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Tobacco use remains a significant public health concern globally, with over 8 million anticipated deaths annually by 2030, despite declining rates in some high-income nations. Smoking is prevalent worldwide, particularly in developing and middle-income countries, where over 80% of smokers reside. The inhalation of tobacco substances leads to various diseases, including cancer and respiratory ailments, resulting in more deaths than AIDS, tuberculosis, and other major causes combined. Secondhand smoke exposure also poses significant health risks. The economic burden of tobacco-related deaths and diseases is substantial, especially in low- and middle-income economies, where almost 80% of tobacco-related deaths occur. Lack of awareness, societal influence, and ineffective enforcement of anti-tobacco laws contribute to widespread tobacco use. Although antitobacco campaigns and policies have shown some success, challenges persist, particularly in rural areas where tobacco dependence is high. In India, despite declining tobacco use attributed to awareness campaigns and increased taxes on cigarettes, certain demographics, such as middle-aged individuals, illiterates, and rural residents, continue to have high tobacco consumption rates due to inadequate implementation of anti-tobacco norms and limited access to information. Quitting smoking can significantly extend life expectancy and reduce the risk of smoking-related diseases. However, nicotine addiction poses a challenge, with only a small percentage of users successfully quitting without assistance. Professional support and cessation drugs can double the likelihood of successful quitting, and nicotine replacement therapy has shown effectiveness. Overall, there is no safe level of cigarette use, emphasizing the importance of comprehensive tobacco control efforts to mitigate the global health and economic impacts of tobacco use. This review deals with the health risks associated with tobacco consumption in humans. [ABSTRACT FROM AUTHOR]

Context: Cannabis use has been the most commonly used illicit psychoactive substance in India. Increasing use of cannabis has been associated with an increased risk of co-morbid psychotic spectrum disorders with worse outcomes. This risk increases with increased use in a dose-dependent manner. A very complex association exists between cannabis use and mental illness hence it is essential to understand the relationship between the two to facilitate better care and management. Aim: The present study was conducted to assess the socio-demographic profile and psychiatric co-morbidities of cannabis users attending a tertiary mental health establishment in Goa. Materials and Methods: A retrospective case record study was carried out among self-reported cannabis users attending services at a tertiary mental health establishment from June 2021 to June 2022. Data regarding cannabis use, clinical profile, and socio-demographic profile of the individuals was obtained and analyzed using appropriate statistical tests. Results: One hundred and sixty-four cannabis users were evaluated which consisted of 140 males and 24 females, the mean age being 28 years with a standard deviation of 7.68. Ganja was the most commonly used form smoked as joints. The median age of initiation was 18 with females starting at a later age than males. Later initiation was associated with using lower quantities. Concurrent alcohol and nicotine use was present in 90% of the cases. The most commonly associated diagnosis was substance-induced psychosis. Conclusions: Cannabis use in individuals with mental illness is more common in males and an early age of initiation was linked to earlier age of onset of psychiatric illness. [ABSTRACT FROM AUTHOR]

The rapid proliferation of smokeless tobacco (SLT) in India has occurred without adequate information on the possible dangers and toxicity of these products. Tobacco flavors as well as nicotine (both protonated and un-protonated) are responsible for health dangers and addiction. The study aimed to offer information on the physical characteristics of commonly used smokeless tobacco products (including microscopic analysis), along with nicotine content (both total and un-protonated), pH, moisture, and flavors. The Standard Operating Procedures (SOPs) validated by the World Health Organization (WHO) recognized Tobacco Testing Laboratory TobLabNet) were applied for the analysis of various constituents of the SLTs. The microscopic analysis indicated that some of the SLT products like khaini were finely processed and available in filter pouches for users' convenience and prolonged use leading to prolonged retention and addiction potential. Nicotine absorption and availability (both protonated and un-protonated) are affected by moisture and pH. Essences provide a pleasant aroma and flavor, with an increased risk of misuse and other health problems. Few chewing tobacco and Zarda had the lowest levels of un-protonated nicotine (0.10–0.52% and 0.15–0.21%, respectively), whereas Gul, Gudhaku, and Khaini had the highest levels, ranging from 95.33 to 99.12%. Moisture and pH ranged from 4.54 to 50.19% and 5.25–10.07 respectively. Menthol (630.74–9681.42 µg/g) was the most popular flavour, followed by Eucalyptol (118.16–247.77 µg/g) and camphor (148.67 and 219.317 µg/g). SLT's health concerns and addiction dangers are exacerbated by the high proportion of bioavailable nicotine coupled with flavors. The findings of this study have important implications for the regulation and use of SLT in countries where use of SLT is prevalent. [ABSTRACT FROM AUTHOR]

Background: Smoking is a major predisposing factor for many health problems including cancers, vascular disorders, etc., To quit smoking is the only solution to prevent them. Various medicinal and non-medicinal methods are used worldwide for the same. The present study evaluates the effect of a nicotine free herbal formulation containing ingredients like Mucuna pruriens, Withania somnifera, Bacopa monnieri, etc., for cessation of smoking and its effects on other health parameters related to smoking. Materials and Methods: The present study was a placebo controlled, double blind, randomized, and multi-centric clinical study conducted at three clinical sites in India. After ethical approval and informed consent, all participants were given Smotect Tablets or Placebo tablets in a dose of 2 tablets twice daily for 90 days. A total of 103 participants (52 in trial group and 51 in placebo group) completed the study. Evaluation of cessation of smoking was done along with other parameters like measurement of lung capacity, clinical assessment, and laboratory investigations before and after the study. Results: A significant reduction in smoking as well as in the alveolar Carbon monoxide (p < 0.05) and Carboxyhemoglobin levels (p < 0.05) were observed with the use of Smotect tablets as compared to placebo over a period of 90 days. Significant improvement was also observed in quality of life, energy and stamina levels, and reduction of stress level. Smotect tablets were found to be safe without causing any adverse effects. Conclusion: Smotect Tablets is an effective and safe remedy for cessation of smoking and reducing other effects related to smoking. [ABSTRACT FROM AUTHOR]

