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Zettergren A, Sompa S, Palmberg L, Ljungman P, Pershagen G, Andersson N, Lindh C, Georgelis A, Kull I, Melen E, Ekström S, Bergstrom A. Assessing tobacco use in Swedish young adults from self-report and urinary cotinine: a validation study using the BAMSE birth cohort. BMJ Open 2023; 13:e072582. [PMID: 37438074 DOI: 10.1136/bmjopen-2023-072582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/14/2023] Open
Abstract
OBJECTIVES Studies on health effects of tobacco often rely on self-reported exposure data, which is subjective and can lead to misclassification. The aim of this study was to describe the prevalence of cigarette smoking, snus and e-cigarette use, as well as to validate self-reported tobacco use among young adults in Sweden. METHOD Participants of a population-based Swedish cohort (n=3052), aged 22-25 years, assessed their tobacco use in a web questionnaire. Urinary cotinine was analysed in a subsample of the study population (n=998). The agreement between self-reported tobacco use and urinary cotinine was assessed using Cohen's Kappa coefficient (κ) at a cut-off level of 50 ng/mL. RESULTS Patterns of tobacco use differed between men and women. Among men, 20.0% reported daily snus use, 5.8% daily cigarette smoking and 5.6% any e-cigarette use. In contrast, 3.2% of the women reported daily snus use, 9.0% daily cigarette smoking and 2.4% any e-cigarette use. Among the tobacco use categories, daily snus users had the highest levels of cotinine. Of reported non-tobacco users, 3.5% had cotinine levels above the cut-off, compared with 68.0% among both occasional cigarette smokers and snus users, 67.5% among all e-cigarette users and 94.7% and 97.8% among daily cigarette smokers and snus users, respectively. Agreement between self-reported tobacco use and urinary cotinine was classified as strong for daily use of cigarettes (κ=0.824) and snus (κ=0.861), while moderate to weak for occasional smoking (κ=0.618), occasional snus use (κ=0.573) and any e-cigarette use (κ=0.576). CONCLUSIONS We found high validity of self-reported tobacco use in our study population, particularly for daily tobacco use. Further, we found that daily snus users were exposed to high levels of cotinine. Together with previous findings, our results indicate good validity of self-reported tobacco use among young adults.
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Affiliation(s)
- Anna Zettergren
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Shanzina Sompa
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lena Palmberg
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niklas Andersson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Christian Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Antonios Georgelis
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Inger Kull
- Sachs' Children and Youth Hospital, Södersjukhuset AB, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Erik Melen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Södersjukhuset AB, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Sandra Ekström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Anna Bergstrom
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
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Shrestha S, Mishra DR, Dhakal N, Bhandari S, Khanal S, Lamsal M. Correlation of urinary cotinine with cardiovascular risk factors in pan masala tobacco users. Indian Heart J 2019; 71:459-463. [PMID: 32248918 PMCID: PMC7136352 DOI: 10.1016/j.ihj.2019.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 08/03/2019] [Accepted: 10/12/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Tobacco consumption is considered as one of the major risk factors for cardiovascular (CV) morbidity. However, the effect of paan masala tobacco (PMT) (a type of smokeless tobacco) consumption has not been well studied in our context. Our study is aimed to find an association of CV risk factors between PMT users and nonusers and to correlate those parameters with urinary cotinine level, a degradation product of nicotine occurring in tobacco. METHODS This comparative cross-sectional study was carried out among 200 participants. The effect of PMT use on CV risk factors such as blood pressure (BP), lipid profile, and body mass index was measured against urine cotinine level. Statistical tests used were χ2 test for categorical variable, independent t-test, Mann-Whitney U test, and Spearman's correlation applied for numerical variable, and multivariate regression analysis was performed as required. The level of significance was set at p < 0.05. RESULT Mean BP, total cholesterol, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and median cotinine level were found to be significantly higher in PMT users than in controls (p < 0.001). Urinary cotinine level was positively correlated with mean BP, TC, TG, and LDL-C in PMT users (p < 0.001). Similarly, the odds of having hypercholesterolemia and increased diastolic BP was also significantly higher in PMT users (p < 0.001). CONCLUSION PMT use has an adverse effect on CV risk parameters and there is a rational of cotinine measurement for screening CV risk among PMT users.
