|LETTER TO EDITOR
|Year : 2014 | Volume
| Issue : 5 | Page : 88
Nasal use of snuff
SS Narake, PC Gupta
Healis Sekhsaria Institute for Public Health, Navi Mumbai, Maharashtra, India
|Date of Web Publication||19-Dec-2014|
S S Narake
Healis Sekhsaria Institute for Public Health, Navi Mumbai, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Narake S S, Gupta P C. Nasal use of snuff. Indian J Cancer 2014;51, Suppl S1:88
Nasal inhalation of fine, dry tobacco powder is an old practice. It was quite common and probably a predominant form of tobacco use in the 19 th century.  With the advent of manufactured cigarettes, other forms of tobacco rapidly declined in the 20 th century. As a result, there are hardly any epidemiological studies on snuff inhalation although there are isolated reports on snuff induced malignancy  and limited clinical and histopathological observation on health effects.  The Global Adult Tobacco Survey (GATS 2009-2010) of India gives a chance to look at epidemiology of snuff inhalation due to its large national representative sample size (n = 69,296). 
The GATS India conducted in 2009-2010 as a household survey of the person age 15 and above. This survey provides national and regional estimate by residence (urban and rural) and gender and state estimates by gender. According to a report on GATS-India, prevalence of any smoked tobacco product was 14% and of any smokeless tobacco product was 25.9%. The smokeless tobacco use included nasal use of snuff, and a reanalysis of GATS data set showed that 869 (0.8%) persons reported as the current user of nasal snuff in India. The highest reported use of nasal snuff was in the state of Mizoram (397 Persons), followed by Chhattisgarh (67) and then Gujarat (57).
Sample frequency and prevalence of nasal snuff users with respect to gender, residence, age, education and occupation given in [Table 1]. The prevalence was higher among females (1.2%) compared to males (0.5%) and higher in rural areas (1.0%) compared with urban (0.5%). The prevalence increased with age (0.3% in 15-24 years age group to 2.0% in 65+) and decreased with increase in educational level (1.4% among those without formal education to 0.2% among those with secondary level education or above). Most users (788 out of 869) reported inhaling snuff along with the use of other tobacco products and the prevalence of only snuff inhalation was quite low (0.15%).
Except that the snuff inhalation was higher among females, rest of the characteristics of snuff inhalation are similar to smokeless tobacco use. Snuff inhalation induces sneezing. Inhalation as well as sneezing is not compatible with modern lifestyle, and that may be another reason for its prevalence becoming low.
Since snuff inhalation, by itself, is practiced by a few individuals (0.15%), currently it does not seem to represent a public health problem.
| » Acknowledgments|| |
The authors recognize that this work would not have been possible without the data collected for the GATS 2009-2010 in India. We gratefully acknowledge the contributions of the ministry of health and family welfare, Government of India; the International Institute for Population Sciences, Mumbai; the World Health Organization (WHO) country office for India, WHO South East Asia Regional Office; Centers for Disease Control and Prevention (CDC); CDC foundation, Atlanta; research triangle Institute international and Johns Hopkins Bloomberg School of Public Health for their dedicated efforts. Towards conducting the survey, analyzing the data, and reporting the findings time.
| » References|| |
Sapundzhiev N, Werner JA. Nasal snuff: Historical review and health related aspects. J Laryngol Otol 2003;117:686-91.
Sreedharan S, Hegde MC, Pai R, Rhodrigues S, Kumar R, Rasheed A. Snuff-induced malignancy of the nasal vestibule: A case report. Am J Otolaryngol 2007;28:353-6.
Sreedharan S, Kamath MP, Khadilkar U, Hegde MC, Kumar RM, Mudunuri RR, et al.
Effect of snuff on nasal mucosa. Am J Otolaryngol 2005;26:151-6.
International Institute for Population Sciences. Global Adult Tobacco Survey (GATS) India 2009-2010. New Delhi: Ministry of Health and Family Welfare, Government of India; 2010.