Background': India is ranked second in the world in terms of tobacco use and tops the list of eight high-burden countries that account for two-thirds of the new tuberculosis (TB) cases globally. As tobacco smoking among TB patients is associated with unsuccessful TB treatment outcomes, effective smoking cessation interventions for TB patients is essential to combat this double pandemic. Aim: The study determined the effectiveness of nicotine replacement therapy (NRT) on smoking reduction and cessation among pulmonary TB patients. Settings and Design: The study included 300 pulmonary TB patients undergoing antitubercular treatment in government health care centers of Dakshina Kannada district in southern India. Materials and Methods: The participants in this two-armed, single-blinded, placebo-controlled, block-randomized trial were divided equally (n = 150) for experimental arm (brief advice + NRT) and control arm (brief advice + placebo). The total duration of treatment and follow-up was 6 months. Unadjusted relative risk (URR) and adjusted relative risk (ARR) were calculated for treatment outcomes at 95% confidence interval (CI). Generalized linear regression analysis was performed upon variables with P value less than 0.2. Results: After 6 months of intervention including follow up, there was a significant reduction in self-reported smoking (ARR = 1.08, 95% CI 1.01-1.17, P = 0.03) in the experimental arm compared with the control arm. Biochemically verified smoking abstinence was not significantly different between the two arms (ARR = 1.01, 95% CI 0.72-1.38, P = 0.97). Conclusion: The study showed statistically significant effectiveness of NRT for self-reported smoking reduction. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the prevalence of substance use disorder (SUD) and its association with the course and outcome of bipolar disorder (BD). Materials and Methods: A total of 773 patients with BD were recruited from 14 centers in different parts of India, and they were evaluated for the prevalence of comorbid substance dependence, course and outcome, subjective cognitive functioning, and disability. Results: About one-fourth (22.9%) of the participants had one or more substance dependence. In terms of specific substance of abuse, 136 (17.6%) had nicotine dependence, 80 (10.3%) patients had alcohol dependence, 13 (1.7%) had cannabis dependence, and nine (1.2%) had opioid dependence. Compared to those without comorbid substance dependence, those with a dual diagnosis (i.e., using at least one substance in a dependent pattern) were less educated, more often males, more often currently single, more often employed, had a lower number of depressive episodes per year of illness, had a higher number of manic and mixed episodes per year of illness in the first 5 years of illness, had a higher level of disability, and more often had a history of hospitalization and a history of receiving electroconvulsive therapy (ECT); also, a higher proportion of them had manic predominant polarity, more often had recurrent mania course, and were more often receiving a combination of lithium and valproate. Conclusion: About one-fourth of BD patients have comorbid SUDs, and presence of SUD has a negative impact on the course and outcome of BD. [ABSTRACT FROM AUTHOR]

Background: The cumulative effect of cigarette smoking is usually measured by "pack years," but the same is not present for Bidis. This study was conducted to calculate the concept of "bidi years" in comparison to the concept of "pack-years" for a cigarette. Methods: Thirty random samples, each of bidis and cigarettes, were selected through a survey of common brands used by smokers in India. The nicotine and carbon monoxide (CO) contents were analyzed by high-pressure liquid chromatography and gas chromatography methods, respectively. Results: The average nicotine content in thirty samples of different Bidis and Cigarettes was 214.46 ± 57.8 and 616.31 ± 22.6 mg/dL, respectively (P < 0.001). The CO content with a lower mean of 15.57 ± 5.88 was observed in cigarettes as compared to 70.4 ± 22.08 in bidies (P < 0.001). The weight of one cigarette is 0.56 times that of the weight of one bidi. Based on the nicotine content, the equivalent pack years for bidis is calculated as 43 bidis per day per year. Conclusion: Based on the nicotine content, it is proposed that the equivalent for one cigarette pack-year or 20 cigarette years are taken as 43 bidis per day per year. Even though each bidi stick has an average of 0.46 times the nicotine content of cigarettes, longer abstinence as compared to cigarette is required to bring the nicotine level to normal due to the deeper puffs needed. With the CO content of bidis being 4.5 times that of cigarettes, it is advised that the minimum duration of cessation of smoking before operative procedures be 24 h as compared to 6 h for cigarettes. [ABSTRACT FROM AUTHOR]

India is the second largest tobacco consumer and the third largest tobacco producer in the world. The current trends of tobacco use in India includes 1 million deaths per year, and the problem is worsening, and also, tobacco use will cause 13% of deaths in India by 2022. To control this number, it is an alarming situation to work on the main etiology. Smoking cessation programs are considered very useful in helping tobacco users to quit, as it is a very difficult addiction to break and effective approaches are required. So, authors reported a case of 61-year-old male patient who was a chronic smoker and used to smoke 20–25 cigarettes per day. He started noticing the ill effects of tobacco in the body, so he finally decided to seek help from doctor. His habit reduced to half in few days, and finally he completely quitted smoking with the help of behavioral therapy and pharmacotherapy. [ABSTRACT FROM AUTHOR]

Background: Schizophrenia is a major psychiatric disorder with diverse clinical presentations and comorbidities. Comorbid nicotine use worsens the clinical symptomatology, predisposes the individuals to other chronic illnesses, and is associated with poorer outcomes in schizophrenia. It is thus clinically essential to assess the presence of tobacco use, the severity of nicotine dependence, and its correlation with psychopathology in patients with schizophrenia. Aims and Objectives: (i) To describe the pattern of tobacco use and severity of nicotine dependence in schizophrenia patients. (ii) To compare the socio-demographic variables and symptom severity of schizophrenia between tobacco users and non-users. (iii) To determine the correlation between the severity of nicotine dependence and clinical and nicotine related variables in patients of schizophrenia. Materials and Methods: It was a cross-sectional observational study conducted in a tertiary care level psychiatric hospital in the northeast of India. The study included 100 male schizophrenia patients. Fagerstrom Test for Nicotine Dependence (FTND) and FTND - Smokeless Tobacco, and the Positive and Negative Syndrome Scale five-factor model was used for assessment of the severity of nicotine dependence and symptoms of Schizophrenia, respectively. Results: 70% of the study sample used some form of tobacco. The severity of nicotine dependence was significantly higher in patients using both forms of tobacco. Tobacco use was significantly associated with lower educational status, employment status, and positive symptoms of Schizophrenia. Finally, the severity of nicotine dependence was significantly correlated with the severity of positive and emotional symptoms of schizophrenia. Conclusion: Higher positive and emotional symptoms of schizophrenia predicted severity of nicotine use. Study needs to be replicated in larger population of patients suffering from schizophrenia. [ABSTRACT FROM AUTHOR]

