1

Department of Oral Medicine and Radiology, MS Ramaiah Dental College and Hospital, Bangalore - 560 054, Karnataka, India 2 Department of Community Dentistry, MS Ramaiah Dental College and Hospital, Bangalore - 560 054, Karnataka, India Click here for correspondence address and email Date of Submission 18-Aug-2007 Date of Decision 09-Sep-2007 Date of Acceptance 19-Oct-2007

Abstract Objectives: To estimate the nicotine content of some popular Indian brands of smoking tobacco (cigarettes and bidis) and pan masalas (chewable tobacco). Materials and Methods: Commercially available cigarettes, bidis, and pan masalas (chewable tobacco) were obtained from local retail outlets for the study. Nicotine was estimated using gas-liquid chromatography. Results: The analyses showed relatively higher levels of nicotine in tobacco from bidis (26.9 mg gm) as compared to cigarettes(15 mg/gm); the difference is stastically significant ( P < 0.001). The nicotine concentration of tobacco from filtered cigarettes averaged 14.5 mg/gm whereas unfiltered cigarettes averaged 15.6 mg/gm; the difference was not stastically significant ( P > 0.01). Nicotine concentration in chewing tobacco was 3.4 mg/gm. Conclusion: The study concludes that the nicotine content of Indian brands of smoking tobacco was slightly high compared to other international brands. Higher concentration of nicotine was found in bidis compared to cigarettes. The nicotine content in commercially available chewing tobacco products was found to be much lower than in the smoking form of tobacco, but the average daily consumption made it comparable to the smoking form. Keywords: Bidi, cigarette, nicotine, pan masala, tobacco How to cite this article: Reddy SS, Shaik Hyder Ali KH. Estimation of nicotine content in popular Indian brands of smoking and chewing tobacco products. Indian J Dent Res 2008;19:88-91 How to cite this URL: Reddy SS, Shaik Hyder Ali KH. Estimation of nicotine content in popular Indian brands of smoking and chewing tobacco products. Indian J Dent Res [serial online] 2008

[cited 2011 Dec 30];19:88-91. Available from: http://www.ijdr.in/text.asp?2008/19/2/88/40458 Much of the cancer prevalent today is linked to our lifestyles. Tobacco and diet are claimed to account for nearly two-thirds of all cancers we see worldwide; most of these are preventable. The recent decades have seen a massive global increase in tobacco use, the consumption of cigarettes alone having risen from 300 million per year in 1920 to 5.5 trillion in 2000. [1] It has been pointed out that 82,000-99,000 young people worldwide are initiated into smoking each day. [2] The Indian scenario as far as tobacco consumption is concerned is far worse because of the prevalence of the tobacco chewing habit, which covers a wide spectrum of socioeconomic and ethnic groups and is spread over urbanised areas as well as remote villages. This is in addition to the widespread prevalence of smoking, with both cigarettes and bidis being smoked in large numbers. Cigarettes and other forms of tobacco are addicting and nicotine is the substance in tobacco that causes addiction. [3] Once a person is addicted to nicotine, quitting smoking is difficult, and more than 90% of the smokers who try to quit each year fail. The epidemic of addiction to nicotine among young people has enormous implications for public health. [4] On average, an American cigarette contains 8-9 mg of nicotine. [5] Typically, the cigarette delivers about 1 mg (0.3-3.2 mg) of nicotine to the circulation of the smoker, representing an absolute bioavailability of about 12%. It is estimated that 5 mg of nicotine per day is a threshold level that can readily establish and sustain addiction. [6],[7],[8] One measure of the addictive potential of tobacco products is the amount of nicotine available to the consumer. The present study has been undertaken to establish the nicotine content in Indian tobacco products, including some popular brands of smoking (cigarettes and bidis) and chewing forms (pan masalas containing tobacco). Materials and Methods