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Affiliation(s)
- Sanjeeb Shrestha
- Department of Biochemistry, Gandaki Medical College and Teaching Hospital, Pokhara, Nepal.
| | - Deebya Raj Mishra
- Department of Internal Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
| | - Niraj Dhakal
- Department of Biochemistry, Gandaki Medical College and Teaching Hospital, Pokhara, Nepal.
| | - Suresh Bhandari
- Department of Biochemistry, Gandaki Medical College and Teaching Hospital, Pokhara, Nepal.
| | - Sagar Khanal
- Department of Biochemistry, Lumbini Medical College, Lumbini, Nepal.
| | - Madhab Lamsal
- Department of Biochemistry, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
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Otorhinolaryngological symptoms among smokeless tobacco (Maras powder) users. North Clin Istanb 2018; 6:284-292. [PMID: 31650117 PMCID: PMC6790918 DOI: 10.14744/nci.2018.50024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 05/04/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE: This study aims to investigate the relationship between smokeless tobacco (maras powder) consumption and otorhinolaryngological symptoms. METHODS: This descriptive study was carried out on 599 participants. The participants were divided into two groups. Of these, 299 (49.9%) patients aged over 18 years were the first group; they used smokeless tobacco for at least 5 years. The remaining patients comprised the second group, which included 300 (50.1%) healthy volunteers who did not use tobacco or its products and demonstrated some similarities with the first group. For the purpose of data collection, a questionnaire consisting of 45 questions was administered to the participants. RESULTS: Cough, sputum, shortness of breath, dysphagia, snoring, and apnea-hypopnea were found to be significantly increased in smokeless tobacco users. The highest odds ratio (OR) found was for sputum at 2.615. Similarly, other oral cavity symptoms such as mouth tickling, dryness of throat, mouth sores, halitosis, taste disorders, and toothache were found to be significantly increased in smokeless tobacco users. It is noteworthy that halitosis was 9.4 times more prevalent among smokeless tobacco users than in the non-tobacco users. Sinonasal symptoms such as sneezing, headache, facial fullness, and anorexia were found to be significantly increased in smokeless tobacco users. However, there were no differences between the groups in terms of ear symptoms. CONCLUSION: This study demonstrated that the negative effects of smokeless tobacco consumption were particularly higher in the oral cavity, which in turn gave rise to a number of serious upper respiratory tract complaints.
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Dagli AF, Sahin N, Bozdag Z, Ucer O, Akatli AN, Artas G, Sahin İ, Yardim M, Dalkilic S, Akkoc RF, Simsek S, Aydin S. Cytological and cytomorphometric characteristics of buccal mucosa cells from smokeless tobacco users. Diagn Cytopathol 2017; 45:976-982. [DOI: 10.1002/dc.23803] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 08/07/2017] [Accepted: 08/14/2017] [Indexed: 01/10/2023]
Affiliation(s)
| | - Nurhan Sahin
- Department of Pathology; Inonu University; Malatya 44280 Turkey
| | - Zehra Bozdag
- Department of Pathology; Gaziantep University; Gaziantep 27310 Turkey
| | - Ozlem Ucer
- Department of Pathology; Firat University; Elazig 23190 Turkey
| | - Ayse Nur Akatli
- Department of Pathology; Inonu University; Malatya 44280 Turkey
| | - Gokhan Artas
- Department of Pathology; Firat University; Elazig 23190 Turkey
| | - İbrahim Sahin
- Department of Medical Biochemistry (Firat Hormones Research Group); School of Medicine, Firat University; Elazig 23190 Turkey
- Department of Histology and Embryology; Erzincan University; Erzincan 24100 Turkey
| | - Meltem Yardim
- Department of Medical Biochemistry (Firat Hormones Research Group); School of Medicine, Firat University; Elazig 23190 Turkey
| | - Semih Dalkilic
- Department of Molecular Biology and Genetic; Firat University; Elazig 23119 Turkey
| | - Ramazan Fazil Akkoc
- Department of Anatomy; Faculty of Medicine, Firat University; Elazig 23190 Turkey
| | - Sercan Simsek
- Department of Pathology; Firat University; Elazig 23190 Turkey
| | - Suleyman Aydin
- Department of Medical Biochemistry (Firat Hormones Research Group); School of Medicine, Firat University; Elazig 23190 Turkey
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Akcay A, Aydin MN, Acar G, Mese B, Çetin M, Akgungor M, Cabioglu E, Bozoglan O, Ardic I, Çakici M. Evaluation of left atrial mechanical function and atrial conduction abnormalities in Maras powder (smokeless tobacco) users and smokers. Cardiovasc J Afr 2016; 26:114-9. [PMID: 26592906 PMCID: PMC4538911 DOI: 10.5830/cvja-2014-070] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 11/27/2014] [Indexed: 11/17/2022] Open