Introduction: Tobacco consumption is one of the most leading causes of preventable deaths around the world. According to the World Health Organisation (WHO), eight million deaths occur annually due to tobacco usage. Aim: To identify the prevalence of oral lesions among people who use tobacco, their knowledge on health hazards of tobacco uses and the dependence on nicotine among adults in the age group between 18 and 60 years. Materials and Methods: A community-based, cross-sectional study was conducted in Department of Community Medicine, Christian Medical College, Vellore, Tamil Nadu, India, among an urban community of Vellore, January 2019 and June 2019. This study included 930 participants. An interviewer administrated questionnaire was used to assess the prevalence of tobacco and dependence on nicotine among adults. The participants who use tobacco were examined for oral lesions. Univariate analysis was performed to highlight the variables of this study and logistic regression model was used to find the adjusted odds ratios and p-values. Results: The total number of adults who participated in this study was 930. The median age group among the study population was 38 years and the mean age was 38.26±12 years. About two-third (62.2%) of the participants were females. The proportion of adults currently using tobacco in any form was 24.19% (n=225) with those Smoking Tobacco (ST) was 59.1% (n=133), Smokeless Tobacco (SLT) was 38.6% (n=87) and using both ST and SLT were 2.2% (n=5). The prevalence of oral mucosal lesions was found to be 60.1% with smoker's palate (N=96) being the most frequently occurring oral mucosal lesion. The nicotine dependence was found to be significant in the subjects with age more than 45 years and had used tobacco for more than 20 years. On the analysis of the knowledge on health hazards, it was identified that 76.3% of the participants were aware that use of tobacco in any form can cause oral lesions. Conclusion: This study highlights that oral lesions and nicotine dependence are highly prevalent among the tobacco users. This emphasises the need for community-based oral health awareness programs highlighting the consequences of tobacco usage in order to prevent the incidence of oral cancers. [ABSTRACT FROM AUTHOR]

Objective. To assess the knowledge, practice, attitude, and preparedness of dental professionals in prescribing nicotine replacement therapy (NRT). Methodology. A prevalidated voluntary web-based questionnaire was generated as a link through Google Drive and was sent to 117 dental professionals in North India using Whatsapp, Messenger, and Instagram social media platforms. A total of 94 responses were received and out of which 76 responses were analyzed (18 forms were excluded due to incomplete or duplicate responses). Frequency analysis was done using SPSS software version 21. Result. The participation rate was found to be 80.3%. More than half of the study population were familiar with the term NRT (77.6%) and its uses (67.1%), but approximately less than half of the total study subjects knew the duration (32.9%), cost (27.6%), dosage (25%), and contraindications (36.8%) of the NRT. Approximately 56.6% of the study participants showed a positive attitude towards helping patients to quit smoking through tobacco cessation counseling. Nearly one-fourth of the study population, i.e., 27.6%, were confident in explaining the negative impacts of tobacco, while 22.4% knew about the tobacco cessation protocol. Among the participants, only 27.6% reported that they practice NRT and out of which approximately less than 20% of the study participants were prescribing correct dose of NRT. Conclusion. Though study subjects had an ample knowledge regarding NRT use in tobacco cessation, it does not reflect their current attitude and preparedness. Thus, there is a need for continuing education to further train dental professionals for prescribing NRT. [ABSTRACT FROM AUTHOR]

Background: The present study aims to estimate the prevalence and correlates of multimorbidity among women aged 15–49 years in India. Additionally, the population attributable risk for multi-morbidity in reference to those women who smoke tobacco, chew tobacco, and consume alcohol is estimated. Methods: The data was derived from the National Family Health Survey which was conducted in 2015–16. The effective sample size for the present paper 699,686 women aged 15–49 years in India. Descriptive statistics along with bivariate analysis were used to do the preliminary analysis. Additionally, binary logistic regression analysis was used to fulfil the objectives. Results: About 1.6% of women had multimorbidity in India. The prevalence of multimorbidity was high among women from southern region of India. Women who smoke tobacco, chew tobacco and consume alcohol had 87% [AOR: 1.87CI: 1.65, 2.10], 18% [AOR: 1.18; CI: 1.10, 1.26] and 18% [AOR: 1.18; CI: 1.04, 1.33] significantly higher likelihood to suffer from multi-morbidity than their counterparts respectively. Population Attributable Risk for women who smoke tobacco was 1.2% (p<0.001), chew tobacco was 0.2% (p<0.001) and it was 0.2% (p<0.001) among women who consumed alcohol. Conclusion: The findings indicate the important role of lifestyle and behavioural factors such as smoking and chewing tobacco and consuming alcohol in the prevalence of multimorbidity among adult Indian women. The subgroups identified as at increased risk in the present study can be targeted while making policies and health decisions and appropriate comorbidity management can be implemented. [ABSTRACT FROM AUTHOR]

Biomarkers of exposure to harmful tobacco constituents are key tools for identifying individuals at risk and developing interventions and tobacco control measures. However, tobacco biomarker studies are scarce in many parts of the world with high prevalence of tobacco use. Our goal was to establish a robust method for simultaneous analysis of urinary total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), N′-nitrosonornicotine (NNN), and cotinine at the Advanced Centre for Treatment, Research and Education in Cancer (ACTREC) in Mumbai, India. These biomarkers are validated measures of exposure to the carcinogenic tobacco nitrosamines 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and NNN and the addictive alkaloid nicotine, respectively. The established method is characterized by excellent accuracy, linearity, and precision, and was successfully applied to the analysis of 15 smokeless tobacco (SLT) users and 15 non-users of tobacco recruited in Mumbai. This is the first report of establishment of such procedure in a laboratory in India, which offers the first in-country capacity for research on tobacco carcinogenesis in Indian SLT users. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the current study was to compare urinary cotinine levels, nicotine dependence and physical effects related to smoking in smokers before and after laser auricular acupuncture, psychological counselling and a combination of laser treatment with counselling. Methods: This study was carried out from February to July 2019 in India. A total of 60 smokers were randomly allocated to three interventional groups. Urinary cotinine levels, nicotine dependence and physical effects due to smoking were evaluated using NicAlert strips (Nymox Pharmaceutical Corp., Quebec, Canada) the Fagerström questionnaire and a visual analogue scale, respectively, at baseline and one month post-intervention. Pearson’s chi-square, Kruskal Wallis analysis of variance and Wilcoxon sign rank tests were used for statistical analyses. Results: There was a significant reduction in urinary cotinine levels and nicotine dependence and significant improvement in behaviour and physical effects related to smoking in all groups post-intervention (P <0.05). Reduction in nicotine dependence was significantly higher in the laser group (4.4 ± 1.66) compared to other groups (P <0.01). Reduction in urinary cotinine levels was highest in the laser with counselling group (0.85 ± 0.3) compared to the other groups. There was a significant reduction in irritability, headache, craving for smoking, tiredness and anxiety as well as a substantial increase in calmness, unpleasant taste of smoking, the ability to concentrate and appetite in the laser auricular acupuncture group compared to the other groups (P <0.01) Conclusion: Laser auricular acupuncture alone and in combination with psychological counselling can reduce nicotine dependence among smokers. [ABSTRACT FROM AUTHOR]

