Background. The current study investigated the effect of dipping tobacco (DT) use on arterial wall stiffness which is a known marker of increased risk of cardiovascular events. Methods. A case-control study which included 101 adult males was carried out in Al-Shaab Teaching Hospital. Blood pressure and pulse wave analysis parameters were recorded in 51 DT users (study group) before and after 30 minutes of placing tobacco and in 50 nontobacco users (control group). Anthropometric measurements were collected using data collection sheet. Data were entered into a computer and analyzed by using the software Statistical Package for the Social Sciences (SPSS) version 20 (SPSS Inc., Chicago, IL, USA). Results. At baseline measurements, heart rate (HR) was significantly lower in the study group compared to the control group ( 66.15 ± 9.21 vs. 72.87 ± 10.13 beats/min; P value ≤ 0.001). Subendocardial viability ratio (SEVR) was significantly higher in the study group compared to the control group ( 203.44 ± 30.34 vs. 179.11 ± 30.51 % ; P value ≤ 0.001). Acute effects of DT compared to pretobacco dipping showed significant increase in HR ( 72.50 ± 10.89 vs. 66.15 ± 9.21 beats/min; P value ≤ 0.001) and significant decrease in augmentation pressure (AP) (4.30 (2.30-8.00) vs. 3.30 (0.60-6.3) mmHg; P value ≤ 0.001), ejection duration (ED) ( 271.65 ± 19.42 vs. 279.53 ± 20.47   ms ; P value ≤ 0.001), and SEVR ( 187.11 ± 29.81 vs. 203.44 ± 30.34 ; P value ≤ 0.001). Linear regression analysis for AP predictor showed that only HR and AIx@75 affect and predict the values of AP ( Beta ± SE ; − 0.242 ± 0.019 , P value ≤ 0.001; 0.685 ± 0.014 , P value ≤ 0.001). Conclusions. Long-term use of DT was not associated with permanent changes in heart rate and blood pressure. Acute tobacco dipping caused an acute increase in heart rate and oxygen demands of myocardium.

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