abstract:Objectives: There is a lack of awareness regarding the carcinogenicity of Afzal, an illegal smokeless tobacco product (STP) widely used among the Omani youth. Previous research has shown that certain types of tobacco-specific nitrosamines (TSNAs) are associated with oral and lung cancers. This study therefore aimed to assess levels of four common TSNAs in a randomly selected sample of Afzal. Methods: This study was carried out at Sultan Qaboos University in Muscat, Oman, between April and September 2013. A random sample of Afzal was analysed for four types of TSNAs using high-performance liquid chromatography-tandem mass spectrometry. The four types of TSNAs analysed were 4-(N-nitrosomethylamino)-1-(3-pyridyl)-1-butanone (NNK), N-nitrosonornicotine (NNN), N-nitrosoanatabine (NAT) and N-nitrosoanabasine (NAB). As a reference product, a sample of laboratory-manufactured American moist snuff (Centers for Disease Control and Prevention, Atlanta, Georgia, USA) was also used to confirm the accuracy and precision of the analysis. Results: The analysis revealed total TSNA levels of 3.573 μg/g in the Afzal sample. Mean levels of NNN, NNK, NAT and NAB were 1.205, 1.015, 0.809 and 0.545 μg/g, respectively. Conclusion: Levels of the two most abundant TSNAs (NNN and NNK) found in the Afzal sample exceeded international regulatory limits. Afzal users therefore need to be educated regarding the potential health risks associated with their STP use. Stricter implementation of current legislation is recommended to reduce the availability and usage of Afzal in Oman.

abstract:Objectives: Afzal is a common smokeless tobacco product (STP) available illegally in Oman. This study aimed to assess pH and moisture levels and determine cancer-enhancing factors in a randomly selected sample of Afzal. Methods: This study was carried out at the Sultan Qaboos University in Muscat, Oman, between April and December 2013. A package of Afzal was purchased from a single provider and divided into samples. The pH and moisture content of the samples were measured according to the protocols of the Centers for Disease Control and Prevention. Gas chromatography-mass spectrometry was used to analyse nicotine levels and ionexchange chromatography (IC) was used to determine concentrations of nitrate, nitrite, chloride, fluoride, bromide, sulphate and phosphate anions. Results: The samples had an alkaline pH of 10.46 with high levels of total (48,770.00 µg per g of STP [µg/g]) and unionised (48,590.00 µg/g) nicotine. The concentration of nitrate (8,792.20 µg/g) was alarmingly high. The chloride concentration (33,170.80 µg/g) showed a surge on IC chromatography. The moisture content percentage was 52.00%. Conclusion: The moisture content percentage and chloride concentration of Afzal was consistent with those of other STPs. In contrast, nitrite, sulphate and phosphate concentrations were below reported levels of other STPs. All anion concentrations were below the maximum daily limit set by international health organisations. However, the high concentrations of nitrite, nitrate and nicotine and the elevated alkaline pH observed in the analysed Afzal samples suggest that STP users will face health risks as a result of their use. Keywords

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Afzal is a common smokeless tobacco product (STP) in Oman, and it is believed to contain toxins that may affect the reproductive hormones and hence reproductive function. This study assessed the effect of  Afzal  on the gonads of Wistar rats.  In order to assess gonad toxicity induced by this STP, an aqueous extract of Afzal was added to drinking water to be administrated orally to Wistar albino rats (n = 72) classified as young (4 weeks old) and adult (20 weeks old) of both genders weighing between 60-80 g and 150-240 g respectively for 8 weeks. The rats were divided into 3 groups; control (received distilled water instead of Afzal extract), low-dose (received 3 mg nicotine/kg body weight/day) and high-dose (received 6 mg nicotine/kg body weight/day). At the termination of the study, the rats were euthanized and their blood samples and ovaries were collected for biochemical and histopathological investigations. Testosterone and estradiol hormones showed a significant decrease (P<0.05( in Afzal-treated groups (low and high doses) compared with the control. Histopathological findings revealed the damaging effects manifested as a reduction in the number of the germ cells with deformed organization and in fatty and fibrous degenerations in testes and ovaries. Afzal was found to have adverse effect on the reproductive hormones and gonadal pathology in Wistar rats of both genders, and hence users of Afzal need to consider the risk associated with its frequent use.