Context: Tobacco smoking is one of the preventable causes of death. Global Adult Tobacco Survey 2 report showed that 19% Indian males were current smokers. It is important to find out factors which help smokers on smoking cessation, ultimately to prevent of lung and other morbidities. There are few community-based studies on intention and attempt to quit smoking in rural area. Aims: The present study aimed to determine the factors associated with intention and attempt to quit smoking among current smokers. Settings and Design: A cross-sectional study was conducted from June to September 2019 among 198 male daily smokers residing in the rural field practice area of AllH and PH, Kolkata. Subjects and Methods: After cluster sampling, data were collected by predesigned schedule by the face-to-face interview. Results: 151 (76.3%) study subjects intended to quit smoking. 63 (31.8%) study subjects attempted to quit in last 1 year. Thirty-one (47.5%) showed high-to-medium nicotine dependence. There was a significant association of intention to quit with agriculture as occupation (acquisitive crime [AOR]-2.17, confidence interval [CI]-1.01--4.63), low nicotine dependence (AOR-2.98, CI-1.43--6.21), doctor's advice (AOR = 2.84, CI-1.27--6.33), and family pressure (AOR = 2.16, CI-1.07--4.38). Attempt to quit was significantly associated with low nicotine dependence (AOR = 5.85, CI-2.85--12.00), family pressure (AOR = 2.94, CI-1.47--5.91). Conclusion: Along with counseling to reduce nicotine dependence, comprehensive approach both from family members as well as health care providers, is vital to escalate the quitting behaviour in smoking habit. [ABSTRACT FROM AUTHOR]

While the marketing and sale of electronic cigarettes (e-cigarettes) in India is forbidden since September, 2019, vaping represents a significant risk to the health and safety of Indian adolescents. Though the prevalence of youth e-cigarette use in India remains unknown, pediatricians are often brought to provide care to youth who vape. In this commentary, background information on e-cigarettes including a review of the different types of vaping devices and of the substances contained in e-cigarette liquids is provided. The short- and long-term health risks associated with vaping, including risks for the developing brain, acute lung injuries and long-term mental health effects, and a practical approach for clinical management of e-cigarette use for Indian pediatricians is presented. Public health measures to prevent and reduce youth vaping and a review of current Indian laws and policies around e-cigarette use are also mentioned. [ABSTRACT FROM AUTHOR]

Background: India accounts for about a quarter of the global TB burden. Worldwide India is the country with the highest burden of both TB and MDR TB. Smoking and alcohol use results in sub-optimal response to anti tuberculosis treatment as well as poor prognosis Alcoholism and Nicotine abuse contribute significantly to the development and treatment course of tuberculosis in patients. Aim of the Study: To assess the Prevalence of Nicotine and Alcohol Addiction among Tuberculosis Patients and to monitor the effect of Brief Counselling Sessions for the De-addiction of Alcohol and Nicotine in the management of Tuberculosis Patients. Material & Methods: We had taken the tuberculosis patients coming to the OPD of Medicine and Respiratory Medicine Departments of DrRMLIMS, Lucknow. We used questionnaires for assessing the Nicotine Dependence and Alcohol dependence among the tuberculosis patients (Fagerstrom Tolerance Questionnaire), The Alcohol use disorders Identification Test (AUDIT). Results: Prevalence of Addiction among tuberculosis patient-54 cases out of 447 total cases (April to October). In our study, we found addiction in 45 males and 9 females, Smoking addiction was seen in 13 tuberculosis patients, alcohol addiction was found in 17 tuberculosis patients, and both smoking and alcohol addiction was seen in 24 patients. Conclusion: Nicotine and Alcohol Addiction problem in Tuberculosis patients should be effectively assessed through the nicotine addiction and AUDIT scales and Brief Cognitive Therapy should be introduced along with regular ATT for effective management of such patients. [ABSTRACT FROM AUTHOR]

Bangladesh exhibits the second highest rate of smokeless tobacco (SLT) product usage in the world, and this has been associated with the high upper aerodigestive tract cancer incidence in this country. The goal of the present study was to examine the levels of the highly carcinogenic tobacco-specific nitrosamines (TSNAs) in Bangladeshi SLT products and compare these levels to that observed in SLT brands from southeast Asia and the USA. The levels of TSNAs and nicotine were determined by LC-MS/MS in twenty-eight SLT brands and several tobacco additives from Bangladesh, as well as several SLT brands from India, Pakistan and the USA. The levels of N-nitrosonornicotine (NNN), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), N-nitrosoanatabine (NAT) and N-nitrosoanabasine (NAB) in Bangladeshi SLT brands ranged from 1.1–59, 0.15–34, 0.79–45, and 0.037–13 μg/g SLT powder, respectively. The mean levels of the highly carcinogenic TSNAs (NNN+NNK) were 7.4-, 2.4-, and 63-fold higher in Bangladeshi SLT products as compared to SLT brands from the USA, India and Pakistan, respectively; these trends were also observed for NAT and NAB. Similar mean levels of nicotine were observed in the Bangladeshi brands (31 mg/g powder) versus brands from the USA (25 mg/g powder) and India (20 mg/g powder); they were 3-fold higher than brands from Pakistan (10 mg/g powder). Gul SLT brands exhibited the highest pH and the highest levels of unprotonated nicotine. The high levels of TSNAs in Bangladeshi SLT brands may be an important factor contributing to the high rates of upper aerodigestive tract cancer in Bangladesh. [ABSTRACT FROM AUTHOR]