Commercial cigarettes, bidis, and pan masalas (containing tobacco) were obtained from local retail outlets for the study. Eight brands of cigarettes (three unfiltered and five filtered), six brands of bidis, and six brands of pan masalas were used for the study. Pure nicotine obtained from ITC (Indian Tobacco Company), Bangalore, was used as a standard. Tobacco weights of the cigarettes were estimated by taking the average of 10 cigarettes, while the tobacco weights of the bidis were based on the average of 20 bidis. The weights of each sachet of pan masala was estimated as the average of 10 sachets. For each brand of cigarette, bidi, and pan masala, the tobacco was removed from the wrapping and pooled for chemical analysis. Two samples were taken from the pooled resource of each brand of cigarette, bidi, and pan masala and analyzed for nicotine. The amount of nicotine was determined using gas-liquid chromatography (GLC) Cheminat 8510, a FI detector, SE 30 column, and nitrogen as a carrier gas at M.S. Ramaiah Drug Testing Laboratory. Gas chromatography samples were prepared by

weighing 200 mg of tobacco and adding 10 ml of 1% potassium hydroxide (KOH) in methanol. The solutions were sonicated for 4 h, keeping the solution temperature below 45C. After sonication, the samples were centrifuged for 5 min. The supernatant (top layer) was then used for gas chromatography analysis. Nicotine standards were prepared in 1% KOH in methanol (2 mg in 10 ml). The amount of nicotine was calculated from the peak obtained in the samples. Concentrations of nicotine were compared between smoking and smokeless tobacco forms and stastically analysed. Results

The weight of pan masala sachets averaged 1992.6 mg. The tobacco content of the sachet averaged 1690 mg [Table - 1]. The nicotine content of the chewing tobacco averaged 3.4 mg/gm, whereas in smoking tobacco the nicotine content was 15 mg/gm. Nicotine content in smoking tobacco was significantly higher compared to that in chewing tobacco (t(11) = 3.5; P < 0.01). The weight of filtered and unfiltered cigarettes averaged 802.3 mg and 800.4 mg, respectively. The tobacco content of filtered and unfiltered cigarettes averaged 712.2 mg and 728 mg, respectively. The nicotine concentration in the tobacco from the filtered cigarettes averaged 14.5 mg/gm, whereas in unfiltered cigarettes it averaged 15.6 mg/gm [Table - 2]. The difference in nicotine concentration of filtered and unfiltered cigarettes was statistically not significant ( P > 0.05). The bidis had an average weight of 399.4 mg. The weight of the tobacco in each bidi averaged 187.5 mg [Table - 3]. The tendu leaf wrapping accounted for 47% of the total bidi weight. The nicotine concentration of the tobacco from the the bidis averaged 26.9 mg/gm, whereas it averaged 15 mg/gm in the tobacco from cigarettes; this difference was statistically significant (t(13) = 3.9; P < 0.001). Discussion

Abuse of tobacco, like drug and alcohol abuse, is a worldwide public health problem. In India, it is estimated that 57% of the population aged 15 years and above (i.e., >500 million) use tobacco in one form or the other. Of this group 72% smoke bidis, 12% smoke cigarettes, and 16% use tobacco in the smokeless form. [8] Of the 250 million kilograms of tobacco cleared for domestic consumption in India, 86% is used in the smoking form and 14% in the smokeless form. [9] Of the millions of people in this country who use chewing tobacco, as many as 1 in 4 is under the age of 19 years. [10],[11] Pan masala containing tobacco was introduced in the Indian market during 1970s. It is a mixture of areca nut, lime, catechu, and sweetening, colouring, and flavouring agents, with or without tobacco. [11] Only pan masalas containing tobacco was used in the present study. Tobacco-containing brands are preferred by many due to their intoxicating effect

