我国烟草行业相关科研技术人员准确把握加热型无烟气烟草制品研发的技术特点,对2001~2012年国家知识产权局和欧洲专利局世界专利数据库有关加热型无烟气烟草制品专利进行了检索、统计和分析。结果表明：①2001~2012年国家知识产权局共公开264件加热型无烟气烟草制品专利。其中,电加热型专利251件,燃料加热型专利8件,理化反应加热型专利5件;②2001~2012年欧洲专利局世界专利数据库中有加热型无烟气烟草制品专利254件。其中,电加热型专利192件,燃料加热型专利45件,理化反应加热型专利17件;③国外企业在我国申请的加热型无烟气烟草制品专利有27件,其中发明专利24件,菲.莫公司12件,日本烟草公司5件;④近10年间我国烟草行业申请4件加热型无烟气烟草制品方面的专利,而且都是实用新型。国外烟草企业在加热型无烟气烟草制品领域的专利拥有量占优势,尤其是在含有可见的烟草物质的电加热型卷烟领域,在我国已初步形成了较为严密的专利布局,而我国烟草行业在加热型无烟气烟草制品的专利明显处于弱势地位,在该领域的研发力度有待加强。

GC/MS法同时检测无烟气烟草制品中的1,2-丙二醇、丙三醇和三甘醇

为了准确测定无烟气烟草制品中保润剂的含量,以14,-丁二醇为内标建立了同时检测无烟气烟草制品中1,2-丙二醇、丙三醇、三甘醇的气相色谱/质谱/选择离子监测(GC/MS/SIM)方法,采用该方法和CORESTA推荐的GC/FID法测定了30个无烟气烟草制品样品,并将2种方法的检测结果进行了比较。结果表明:①该方法的检出限和定量限分别为1.25～2.75μg/g和4.10～9.05μg/mL,回收率89.3%～100.3%,相对标准偏差(RSD)1.16%～4.37%;②所测无烟气烟草制品中1,2-丙二醇、丙三醇、三甘醇的含量分别在0.011～40.817,0.024～39.044和0.012～0.099 mg/g之间;③GC/FID法检出13个样品中含12,-丙二醇,检出率43.3%;14个样品中含丙三醇,检出率46.7%,其中能够准确定量的有9个样品;未检出三甘醇;④GC/MS/SIM法检出29个样品中含1,2-丙二醇,检出率96.7%,其中能够准确定量的有16个样品;28个样品中含丙三醇,检出率93.3%,其中能够准确定量的有25个样品;21个样品中含三甘醇,检出率70.0%,其中能够准确定量的有11个样品;⑤GC/FID和GC/MS/SIM法共同检出的13个样品中的12,-丙二醇含量和9个样品的丙三醇含量的皮尔逊(Pearson)相关系数均大于0.99,概率P值均小于显著性水平0.05,配对t检验概率P值均大于显著性水平0.05。结论:两种方法的定量结果一致,但GC/MS/SIM法灵敏度更高,定性更准确,GC/MS/SIM法更适合无烟气烟草制品中12,-丙二醇、丙三醇、三甘醇的定性定量分析。

国外口含型无烟气烟草制品总烟碱、游离烟碱和烟草特有亚硝胺含量分析

采用CORESTA推荐方法测定了65种国外口含型无烟气烟草制品样品的含水率、烟碱、pH、游离烟碱和4种烟草特有亚硝胺(TSNAs)。结果表明,口含型无烟气烟草制品的各项化学指标差异显著:含水率为12.07%～55.58%;pH为5.55～8.98;以湿重计,烟碱含量为5.41～27.68 mg/g,释放游离烟碱含量为0.63～10.46 mg/g,游离烟碱释放率为7.8%～72.3%;N-亚硝基降烟碱(NNN)为0.31～17.00μg/g,4-(N-亚硝基甲胺基)-1-(3-吡啶基)-1-丁酮(NNK)为0.07～6.00μg/g,N-亚硝基新烟草碱(NAT)为0.11～6.51μg/g,N-亚硝基假木贼碱(NAB)为0.01～2.54μg/g,同一样品中4种TSNAs总含量为0.54～31.91μg/g。

