Analysis of Tobacco-Specific Nitrosamines in the Common Smokeless Tobacco Afzal in Oman

Abstract

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.

Assessment of concentration and toxicological (Cancer) risk of lead, cadmium and chromium in tobacco products commonly available in Bangladesh

“…The similar conentration of Cd was found in Oman [37], Pakistan [28], and in India [33]. Chromium concentration was high in every tobacco product and is supported by the literature [28,33,[35], [36], [37]].

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The Oral Microbiome of Smokeless Tobacco Users in Latvia

“…A recent study on snus Afzal from Oman showed that it exceeded the limits for N-Nitrosonornicotine (NNN) and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) in tobacco products (Al-Mukhaini et al, 2016). The smokeless tobacco products produced in Russia, Sudan, and other Asian countries bear no information on compliance with the quality standards of those countries and the quality of refinement, which suggests that snus produced in these countries may contain other admixtures and have greater effect on oral health.…”

Characterisation of Nicotine and Cancer-Enhancing Anions in the Common Smokeless Tobacco Afzal in Oman

“…19 Quantities of Swedish snus are well monitored as they are typically sold in 1.00 g tea bag-sized sachets; 19 in contrast, Afzal users usually self-determine doses (typically a pinch-sized amount per single dose ranging from 1.00-2.00 g) which are then repeated as desired. 13 As a result, Cl -consumption will increase due to repeated Afzal use during the day. 16 Few studies have investigated the other anions tested in this study ( 4 2-(4,560.00-12,300.00 µg/g) and PO 4 2-(309.00-1,300.00 µg/g) levels in American STPs; their findings were higher than anion levels indicated in the current study (1,502.20 µg/g and 37.80 µg/g, respectively).…”

“…Previous research has determined the composition of heavy metals in Afzal. 13 The aim of this study was therefore to measure pH and moisture levels and assess cancer-causing agents in a random sample of Afzal.…”