Smokeless Tobacco (SLT)

Habit of smokeless tobacco (SLT) as ‘‘chewing tobacco’’ or ‘‘spit tobacco’’ becoming a global threat for human health day by day due to its numerous deleterious effects. The usage of SLT was reported to be more prevalent in South Asian countries comparing to the Western world [1], although current studies had revealed the world wide usage of SLT-related products [2, 3]. Chewing tobacco or spit tobacco, which is largely used in India and also in USA, is mixed with betel leaves, areca nut, lime and catechu and is sold as legally commercial products termed ‘‘gutkha.’’ [4]. It comprises of vast number of toxicants and carcinogens and these are responsible for its unfavourable health effects [5, 6]. The tobacco-specific nitrosamines (TSNAs) are

Keeping SLT in mouth, either snuff or chewing tobacco, is identified to encourage wrinkled changes in the oral mucosa, associated with oral injury and inflammation and may direct to Snuff dipper’s lesion, also referred to as leukoplakia. This is characterized by an increased occurrence of gingival recession with associated loss of attachment, cervical abrasion and oral tissue damage [1]. It has been reported that oral administration of the aqueous extract of smokeless tobacco to male rats, resulted in the apoptosis and damage of lung, liver and kidney tissues, along with the significant up regulation of pro-apoptotic and inflammatory genes [14, 15].

SLT consumption is more common among lower socioeconomic groups in India such as poor, semi-skilled manual workers, unemployed people and those with less education [16]. It supposed to have healing property for curing toothache, headache and stomach ache which leads many adults to become users. Some parents even encourage their children to use SLT [17]. Curiosity, peer pressure and offers by friends and acquaintances contribute to initiation of use

We also want to study a spectrum of different physiological parameters between the SLT user and non user groups from a mechanistic view point by measuring total haematological parameters and some clinico biochemical parameters like, random sugar, urea, creatinine, lipid profile, ESR, C-Reactive Protein either from blood or serum, anti oxidant assays were performed from isolated peripheral blood mononuclear cells (PBMC) and red blood cell (RBC) membrane to measure the extent of oxidative stress, cell cycle analysis of PBMC was done using flowcytometry to detect the distribution of DNA content in different phases, level of different pro- and anti- apoptotic markers such as p53, p21, Bax, Bcl2 were analysed. Structural changes of RBC were analysed microscopically among the studied groups. This is perhaps the first ever exhaustive report on menace of SLT on Indian population which will surely reveal a therapeutic approach to treat the