Background: Tobacco smoking is one of the biggest and avoidable public health threats in the world, especially in low- and middle-income countries. India represents a highly complex public health environment due to the large number of smokers and complexities arising from tobacco use in different forms, including a variety of smokeless tobacco (SLT) products. Electronic cigarettes, an alternative nicotine delivery system with significantly less harmful emissions than smoke, could be an option for those who are unable to achieve smoking abstinence using other available means. This study, which we believe is the first of this kind in India, was conducted to obtain data on the characteristics and tobacco use profile of e-cigarette users (vapers) in India. Methods: An interview-based survey was performed in the 8 largest metropolitan cities in India using a convenience sampling approach involving a total of 3000 subjects. Inclusion criteria were being a current e-cigarette user and aged 18 years or more. Interviewers were asked to continue recruitment until a total sample of 375 was reached in each target city. Results: A total of 3000 vapers (81.4% males and 18.6% females, median age 29 years) participated to the study. The majority (80%) were first exposed to nicotine via tobacco smoking, SLT use, or both. Most of the subjects (79%) believed that e-cigarettes were less harmful than smoking. The vast majority of smokers (71.3%) reported smoking cessation (30.0%) or reduction in consumption (41.3%) with the help of e-cigarettes. Similar changes were observed in SLT users. Participants reported minimal side effects and some health benefits after e-cigarette use initiation. Conclusion: Indian vapers who participated to this study were predominantly smokers and SLT users before e-cigarette use initiation, with the majority subsequently quitting or reducing tobacco use. Minimal side effects of e-cigarette were experienced, while some health benefits were also reported. [ABSTRACT FROM AUTHOR]

Background: Women constitute a significant labor pool in the Indian tobacco industry as bidi (hand-rolled cigarette) rollers. On an average, they roll around 600 bidis/day and are exposed to 120 g of tobacco and 3 g of nicotine. Bidis do not have chemical preservatives or stabilizing agents, and therefore, the rollers are exposed only to nicotine by handling and inhalation. The study objective was to assess pregnancy outcome in these women with occupational tobacco exposure. Materials and Methods: A prospective cohort study of bidi-rollers (n = 177) and women with no tobacco exposure (n = 354), followed up for pregnancy outcome, neonatal anthropometry, and nicotine absorption by cotinine assays. Adjusted risk and adjusted mean differences with a 95% confidence interval were derived. Results: Outcomes included increased adjusted risk for gestational hypertension (3.54 [1.21, 10.31]; P = 0.021) and fetal growth restriction (2.71 [1.39, 5.29]; P = 0.004). Risk for prematurity was not statistically significant (1.81 [0.74, 4.45]; P = 0.194). Lower adjusted mean difference of birth weight (-104 g [-177, -31]; P = 0.005), length (-0.4 cm [-0.8, -0.1]; P = 0.006), and head circumference (-0.4 cm [-0.6, -0.1]; P = 0.002) were seen with increased risk for small for gestational age (1.75 [1.12, 2.73]; P = 0.015). Nicotine absorption was evident in one-third of maternal and cord blood estimations. Conclusion: Occupational passive tobacco exposure results in adverse pregnancy outcome. [ABSTRACT FROM AUTHOR]

Climate change and geography affect all the living organisms. To date, the effects of climate and geographical factors on plant metabolome largely remain open for worldwide and local investigations. In this study, we designed field experiments with tobacco (Nicotiana tabacum) in India versus USA and used untargeted metabolomics to understand the association of two weather factors and two different continental locations with respect to tobacco metabolism. Field research stations in Oxford, North Carolina, USA, and Rajahmundry, Andhra Pradesh India were selected to grow a commercial tobacco genotype (K326) for 2 years. Plant growth, field management, and leaf curing followed protocols standardized for tobacco cultivation. Gas chromatography–mass spectrometry based unbiased profiling annotated 171 non-polar and 225 polar metabolites from cured tobacco leaves. Principal component analysis (PCA) and hierarchical cluster analysis (HCA) showed that two growing years and two field locations played primary and secondary roles affecting metabolite profiles, respectively. PCA and Pearson analysis, which used nicotine, 11 other groups of metabolites, two locations, temperatures, and precipitation, revealed that in North Carolina, temperature changes were positively associated with the profiles of sesquiterpenes, diterpenes, and triterpenes, but negatively associated with the profiles of nicotine, organic acids of tricarboxylic acid, and sugars; in addition, precipitation was positively associated with the profiles of triterpenes. In India, temperature was positively associated with the profiles of benzenes and polycyclic aromatic hydrocarbons, but negatively associated with the profiles of amino acids and sugar. Further comparative analysis revealed that nicotine levels were affected by weather conditions, nevertheless, its trend in leaves was independent of two geographical locations and weather changes. All these findings suggested that climate and geographical variation significantly differentiated the tobacco metabolism. [ABSTRACT FROM AUTHOR]

Context: Tobacco will cause one billion deaths in the 21st century. The use of tobacco causes dependence both psychological and physical. Aims: To find out the level of nicotine dependence and it correlates among adolescents. Settings and Design: A community-based, cross-sectional, observational study was conducted in the Burdwan town, West Bengal, among 1354 adolescent tobacco users. Materials and Methods: Data were collected by direct interview using a pretested, predesigned, semistructured schedule containing the Fagerström Test for Nicotine Dependence (FTND) questionnaire. Statistical Analysis: Pearson's Chi-square test, Student's unpaired t-test, one-way analysis of variance, Pearson's product-moment correlation coefficient, and multivariable linear regression were used. All the statistical analyses were performed using SPSS version 19.0. Results: The mean FTND score was significantly higher among adolescents aged >15 years, males, Hindu, tobacco users from joint family, who belonged to lower socioeconomic status, who started using tobacco at the age of 10-12 years, using tobacco for ≥5 years, who were not married, were illiterate, working, and not aware of the injurious effect of tobacco to health. Conclusions: A suitable individualized approach should be used for those who want to quit tobacco depending on their FTND score. [ABSTRACT FROM AUTHOR]

Background: Tobacco is the significant cause of preventable death worldwide. The prevalence of smoking in India is 13.3%. Among the chemical constituents in the cigarette, nicotine is the one most often associated with dependence resulting in increased consumption of them. Studies have proven the dose-dependent relationship of cigarette smoking with lung and oropharyngeal cancer. Hence, assessment of nicotine dependence among the smokers is essential as it influences the tailor-made intervention. Objectives: The objectives of this study were to assess the nicotine dependence and exhaled carbon monoxide (CO) levels among the smokers in Bengaluru. Materials and Methods: A cross-sectional survey was conducted among 396 smokers selected using probability proportional to size sampling technique. Fagerstrom Test for Nicotine Dependence was used to assess the levels of nicotine dependence. Exhaled CO levels were measured using the Smokerlyzer to indicate the nicotine dependence. Results: About 23.7% of the participants had the very low dependence on nicotine. Nearly 26% and 22.5% of the participants had the high and very high dependence on nicotine correspondingly. The number of years of smoking was found as a significant risk indicator for nicotine dependence. Exhaled CO levels were significantly correlated with the nicotine dependence (P = 0.000) indicating it as a marker for nicotine dependence. Conclusion: The high nicotine dependence among the participants warrants effective public health policies to prevent tobacco-related diseases. Considering the risk indicator, the number of years of smoking, smoking cessation programs should target the participants with the habit of continuous smoking with tailor-made interventions to prevent the relapse among them. [ABSTRACT FROM AUTHOR]