新型烟草制品毒理学评价研究进展

为了解新型烟草制品的健康风险评估进展,对加热非燃烧型烟草制品、无烟气烟草制品和电子烟三类新型烟草制品的毒理学评价研究进行了综述。临床前毒理学评价是新型烟草制品健康风险评估程序中一个重要组成部分。1碳加热型和电加热型卷烟的毒理学评价方法包括细菌致突变试验、染色体畸变分析、姊妹染色单体交换试验、细胞毒性试验、DNA损伤分析、胞内相关酶分析等体外试验,以及皮肤涂抹致肿瘤、烟气吸入动物模型实验。加热非燃烧型卷烟的毒性低于传统卷烟。2无烟气烟草制品的毒理学评价方法包括Ames试验、细胞毒性试验、细胞增殖试验、细胞凋亡试验、染色体畸变分析、姊妹染色体交换试验、微核分析等体外测试,以及动物模型实验。无烟气烟草制品对人体健康有不利影响。3电子烟临床前毒理学评价研究较少。因此,发展一系列适合不同类型烟草制品的体外、体内毒理学测试方法,科学、客观、全面地评价新型烟草制品的健康影响,将成为我国烟草相关风险评估工作的重要内容之一。

口含烟发展现状及原料研究进展

在世界控烟越来越严峻的形势下,各国烟草生产者把口含型烟草制品或卷烟替代品的研究和开发作为发展的重要目标和竞争点。我国的口含型烟草制品研发领域尚处于初级阶段。为了解口含烟的发展状况及原料需求,对口含型烟草制品的主要种类、发展历程及现状、销售状况及原料的需求种类和特点进行综述,展望了口含型烟草制品的未来发展方向及前景。

胶基型无烟气烟草制品中烟碱的释放行为研究

研制了一种用于体外评价胶基型无烟气烟草制品烟碱释放行为的模拟咀嚼机,并利用该设备结合高效液相色谱仪测试了4种市售胶基型无烟气烟草制品的体外烟碱释放率。该设备主要包括溶媒存储瓶、蠕动泵、恒温槽、循环水箱、载物台、空气压缩机、气缸、电机、气动夹子和释放液收集装置。其中循环水箱和载物台形成的测试腔用来模拟人体口腔,以人工唾液为溶媒,空气压缩机带动气动夹子反复挤压被测样品以模拟人体咀嚼状态。体内、体外烟碱释放测试结果表明:利用该模拟咀嚼机评价胶基型无烟气烟草制品烟碱释放行为的方法简便可靠,测试结果与人体使用该类产品时的烟碱释放情况接近。该技术对胶基型无烟气烟草制品的质量控制、烟碱生物利用度评价以及烟碱调控具有一定的应用价值。

袋装口含型无烟气烟草制品烟碱体外释放分析

研制了一套能够模拟口含型无烟气烟草制品烟碱在口腔释放的体外释放装置,并采用该装置对袋装口含型无烟气烟草制品烟碱及游离烟碱的释放进行分析。该装置主要包括溶媒存储瓶、恒流泵、恒温槽、预热线圈、保温管、恒温溶出池和释放液收集装置,其中恒温溶出池用来模拟人体口腔,通过恒流泵、恒温槽、预热线圈、保温管、恒温溶出池使烟碱在模拟条件下释放。该装置操作方便,稳定性好,能够有效地模拟口含型无烟气烟草制品在口腔的释放行为,区分不同产品间的烟碱释放差异,对口含型无烟气烟草制品的质量评价、烟碱调控以及烟碱生物利用度评价具有一定的实用价值。