and also the added flavour and taste due to the tobacco in the mix. In the present study, the nicotine concentration of chewing tobacco averaged 3.4 mg/gm (range 2.6-4.1 mg/gm), whereas it averaged 15 mg/gm in smoking tobacco. That is, nicotine concentrations in the smoking form of tobacco was found to be almost four times higher compared to that in chewing tobacco; however, this was largely compensated for by the greater intake of chewing tobacco. According to Centre for Disease Control (CDC), chewing tobacco used 7-8 times a day may be equivalent to smoking 30-40 cigarettes per day. An increased incidence of squamous cell and verrucous carcinomas of the oral cavity and pharynx has been found in patients who use chewing tobacco. [12],[13] The risk increases with the increase in the frequency and duration of the habit. [14] The odds for oral cancer is estimated to be 7.3 in smokers, 1.3 in alcoholics, and 11.4 in those habituated to chewing tobacco. [8] Though the nicotine content of chewing tobacco is lower than that in the smoking form, it is said to have an increased carcinogenic potential because it remains in contact with the oral mucosa for longer periods of time. Additionally, in contrast to smokers, who absorb nicotine primarily through the pulmonary vasculature, chewing tobacco users absorb nicotine both through the buccal mucosa and the gastrointestinal tract. Tobacco-specfic N-nitrosamines, present in higher concentrations in smokeless tobacco, are readily extracted by saliva; the absorption is further enhanced in alkaline environments. [12],[15],[16] Kozlowski et al ., in their study, have shown the nicotine content of cigarettes to be 10.2 mg/gm in US brands, 13.5 mg/gm in Canadian brands, and 12.5 mg/gm in the UK brands. American cigarettes are considered more likely to use 'casings' (sauces and flavourings) than the Canadian or British brands and so it is expected that the columns in American cigarettes would, in general, have lower nicotine contents. [17] Fukumoto et al ., in their study on Japanese filtered cigarettes, found 11.72 2.27(SD) mg of nicotine per cigarette. [18] Pakhale et al ., in their study on Indian cigarettes, have found the nicotine concentration to be 16.2 mg/gm. [19] In our study, the nicotine concentration of the Indian cigarettes averaged 15 mg/gm, with 14.5 mg/gm in filtered cigarettes and 15.6 mg/gm in unfiltered brands. Some brands have a higher nicotine content than others, indicating that tobacco types or blends and tobacco casings can be used to manipulate the nicotine content and the nicotine delivery of cigarettes. The difference in the nicotine concentration between Indian cigarettes and other international brands can, perhaps, be attributed to difference in the technique employed for estimation of nicotine. Plant variety, cultivation, curing methods, and the design of the smoking product (including the wrapper used and the presence/absence of filters differing in effeciencies) are very different in India and in Western countries. These factors are known to influence the formation and yields/levels of toxic chemicals in tobacco and tobacco smoke. [19] in our study, the difference in nicotine content between Indian filtered and unfiltered cigarettes was not significant, and the same has been shown by Malson et al . in their study. [20] Bidis, an alternate type of cigarette, consisting of finely ground, sun-dried tobacco rolled in a brown temburni (Diospyros melanoxylon) leaf is the most popular form of tobacco used in India. [9] In the present study, the nicotine content of bidis was found to be 26.9 mg/gm, whereas it was 15 mg/gm in cigarettes. This observation is consistent with the

findings of Malson et al . [20] Pakhale et al ., in their study on the nicotine concentration of bidis, found it to be 37.7 mg/gm. [19],[20] Malson et al . found exported Indian brands of bidis to have a concentration of nicotine of 21.2 mg/gm, which is lower than the value found in the present study (26.9 mg/gm). [20] This difference in nicotine concentration can be attributed, perpaps, to the different brands of unflavoured Indian bidis used. Results from a clinical study that measured plasma nicotine concentrations indicate that higher concentrations of nicotine were seen after smoking bidis than cigarettes. [7],[21] The dependance potential of bidis is evident from the fact that in India, bidi smoking accounts for 40% of tobacco consumption. [22],[23] Epidemiological studies in India have showed that bidi use is associated with increased incidence of oral, pharyngeal, laryngeal, lung, esophagal cancers, [23],[24] as well as stomach and liver cancer; [25],[26],[27] also, overall cancer risks are higher for bidi smokers than for cigarette smokers. [24],[28],[29] Conclusion

This study concludes that the nicotine content of smoking tobacco was slightly high compared to other international brands. A higher concentration of nicotine was found in bidis, as compared to cigarettes. The nicotine concentration of commercially available chewing tobacco products was found to be much lower than that of the smoking form of tobacco, but the higher average daily consumption made it comparable to the smoking form. The above information is likely to be useful in the evualation, interpretation, and comparison of data on smoking-related cancers among Eastern and Western populations. Indian chewing tobacco users are often also smokers; the excessive use of chewing tobacco and concurrent smoking of bidis (which require deep inhalations to prevent it from getting extiguishted and, moreover, are unfiltered), reverse smoking in certain populations, and the slightly increased nicotine concentration in Indian tobacco products, all contribute to the increased incidence of oral cancer in India when compared to West, where the incidence of lung cancer is more than that of oral cancer. Recommendation

The amount of nicotine present in cigarettes or bidis or the role of filter ventilation in the manipulation of tar and nicotine yields of cigarette are less known to the public except those associated with the tobacco industry. Hence, it is strongly recommended that the nicotine content of tobacco products should be mentioned on the packets and the presence of vents should be indicated on cigarettes with coloured bands. By regulating the availability of nicotine in tobacco products it maybe possible to prevent the transition from experimental or occasional smoking to addiction. The manufacturers of tobacco products should make sincere efforts to reduce the delivery of noxious substances through tobacco products.