Context: Abuse of tobacco, such as drug and alcohol abuse, is a worldwide public health problem. Once a person is addicted to nicotine, quitting smoking is difficult. A measure of the addictive potential of tobacco products is the amount of nicotine available from them. The present study is an attempt to assess the nicotine content of tobacco products available in Bhopal.Aims: This study aims to assess the nicotine content of some popular brands of smoked (cigarettes and bidis) and chewed forms (pan masalas containing tobacco) of tobacco available in Bhopal.Settings and Design: This was an in vitro cross-sectional study.Subjects and Methods: Six brands of cigarettes (filtered), six brands of bidis, and six brands of chewed tobacco (pan masalas) were used for the study. The methodology published by Association of Official Analytical Chemists was followed, and reagents conforming to American Chemical Society specifications were used.Statistical Analysis Used: One-way ANOVA, Bonferroni post hoc test.Results: The mean nicotine levels for cigarettes, bidis, and chewed tobacco were 7.84 ± 5.10, 16.86 ± 5.66, and 16.30 ± 3.33, respectively. The differences in the mean scores were compared using one-way ANOVA and were found to be statistically significant with F = 6.636 and P = 0.009. Bonferroni post hoc test assessed the difference in mean nicotine content among the groups indicating that the difference between cigarettes versus bidis and cigarette versus chewed tobacco was significant with P = 0.016 and 0.024, respectively.Conclusions: Bidis had the highest content of nicotine, followed by chewed tobacco (pan masalas) and cigarettes. [ABSTRACT FROM AUTHOR]

Introduction: Acute coronary syndrome (ACS) caused by coronary atherosclerosis include ST-segment elevation myocardial infarction (STEMI), non-STEMI, and unstable angina. The relation between psychiatric disorders and coronary artery disease is a complex one which includes the effect of the psychosocial factors on heart and vice versa. Point prevalence studies have been reported, but there is paucity of follow-up studies from India. Materials and Methods: The study is a follow-up evaluation at discharge of 248 consecutive patients presented with ACS at JSS Hospital, Mysuru, Karnataka, over a period of 6 months to assess the psychiatric comorbidities. The patients were assessed on a structured and validated pro forma before discharge, at 3 months, and at 6 months. Screening of psychiatric disorders was done using Mini International Neuropsychiatric Interview PLUS 5.0.0 and assessment of depression was done using Hamilton Depression Rating Scale. ANOVA, Student's t-test, and SPSS 21 were used for statistical analysis. Results: The most common psychiatric comorbidities include major depressive disorder (44%), it persisted at the end of 3 (P < 0.001) and 6 (P < 0.001) months. A spectrum of anxiety disorders including panic disorder (12.10%), dysthymia (3.60%), agoraphobia (2.40%), social phobia (2%), obsessive-compulsive disorder (1.6%), specific phobia (1.2%), and posttraumatic stress disorder (0.8%) in descending order at the end of 6 months were found. Significant reduction in substance use of nicotine (66.1%) and alcohol (56.0%) was reported on follow-up. Conclusion: Depression, anxiety, and substance use occur in patients with ACS which persist on follow-up. Early recognition at discharge and appropriate counseling on follow-up improve the clinical outcomes. [ABSTRACT FROM AUTHOR]

Objectives: A variety of smoked and smokeless tobacco products with varying nicotine content are accessible in India. Nicotine quantity in tobacco products has direct bearing on tobacco dependence. Our objective was to estimate nicotine content in various types of smoked and smokeless products. Disclosure for essential health warning was also checked. Materials and Methods: Liquid-liquid extraction was used for nicotine extraction and high-performance thin layer chromatography technique was applied for quantification of nicotine in seventy-one smoked and smokeless tobacco products. Results: Significant variation in nicotine content was observed across products. In smoked tobacco, nicotine content varied from 1.01 to 13.0 mg/rod, while in smokeless tobacco products it ranged from 0.8 mg/g to 50.0 mg/g. Moisture content varied from 9% to 21%. Conclusion: This work lists a range of smoked and smokeless tobacco products available in this region. We report a wide variability in nicotine quantity across smoked and smokeless tobacco products. Such variation in nicotine content may have important implications for tobacco cessation interventions and policies [ABSTRACT FROM AUTHOR]

Aim: To compare air nicotine levels in public places in Ahmedabad, India, before (June 2008) and after (January, 2010) the implementation of a comprehensive smoking ban which was introduced in October 2008. Materials and Methods: Air nicotine concentrations were measured by sampling of vapor-phase nicotine using passive monitors. In 2008 (baseline), monitors were placed for 5-7 working days in 5 hospitals, 10 restaurants, 5 schools, 5 government buildings, and 10 entertainment venues, of which 6 were hookah bars. In 2010 (follow-up), monitors were placed in 35 similar venues for the same duration. Results: Comparison of the overall median nicotine concentration at baseline (2008) (0.06 μg/m3 Interquartile range (IQR): 0.02-0.22) to that of follow-up (2010) (0.03 μg/m3 IQR: 0.00-0.13), reflects a significant decline (% decline = 39.7, P = 0.012) in exposure to second-hand smoke (SHS). The percent change in exposure varied by venue-type. The most significant decrease occurred in hospitals, from 0.04 μg/m3 at baseline to concentrations under the limit of detection at follow-up (%decline = 100, P < 0.001). In entertainment venues, government offices, and restaurants, decreases in SHS exposure also appeared evident. However, in hookah bars, air nicotine levels appeared to increase (P = 0.160). Conclusion: Overall, SHS exposure was significantly reduced in public places after the smoke-free legislation came into force. However, nicotine concentrations were still detected in most of the venues indicating imperfect compliance with the comprehensive ban. [ABSTRACT FROM AUTHOR]