Abstract
Objective In Turkey, a type of smokeless tobacco called Maras powder (MP) is widely used in the south-eastern region. Smokeless tobacco is found in preparations for chewing and for absorption by the nasal and oral mucosae. The purpose of this study was to investigate whether MP damages intra- and inter-atrial conduction delay and left atrial (LA) mechanical function as much as cigarette smoking. Method A total of 150 chronic MP users (50 males, 32.5 ± 5.4 years), smokers (50 males, 32.1 ± 6.0 years) and controls (50 males, 30.1 ± 5.8 years) were included in the study. LA volumes were measured echocardiographically according to the biplane area–length method. Atrial electromechanical coupling was measured with tissue Doppler imaging and LA mechanical function parameters were calculated. Results The LA passive emptying fraction was significantly decreased and LA active emptying volume (LAAEV) was significantly increased in the MP group (p = 0.012 and p = 0.024, respectively), and the LA active emptying fraction (LAAEF) was significantly increased in the smokers (p = 0.003). There was a positive correlation between the amount of MP used and smoking (pack years) with LAAEV and LAAEF (r = 0.26, p = 0.009 and r = 0.25, p = 0.013, respectively). Lateral atrial electromechanical intervals (PA) were significantly higher in MP users, and the septal mitral PA was statistically higher in the smokers (p = 0.05 and p = 0.04, respectively). Conclusion We suggest that atrial electromechanical coupling intervals were prolonged and LA mechanical function was impaired in MP users and smokers, but there was no significant difference between the MP users and smokers. These findings may be markers of subclinical cardiac involvement and tendency for atrial fibrillation.
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Affiliation(s)
- Ahmet Akcay
- Department of Cardiology, Faculty of Medicine, Kahramanmaras Sutcuimam University, Kahramanmaras, Turkey
| | - M Naci Aydin
- Department of Cardiology, Faculty of Medicine, Kahramanmaras Sutcuimam University, Kahramanmaras, Turkey
| | - Gurkan Acar
- Department of Cardiology, Faculty of Medicine, Kahramanmaras Sutcuimam University, Kahramanmaras, Turkey
| | - Bulent Mese
- Department of Cardiovascular Surgery, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Mustafa Çetin
- Department of Cardiology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Mehmet Akgungor
- Department of Cardiology, Faculty of Medicine, Kahramanmaras Sutcuimam University, Kahramanmaras, Turkey
| | - Eren Cabioglu
- Department of Cardiology, Faculty of Medicine, Kahramanmaras Sutcuimam University, Kahramanmaras, Turkey
| | - Orhan Bozoglan
- Department of Cardiovascular Surgery, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Idris Ardic
- Department of Cardiology, Faculty of Medicine, Kahramanmaras Sutcuimam University, Kahramanmaras, Turkey
| | - Musa Çakici
- Department of Cardiology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
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Göney G, Çok İ, Tamer U, Burgaz S, Şengezer T. Urinary cotinine levels of electronic cigarette (e-cigarette) users. Toxicol Mech Methods 2016; 26:414-8. [PMID: 27278718 DOI: 10.3109/15376516.2016.1144127] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The popularity of electronic cigarettes (e-cigarettes) is rapidly increasing in many countries. These devices are designed to imitate regular cigarettes, delivering nicotine via inhalation without combusting tobacco but currently, there is a lack of scientific evidence on the presence or absence of nicotine exposure. Such research relies on evidence from e-cigarette users urine samples. In this study, we aimed to determine the levels and compare the amount of nicotine to which e-cigarette users, cigarette smokers and passive smokers are exposed. Therefore, urine samples were collected from e-cigarette users, cigarette smokers, passive smokers, and healthy nonsmokers. The urinary cotinine levels of the subjects were determined using gas chromatography-mass spectrometry. The mean (±SD) urinary cotinine levels were determined as 1755 ± 1848 ng/g creatinine for 32 e-cigarette users, 1720 ± 1335 ng/g creatinine for 33 cigarette smokers and 81.42 ± 97.90 ng/g creatinine for 33 passive smokers. A significant difference has been found between cotinine levels of e-cigarette users and passive smokers (p < 0.05). There were no statistically significant differences between e-cigarette users and cigarette smokers (p > 0.05). This is a seminal study to demonstrate the e-cigarette users are exposed to nicotine as much as cigarette smokers.
