On basis of finding contents of Naswar, the study recommended an urgent need to enact and implement Smoke Less Tobacco Control policies to curb its use in Pakistan.
The study is conducted with the support of Research, Innovation and Commercialization (ORIC), Khyber Medical University (KMU) and Pakistan Council of Scientific and Industrial Research (PCSIR).
Sharing findings of the study, Supervisor Dr Muhammad Shazad informed APP that the study is conducted in all seven divisions of Khyber Pakhtunkhwa including Peshawar, Mardan, Hazara, Kohat, DI Khan, Bannu, and Malakand.
A total of 14 most-sold brands of naswar, two from each division were collected using a purposive sampling technique. The objective of the study was to investigate the constituents of the most commonly consumed naswar brands, he added.
Smokeless tobacco (ST) use is a growing public health concern with an estimated 360 million users across the globe of which, more than 90 % live in the South Asian region. In Pakistan with an estimated 8% of the population using different ST products including Paan, Gutkha, and Naswar.
While Naswar use is mostly common among the ethnic Pashtun population of Khyber Pakhtunkhwa (KP) province, wherein around 15 % of the general population uses it. According to a study, in Peshawar, the capital city of KP, around 60 % of the total tobacco users consume naswar.
The researchers while using GC-MS analysis identified 85 different chemical compounds in naswar samples. Nicotine was the most common constituent present in all samples. Depending on the extraction solvent, the highest area% of nicotine was 97 % in the N-Hexane extract while the lowest area% (26.1 %) was found in the ethanolic extract.
Of all the compounds isolated in naswar samples, 23 are classified as hazardous and harmful to humans. The majority of the hazardous and toxic constituents were from carboxylic (cotinine, norcotinine, 1.3-Diethylurea) and polyaromatic group of compounds (benzoic acid, 2-ethylhexyl ester, Benzene, 4-ethyl-1.2-dimethyl-).
Urea, N, N-diethyl- was the major hazardous compound frequently reported in eight samples ranging from (1.64-9.78 %), the study divulged.
Of all the organic and heavy metal elements detected in naswar samples, five constituents are carcinogenic based on the International Agency for Research on Cancer (IARC) classification.
These include chromium, nickel, tungsten, antimony, and lead. As per IARC classification, nickel and chromium are classified as group 1 compounds that are carcinogenic in humans. Tungsten, antimony, and lead are in group 2A which are probably carcinogenic in humans.
In the current study, naswar samples also exhibit considerable compositional ingredients that are considered hazardous for human consumption. For example, nicotine, a well-known alkaloid in tobacco that is linked to addiction and health risks including cardiovascular diseases and cancer was the most common chemical constituent.
Another interesting finding of this study was the identification of ethylamphetamine carbamate in naswar samples. Ethylamphetamine carbamate is an amphetamine derivative and is classified as a drug with addiction and abuse potential. If ingested, it may induce hallucinations, cardiac arrhythmias, blurred vision, and a strong feeling of intoxication.
The presence of amphetamine in these naswar samples raises important questions. It could indicate adulteration of other plant products containing amphetamines with similar properties.
The present study identified several organic (85), metallic (12) and aflatoxins (4) constituents in naswar samples collected from all administrative regions of KP. Naswar also possess highly addictive potential due to alkaline pH (8.61 – 0.271) and high nicotine contents. The addictive potential coupled with the presence of carcinogenic compounds renders naswar a very dangerous product for human consumption. “Given that naswar is manufactured by the cottage industry in Pakistan, steps must be taken to look into regulating their manufacture and sale,” the study concludes.
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