Background: Visual disturbances caused by smoking have been studied extensively though the pathogenesis is poorly understood. The significance to diagnose visual field disturbances because of smoking is that prognosis for return of vision is always good if the consumption of tobacco is restrained timely. Aims & Objective: To study visual field in healthy smokers. Materials and Methods: In this study, subjects from the outpatient clinic were selected randomly: 30 healthy smokers and 30 nonsmokers. These subjects were divided into two groups: test (smokers) and control (nonsmokers). Ocular examination of all the subjects was done including intraocular pressure measurement and fundus examination. Further, visual field analysis was carried out using an automated perimeter (M700; Medmont International). Then, interpretation of visual field was done along with assessment of visual field defects. Values obtained were analyzed using Z-test and unpaired Student's t-test. p-Value less than 0.05 was considered to be statistically significant. Results: Average deviation (AD) and patterned deviation (PD) were found to be significantly high in smokers as compared to nonsmokers (p < 0.001). It was also observed that AD and PD were significantly high if the smoking load (average number of cigarettes multiplied by average duration of smoking) is more than 50,000 (p < 0.005 and p < 0.02, respectively). In smokers, retinal sensitivity was found to decrease and the presence of localized scotomas was observed, but the central vision was found to be preserved. Conclusion: This study is important in diagnosing visual field defects in tobacco amblyopia to stop nicotine toxicity in time with early intervention, thereby preventing further damage to the optic nerve. [ABSTRACT FROM AUTHOR]

Background: Use of tobacco among alcohol dependent population is quite frequent. This co-morbidity increases the risk for various diseases. Understanding the pattern of tobacco use with co-morbid alcohol use may help in planning appropriate prevention/treatment strategies. The study aimed at examining the profile and pattern of nicotine use among alcohol dependent patients visiting a tertiary care treatment center in North India. Materials and Methods: Male patients fulfilling diagnostics and statistical manual of mental disorder fourth edition, criteria for nicotine and alcohol diagnostics and statistical dependence, attending the out-patient department of the tertiary care treatment center were recruited after obtaining informed consent. The socio-demographic profile, drug use history, nicotine associated health problems and general health problem were recorded. Motivation to stop tobacco use was assessed qualitatively using the direct questions about their interest and intentions to quit. Results: A total of 150 subjects were included in the study. The mean age of the study sample was 37.6 ± 10.44 years. Tobacco was reported as the gateway drug in 90% of the cases. Exclusive bidi use reported in 42% of the subjects. Mean duration of bidi and co-morbid alcohol use was higher than cigarette or smokeless tobacco use. Self-reported health problems associated with nicotine use and general health was reported by 41% and 39% of the subjects. Unsuccessful past quit attempts was present in 85% cases. More than 90% of subjects remained interested in quitting the tobacco use. An increased liver enzyme (aspartate transaminase, alanine transaminase and gamma-glutamyl transferase) were observed in 43, 32 and 47% of the cases. Conclusion: The results suggest the nicotine and alcohol dependent patients represent a separate population requiring higher attention from the treating physician. [ABSTRACT FROM AUTHOR]

Background: Tobacco smoking in any form (cigarette, bidi etc.) has long been established as a risk factor for CAD (coronary artery disease) but a very little research has been done on tobacco chewing, which is restricted to South Asia (India, Pakistan, Nepal, Bangladesh, Sri Lanka) whether it increases risk for cardiovascular morbidity or not. Aims & Objective: To assess the cardiovascular risks in tobacco chewers as compared to normal population of Aligarh a city of Western Uttar Pradesh. Materials and Methods: The study was conducted in Department of Physiology, Department of TB Chest and Department of Medicine JNMCH, AMU Aligarh. The study consisted of 30 tobacco chewers (in any form) and 30 subjects without any history of tobacco consumption in any form. The age group varied from 20-60years. Anthropometric measurement age, weight, height, BMI, Pulse, SBP (systolic BP), DBP (Diastolic BP) and Lipid Profile estimation from blood sample. Results: Anthropometric measurements did not show any significant change when compared in two groups (p > 0.05). Cardiovascular Parameters like, Systolic pressure (117.46 ± 11.07); diastolic pressure (83.37 ± 8.74); mean arterial pressures (93.40 ± 6.33) and pulse rate (84.29 ± 5.70), were significantly increased in chewers as compared to normal population (p < 0.05). Lipid Profile Parameters like, Total cholesterol (237.04 ± 82.6); HDL (45.54 ± 5.46); LDL (161.16 ± 76.7) were increased in chewers as compared to control (p < 0.05). Atherogenic index T Choles./HDL (5.22 ± 1.90); LDL/HDL (3.57±1.35); Non-HDL/HDL (4.3 ± 1.0), were also showed a significant increase (p < 0.05). Conclusion: All these findings are suggestive that tobacco chewers are at increased risk of cardiovascular diseases as compared to non-tobacco consuming population. [ABSTRACT FROM AUTHOR]

India is the second largest producer and third largest consumer of tobacco. According to GATS India Report (2009-10), the users of only smokeless tobacco (SLT) are more than double than that of smokers. SLT use is an imminent public health problem, which is contributing to high disease burden in India. It is a "unique" tobacco product due to its availability in myriad varieties, easy access, and affordability especially for adolescents. It has been studied to be a gateway product and facilitates initiation. Currently, the Food Safety and Standards Authority of India (FSSAI) have prohibited the use of tobacco and nicotine in any food products; yet, the implementation of a permanent ban on SLT across India is still pending. This paper examines how multiple legislations have failed to effectively control or regulate SLT in India and regionally; thus, there is need to strengthen SLT control efforts as "no ordinary product." [ABSTRACT FROM AUTHOR]

Smoking is a prevalent behaviour in the population. The aim of this review is to bring to light the effects of smoking on dental implants. These facts will assist dental professionals when implants are planned in tobacco users. A search of "PubMed" was made with the key words "dental implant," "nicotine," "smoking," "tobacco," and "osseointegration." Also, publications on tobacco control by the Government of India were considered. For review, only those articles published from 1988 onward in English language were selected. Smoking has its influence on general as well as oral health of an individual. Tobacco negatively affects the outcome of almost all therapeutic procedures performed in the oral cavity. The failure rate of implant osseointegration is considerably higher among smokers, and maintenance of oral hygiene around the implants and the risk of peri-implantitis are adversely affected by smoking. To increase implant survival in smokers, various protocols have been recommended. Although osseointegrated dental implants have become the state of the art for tooth replacement, they are not without limitations or complications. In this litigious era, it is extremely important that the practitioner clearly understands and is able and willing to convey the spectrum of possible complications and their frequency to the patients. [ABSTRACT FROM AUTHOR]