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Affiliation(s)
- Gülşen Göney
- a Department of Toxicology , Faculty of Pharmacy, Gazi University, Hipodrom , Ankara , Turkey
| | - İsmet Çok
- a Department of Toxicology , Faculty of Pharmacy, Gazi University, Hipodrom , Ankara , Turkey
| | - Uğur Tamer
- b Department of Analytical Chemistry , Hipodrom , Ankara , Turkey , and
| | - Sema Burgaz
- a Department of Toxicology , Faculty of Pharmacy, Gazi University, Hipodrom , Ankara , Turkey
| | - Tijen Şengezer
- c Minister of Health, Sıhhıye District Polyclinic , Sıhhıye, Ankara , Turkey
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"Maras Powder" a Form of Smokeless Tobacco as a Perioperative Risk Factor in Microsurgery. J Hand Microsurg 2015; 7:146-8. [PMID: 26078529 DOI: 10.1007/s12593-014-0125-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 02/26/2014] [Indexed: 10/25/2022] Open
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Sucakli M, Kahraman H, Altunoren O, Celik M, Sayarlioglu H, Dogan E. Evaluation of Knowledge and Behavior of and Attitudes Towards Smoking Cigarettes and Using Smokeless Tobacco in Patients With Chronic Renal Failure. Transplant Proc 2013; 45:2129-32. [DOI: 10.1016/j.transproceed.2013.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 12/18/2012] [Accepted: 03/06/2013] [Indexed: 10/26/2022]
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Bakan B, Özkan F, Sucakli MH, Bilal Ö, Gümüsalan Y. The Osteoporotic Effect of Maras Powder (Turkish Smokeless Tobacco) Consumption in Healthy Males. J Phys Ther Sci 2012. [DOI: 10.1589/jpts.24.1233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Betül Bakan
- Faculty of Medicine, Department of Physical Therapy and Rehabilitation, Sütçü Imam University
| | - Fuat Özkan
- Faculty of Medicine, Department of Radiology, Sütçü Imam University
| | | | - Ökkes Bilal
- Faculty of Medicine, Department of Orthopedic Surgery and Traumatology, Sütçü Imam University
| | - Yakup Gümüsalan
- Faculty of Medicine, Department of Anatomy, Sütçü Imam University
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Guven A, Tolun F. Effects of smokeless tobacco "Maras powder" use on nitric oxide and cardiovascular risk parameters. Int J Med Sci 2012; 9:786-92. [PMID: 23136542 PMCID: PMC3491438 DOI: 10.7150/ijms.4563] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 10/15/2012] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Smokeless tobacco use is common in various parts of the world. In Turkey a type of smokeless tobacco called "Maras powder" is widely used in southeastern region. Smoking is known to have an adverse effect on nitric oxide and cardiovascular risk factors. The aim of this study was to evaluate whether there is difference between the effects of Maras powder and cigarette smoking on the cardiovascular risk factors and nitric oxide levels. METHODS In the study, participants were 48 Maras powder users, 50 cigarette smokers and 45 nontobacco user subjects. Blood samples were collected and hematological parameters and lipid parameters were measured. Plasma Nitric oxide level was also detected by using the Griess method. RESULTS Plasma total cholesterol, LDL-cholesterol, triglyceride levels were significantly higher in Maras powder and cigarette smokers group than in the nontobacco user group (p<0.001). Plasma HDL-cholesterol levels were significantly lower in Maras powder and cigarette smokers group than in the nontobacco user group (p<0.001). Plasma Nitric oxide levels were found significantly lower in Maras powder and cigarette smokers group compared to the nontobacco user group (4.9±0.9 µmol/l, 4.8±1 µmol/l, 9.4±3.4 µmol/l, respectively, p<0.001) whereas there was no significant difference between the Maras powder and cigarette smokers group. In multivariate logistic regression model, cigarette smoking (Odds ratio=17.832, p<0.001), Maras powder usage (Odds ratio=12.311, p=0.002) and mean platelet volume (Odds ratio=1.425, p=0.030) remained independently associated with lower Nitric oxide levels. CONCLUSION We conclude that Maras powder has similar adverse effects on nitric oxide level and cardiovascular risk parameters and thereby it appears to be harmful as cigarette smoking.