无烟气烟草制品化学成分研究进展

为了解无烟气烟草制品的化学成分组成及含量,对其常规化学成分、添加剂、有害成分的组成和含量及分析方法进行了综述。经文献调研发现,不同类型及品牌的无烟气烟草制品pH、含水率、烟碱含量(烟碱总含量、游离态烟碱含量)存在较大差异;添加剂作为配方成分,包含物质种类较多,但研究报道较少;有害成分含量均为痕量级,且TSNAs为主要成分,关注度最高。常规化学成分、添加剂的分析方法以GC和GC-MS为主;有害成分的检测分析中多采用高选择性、高灵敏度的MS/MS检测器;化学轮廓谱分析法能够实现化学组成全貌分析,目前尚处于科研前沿。在国内无烟气烟草制品的研发中,可参考文献中常规化学成分、添加剂的组成及含量进行组分调配,并使有害成分含量最小化;在无烟气烟草制品中化学成分的检测方面,可利用多靶标分析或化学轮廓谱分析技术手段,从而实现高通量分析。

基于专利数据分析的无烟气烟草制品研发趋势研究

为了解国内外无烟气烟草制品专利申请的情况,把握无烟气烟草制品的研发趋势,为我国烟草行业无烟气烟草制品的研究开发与市场发展提供决策参考和技术依据,对国内外无烟气烟草产品技术专利进行了检索分析,并对国际大型烟草公司在无烟烟草方面的进展做了的调查。结果表明:(1)无烟气烟草制品技术专利申请量在2008、2009年这两年时间内取得了较大的进展;(2)2000年以后,无烟气烟草制品的研发热点转移到嚼烟、鼻烟领域;(3)国际大型烟草公司相继进入无烟烟草领域,无烟气烟草制品已成为各大烟草公司的研发热点。

近年国外烟草制品设计及研发若干进展

综述了2004年以来国外烟草公司在低危害卷烟产品设计、低引燃倾向卷烟产品和无烟气烟草制品等方面的研发进展,认为我国应进一步加大低引燃倾向卷烟和无烟气烟草制品研发力度,以应对未来国内外市场烟草消费者的需求。

尼古丁和烟草浸提液对人牙龈成纤维细胞生长和贴附能力的影响

目的 :体外观察尼古丁和烟草浸提液 (ST)对人牙龈成纤维细胞的生长和贴附影响。方法 :用不同浓度的尼古丁和ST作用于人牙龈成纤维细胞 ,用MTT法检测细胞的生长和贴附情况。结果 :随尼古丁和ST浓度的增加 ,细胞的生长率逐渐下降 ,尼古丁和ST对细胞生长半抑制浓度 (IC50 )分别为 0 .0 95 g/L和 11.88g/L ;与对照组相比 ,当尼古丁及ST浓度分别大于 0 .0 1g/L和 6 .2 g/L时差异有显著意义。而对细胞贴附的影响表明 ,随着尼古丁和ST浓度的增加 ,细胞的贴附率逐渐下降 ,尼古丁和ST对细胞贴附的IC50 分别是 0 .6 g/L和 10 .33g/L ;与对照组相比 ,当尼古丁及ST浓度分别大于 0 .1g/L和 12 .4 g/L时差异有显著意义。结论 :尼古丁和浸提取液均可抑制人牙龈成纤维细胞的生长和贴附 。

新型烟草制品中国商标统计分析

为准确把握三类新型烟草制品(新型卷烟、电子烟、无烟气烟草)商标注册申请的现状和特点,对中国商标网1986—2015年申请的有关新型烟草制品的商标进行了检索和统计分析。结果表明:① 2010—2015年是新型烟草制品商标尤其是电子烟商标申请注册的快速增长期。②以广州、深圳电子烟企业为代表的国内其他企业是拥有电子烟有效注册商标最多的群体,国外烟草公司是拥有无烟气烟草有效注册商标最多的群体,国内烟草企业尚无有效注册商标。③国外烟草公司采取以无烟气烟草为主、三类制品并行的商标申请策略,而国内其他企业和国内烟草企业则主要关注电子烟商标。④从商标特点看,以国外烟草公司和国内烟草企业为主的传统烟草生产企业基本以其传统卷烟知名品牌为主题,受众以传统烟民为主,而国内其他企业则主打保健和趣味性概念,受众以年轻人和戒烟群体为主。