Background: Data on prevalence, pattern of tobacco use, proportion of population dependent on nicotine and their determinants are important for developing and implementing tobacco control strategies. The aim of the study was to estimate the prevalence and determinants of tobacco use and nicotine dependency. Methods: A cross-sectional survey among a representative sample of 18,018 individuals in the age group of >=14 years was conducted in the Union Territory of Andaman and Nicobar Islands during 2007-09. A structured questionnaire, a modified version of an instrument which was used successfully in several multi-country epidemiological studies of the World Health Organisation, was used to survey individual socio-demographic details, known co-morbid conditions, tobacco use and alcohol use. Fagerström Test for Nicotine Dependence (FTND) was used to estimate nicotine dependence. Results: The response rate of our survey was 97% (18,018/18,554). Females (n = 8,888) were significantly younger than males (34.3 ± 14.6 Vs 36.2 ± 15.4 years). The prevalence of current tobacco use in any form was 48.9% (95% CI: 48.2-49.6). Tobacco chewing alone was prevalent in 40.9% (95% CI: 40.1-41.6) of the population. While one tenth of males (9.7%, 95% CI: 9.1-10.4) were nicotine dependent, it was only 3% (95% CI: 2.7-3.4) in females. Three fourth of the tobacco users initiated use of tobacco before reaching 21 years of age. Age, current use of alcohol, poor educational status, marital status, social groups, and co-morbidities were the main determinants of tobacco use and nicotine dependence in the population. Conclusion: The high prevalence of tobacco use especially the chewing form of tobacco in the Union Territory of Andaman and Nicobar Islands and the differences in prevalence and pattern of tobacco use and nicotine dependency observed across subgroups warrants implementation of culturally specific tobacco control activities in this population. [ABSTRACT FROM AUTHOR]

Background: Air nicotine monitoring is an established method of measuring exposure to second hand smoke (SHS). Not much research has been done in India to measure air nicotine for the purpose of studying exposure to SHS. It is a risk factor and many diseases are known to occur among non smokers if they are exposed to second hand smoke. Objective: To conduct monitoring of air nicotine for second hand smoke exposure in public places across major cities in India. Materials and Methods: A cross sectional survey was conducted across four cities across the country, using passive air monitoring. The buildings included hospitals, secondary schools, Governmental offices, bars and restaurants. The buildings were selected through convenience sampling method keeping in view specific sentinel locations of interest. Result: The presence of air nicotine was recorded in most of the buildings under the study, which included government buildings, hospitals, schools, restaurants and entertainment venues (bars) in all four cities under the study. The highest median levels of air nicotine were found in entertainment venues and restaurants in cities. Conclusion: The presence of air nicotine in indoor public places indicates weak implementation of existing smoke free law in India. The findings of this study provide a baseline characterization of exposure to SHS in public places in India, which could be used to promote clean indoor air policies and programs and monitor and evaluate the progress and future smoke-free initiatives in India. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Tobacco chewing is associated with millions of cases of chronic obstructive pulmonary diseases (COPD) and coronary artery diseases annually. Major forms of chewable tobacco contain toxicants and carcinogens. According to the World Health Report 2002, tobacco is the leading preventable cause of overall mortality as well as cardiovascular mortality worldwide. Aims and Objective: To reveal the effect of tobacco chewing on the lipid profile. Materials and Methods: This study was conducted to reveal the effect of tobacco chewing on the lipid profile in male subjects. The cross-sectional study was conducted in 60 male subjects aged 30-45 years. The subjects were divided into control group (n = 30) and study group (i.e., smokers; n = 30). All subjects were from either social class 2 or 3 according to Prasad's modified social classification. About 5 mL venous blood sample was drawn after 10-12 h of fasting and lipid profile was analyzed. Results: No significant difference in anthropometric parameter of the control group and the study group was observed. Triglyceride and very-low-density lipoprotein cholesterol levels increased significantly (p < 0.001) in the study group (i.e., tobacco chewers) than in the control group. Total cholesterol and low-density lipoprotein cholesterol levels increased significantly (p < 0.05) in tobacco chewers than in the control group. The mean value of high-density lipoprotein cholesterol levels decreased but not significantly in tobacco chewers than in the control group. Conclusion: Strict measures should be taken up to control the prevalence of tobacco chewing habits and to prevent the risk for diseases such as cardiovascular diseases and COPD. [ABSTRACT FROM AUTHOR]

Background: Though, increased emphasis is being given on spreading dental care facilities and awareness in Indian villages, the target population is unfortunately less literate and is not financially equipped compared to their urban counterparts. The rural aged additionally may have to face problems like desertion by the educated youth to follow better opportunities in cities, disease, and lack of mobility. Aims: The present study strived to evaluate dental myths, oral hygiene methods, and tobacco habits awareness in a rural ageing population in the perspective of a changing India. Setting and Design: The study area consisted of a group of ten villages, situated in district Lucknow, Uttar Pradesh, India. Materials and Methods: The subjects were questioned about dental myths, tobacco habits, and oral hygiene methods and then divided into groups on the basis of age, sex, and educational status. The number of sound teeth in each subject was also counted. Statistical Analysis: Mean-values, standard deviation, Chi-square test and P values were used to make inter-group comparisons. Results and Conclusion: Forty percent of the subjects considered oral hygiene unnecessary, 60.8% of the population was relying on simple mouth rinsing for maintaining oral hygiene, 48% had either the habit of smoking and chewing tobacco or both and 81% of the subjects had one dental myth or the other. We concluded that the rural aged is a deprived lot and a targeted program to infuse scientific dental practices in them is necessary. [ABSTRACT FROM AUTHOR]

The article discusses the findings of an air nicotine monitoring study in Chennai, Tamil Nadu, India to examine the level of second hand smoke exposure in public places. All monitors recorded detectable levels of air nicotine in schools and restaurants. Levels of nicotine in government buildings, hospitals and entertainment venues were found to be above the detection limit. Highest median levels of air nicotine were detected in restaurants.

The article reports on the court rules of the Haryana State High Court and a divisional bench of Punjab, India referring chemical nicotine as a poisonous substance. It says that the court order directs the prohibited use of chemical nicotine as additive to other material. It also mentions that the statement of the High Court describes nicotine abuse as a serious problem which calls for the implementation of the mandate of the Article 21 of India's Constitution.