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Affiliation(s)
- Aytekin Guven
- Baskent University School of Medicine, Department of Cardiology, Konya, Turkey
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Sardas S, Cimen B, Karsli S, Yurdun T, Donbak L. Comparison of genotoxic effect between smokeless tobacco (Maras powder) users and cigarette smokers by the alkaline comet assay. Hum Exp Toxicol 2009; 28:214-9. [PMID: 19734273 DOI: 10.1177/0960327108098333] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Maras powder (MP) is a kind of smokeless tobacco used in the south-eastern region of Turkey and in several other countries of Middle and Far East. The present study was performed to assess the impacts of MP and cigarette smoking on the possible DNA damaging effect. Alkaline comet assay, which is a reliable and an important tool in human biomonitoring studies in the area of genetic toxicology, was used in peripheral lymphocytes of MP users, cigarette smokers, and non-smokers while their frequencies of total comet scores (TCS) were evaluated. The mean TCS (+/-SD) frequency in the peripheral lymphocytes was 14.4 (+/-10.04) for MP users and 8.26 (+/-5.38), 5.94 (+/-3.87) for cigarette smokers (P < 0.05) and non-smoking control subjects, respectively (P < 0.001). There was no significant effect of daily consumption of MP and the duration of MP usage on comet frequencies. In reply to a wrong belief among MP users ("the use of smokeless tobacco product is substantially less hazardous than cigarettes"), the present study shows that the oral use of smokeless tobacco represents a genotoxic hazard which is even higher than the DNA damage observed in cigarette smokers. Therefore, habitual use of MP should be taken into account and could be considered unsafe, equally harmful, and it should not be viewed as a safe alternative to cigarettes.
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Affiliation(s)
- S Sardas
- Department of Toxicology, Faculty of Pharmacy, Marmara University, Istanbul, Turkey.
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Eroğlu L, Orak I, Turhan Haktanir N. Effect of short-term use of oral smokeless tobacco on random-pattern skin flap survival in rats. ACTA ACUST UNITED AC 2009; 39:272-6. [PMID: 16320402 DOI: 10.1080/0284431051003565] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We investigated the effects of smokeless tobacco on the survival of random-pattern skin flaps in rats. Twenty rats were divided into two groups (n=10 each). In the experimental group 200 mg smokeless tobacco (Maras powder) (1 mg nicotine) was inserted intraorally once a day for seven days under general anaesthesia. It was not given to the control group, but the rats were similarly anaesthetised with ketamine. On day 8, plasma cotinine concentrations were measured. The random-pattern dorsal skin flaps measuring 3 x 10 cm were then raised and resutured. Percentage survival area was assessed after a further eight days. The mean (SD) survival was 39 (7)% in the experimental, and 65 (8.9)% in the control, groups (p=0.0001). The mean (SD) plasma cotinine concentrations were 124.4 (73) ng/ml and <10 ng/ml, respectively. Smokeless tobacco use increased the incidence of flap necrosis in random-pattern skin flaps in rats.
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Affiliation(s)
- Lütfi Eroğlu
- Department of Plastic Surgery, Ondokuz Mayis University, Faculty of Medicine, Turkey.
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Zielińska-Danch W, Wardas W, Sobczak A, Szołtysek-Bołdys I. Estimation of urinary cotinine cut-off points distinguishing non-smokers, passive and active smokers. Biomarkers 2007; 12:484-96. [PMID: 17701747 DOI: 10.1080/13547500701421341] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
An objective assessment of exposure to tobacco smoke may be accomplished by means of examining particular biomarkers in body fluids. The most common biomarker of tobacco smoke exposure is urinary, or serum, cotinine. In order to distinguish non-smokers from passive smokers and passive smokers from active smokers, it is necessary to estimate cotinine cut-off points. The objective of this article was to apply statistical distribution of urinary cotinine concentration to estimate cut-off points distinguishing the three above-mentioned groups. The examined group consisted of 327 volunteers (187 women and 140 men) who were ethnically homogenous inhabitants of the same urban agglomeration (Sosnowiec, Poland). The values which enabled differentiation of the examined population into groups and subgroups were as follows: 50 microg l(-1) (differentiation of non-smokers from passive smokers), 170 microg l(-1) (to divide the group of passive smokers into two subgroups: minimally and highly exposed to environmental tobacco smoke), 550 microg l(-1) (differentiation of passive smokers from active smokers), and 2100 microg l(-1) (to divide group of active smokers into two subgroups: minimally and highly exposed to tobacco smoke). The results suggest that statistical distribution of urinary cotinine concentration is useful for estimating urinary cotinine cut-off points and for assessing the smoking status of persons exposed to tobacco smoke.
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Affiliation(s)
- Wioleta Zielińska-Danch
- Department of General and Analytical Chemistry, Medical University of Silesia, Sosnowiec, Jagiellonska, Poland.
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Dönbak L, Celik M, Demirhan I, Nagas S. Genotoxic damage in Maras powder consumers from Kahramanmaras province of Turkey. RUSS J GENET+ 2007. [DOI: 10.1134/s1022795407050055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Aral M, Ekerbicer HC, Celik M, Ciragil P, Gul M. Comparison of effects of smoking and smokeless tobacco "Maras powder" use on humoral immune system parameters. Mediators Inflamm 2006; 2006:85019. [PMID: 16951495 PMCID: PMC1592592 DOI: 10.1155/mi/2006/85019] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The aim of this study is to assess the impacts of "Maras powder" and cigarette smoking on the parameters of the humoral immune system. MATERIAL AND METHODS One hundred seventy seven subjects were included in the study. The IgA, IgG, IgM, C3 and C4 levels were detected via nephelometric method. RESULTS In 1.4% of the control group IgM levels were below normal where it was 10.8% and 18.6% in Maras powder group and in cigarette smoking group respectively. The IgM levels of both groups were significantly lower compared to the control group (P < .05). Nonetheless, the IgE levels of Maras powder group and smoking group were found to be remarkably higher compared to the control group (P < .01). CONCLUSION Effects of Maras powder on humoral immune response were found to be similar to that of smoking.
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Affiliation(s)
- Murat Aral
- Department of Microbiology, KSU Medical School,
46050 Kahramanmaras, Turkey
| | | | - Mustafa Celik
- Department of Family Medicine, KSU Medical School,
46050 Kahramanmaras, Turkey
- *Mustafa Celik:
| | - Pınar Ciragil
- Department of Microbiology, KSU Medical School,
46050 Kahramanmaras, Turkey
| | - Mustafa Gul
- Department of Microbiology, KSU Medical School,
46050 Kahramanmaras, Turkey
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Buyukbese MA, Koksal N, Guven A, Cetinkaya A. Effects of Smokeless Tobacco "Maras Powder" Use on Respiratory Functions. TOHOKU J EXP MED 2004; 204:173-8. [PMID: 15502415 DOI: 10.1620/tjem.204.173] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In Turkey, "Maras Powder," which is a kind of powder yielded from the shields of tobacco, is widely used as smokeless tobacco through buccal mucosa or together with cigarette. Maras powder, composed of ash and a plant named Nicotiana Rustica Linn, is sometimes used to give up smoking. The present study was aimed to investigate the effects of Maras powder use on respiratory functions of healthy subjects who do not have any chronic disease. We found statistically significant differences in percentage of forced expiratory volume in the first second (FEV(1)%) (p = 0.001), the ratio of FEV(1) to forced vital capacity (FEV(1)/FVC) (p = 0.024), percent of maximum expiratory flow rate (FEF(25-75)%) (p = 0.002) and percent of peak expiratory flow (PEF%) (p = 0.037) between cigarette smokers with Maras powder use (n = 23) and control subjects (n = 24). Likewise, when cigarette smokers (n = 24) and control subjects were compared, the differences for all these parameters were significant (p = 0.022, p = 0.048, p = 0.011 and p = 0.047, respectively). Only FEV(1)% and FEF(25-75)% were significantly lower in cigarette smokers with Maras powder use than in Maras powder users (n = 28) (p = 0.011 and p = 0.022, respectively). There was a negative correlation between forced vital capacity and Maras powder use (r = -0.315, p = 0.03). The present study suggests that Maras powder does not cause serious bronchial obstruction. This may be due to usage of the smokeless tobacco through buccal mucosa but not through inhalation as in case of cigarette smoking.
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Affiliation(s)
- Mehmet Akif Buyukbese
- Department of Internal Medicine, Kahramanmaras Sutcu Imam University, Faculty of Medicine, 46050 Kahramanmaras, Turkey.
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