Skip to main content
Tobacco Control logoLink to Tobacco Control
. 2004 Jun;13(2):186–189. doi: 10.1136/tc.2003.006601

Nicotine delivery capabilities of smokeless tobacco products and implications for control of tobacco dependence in South Africa

O Ayo-Yusuf 1, T Swart 1, W Pickworth 1
PMCID: PMC1747856  PMID: 15175538

Abstract

Objectives: Smokeless tobacco (SLT) use is popular among black South African women and children. The study sought to determine the nicotine delivery capability of popular industrialised and traditional SLT brands in South Africa, and to provide information for policy action by regulatory authorities.

Design: Laboratory chemical analysis of four industrialised and one traditional SLT products commercially available, using previously published analytical methods. Potential for dependence was inferred from nicotine delivery capabilities determined by the percentage free base nicotine.

Measurements: Moisture, pH, total nicotine, and percentage free base nicotine.

Results: Total nicotine content was between 6–16 mg/g. The pH varied between 7–10 and this correlated with percentage free base nicotine, which ranged between 10–99%. The nicotine delivery capability of the traditional product was lower than that of the industrialised products except for the recently introduced portion bag snus, which had comparable total nicotine but the lowest pH and percentage free base nicotine. The most popular SLT brands showed the highest percentage free base nicotine ever reported for any industrialised SLT or cigarette brands. Small cans contained higher nicotine than the large cans of the same brand tested. Findings from the study support a potential for limited "product graduation" by users.

Conclusions: South African SLT users are mostly exposed to potentially very highly addictive levels of nicotine that may favour tobacco dependence and its consequent health risks. The increasing use of SLT by women of childbearing age support the need for intensified policy action to control its use.

Full Text

The Full Text of this article is available as a PDF (58.5 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ayo-Yusuf O. A., Swart T. J., Ayo-Yusuf I. J. Prevalence and pattern of snuff dipping in a rural South African population. SADJ. 2000 Nov;55(11):610–614. [PubMed] [Google Scholar]
  2. Benowitz N. L., Porchet H., Sheiner L., Jacob P., 3rd Nicotine absorption and cardiovascular effects with smokeless tobacco use: comparison with cigarettes and nicotine gum. Clin Pharmacol Ther. 1988 Jul;44(1):23–28. doi: 10.1038/clpt.1988.107. [DOI] [PubMed] [Google Scholar]
  3. Benowitz N. L. Systemic absorption and effects of nicotine from smokeless tobacco. Adv Dent Res. 1997 Sep;11(3):336–341. doi: 10.1177/08959374970110030501. [DOI] [PubMed] [Google Scholar]
  4. Benowitz Neal L., Pérez-Stable Eliseo J., Herrera Brenda, Jacob Peyton., 3rd Slower metabolism and reduced intake of nicotine from cigarette smoking in Chinese-Americans. J Natl Cancer Inst. 2002 Jan 16;94(2):108–115. doi: 10.1093/jnci/94.2.108. [DOI] [PubMed] [Google Scholar]
  5. Bolinder G. M., Ahlborg B. O., Lindell J. H. Use of smokeless tobacco: blood pressure elevation and other health hazards found in a large-scale population survey. J Intern Med. 1992 Oct;232(4):327–334. doi: 10.1111/j.1365-2796.1992.tb00593.x. [DOI] [PubMed] [Google Scholar]
  6. Buka Stephen L., Shenassa Edmond D., Niaura Raymond. Elevated risk of tobacco dependence among offspring of mothers who smoked during pregnancy: a 30-year prospective study. Am J Psychiatry. 2003 Nov;160(11):1978–1984. doi: 10.1176/appi.ajp.160.11.1978. [DOI] [PubMed] [Google Scholar]
  7. Clark P. I., Gautam S., Gerson L. W. Effect of menthol cigarettes on biochemical markers of smoke exposure among black and white smokers. Chest. 1996 Nov;110(5):1194–1198. doi: 10.1378/chest.110.5.1194. [DOI] [PubMed] [Google Scholar]
  8. Deshmukh J. S., Motghare D. D., Zodpey S. P., Wadhva S. K. Low birth weight and associated maternal factors in an urban area. Indian Pediatr. 1998 Jan;35(1):33–36. [PubMed] [Google Scholar]
  9. England Lucinda J., Levine Richard J., Mills James L., Klebanoff Mark A., Yu Kai F., Cnattingius Sven. Adverse pregnancy outcomes in snuff users. Am J Obstet Gynecol. 2003 Oct;189(4):939–943. doi: 10.1067/s0002-9378(03)00661-6. [DOI] [PubMed] [Google Scholar]
  10. Fant R. V., Henningfield J. E., Nelson R. A., Pickworth W. B. Pharmacokinetics and pharmacodynamics of moist snuff in humans. Tob Control. 1999 Winter;8(4):387–392. doi: 10.1136/tc.8.4.387. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Idris A. M., Ahmed H. M., Malik M. O. Toombak dipping and cancer of the oral cavity in the Sudan: a case-control study. Int J Cancer. 1995 Nov 15;63(4):477–480. doi: 10.1002/ijc.2910630402. [DOI] [PubMed] [Google Scholar]
  12. Idris A. M., Ibrahim S. O., Vasstrand E. N., Johannessen A. C., Lillehaug J. R., Magnusson B., Wallström M., Hirsch J. M., Nilsen R. The Swedish snus and the Sudanese toombak: are they different? Oral Oncol. 1998 Nov;34(6):558–566. doi: 10.1016/s1368-8375(98)00047-5. [DOI] [PubMed] [Google Scholar]
  13. Kandel D. B., Chen K. Extent of smoking and nicotine dependence in the United States: 1991-1993. Nicotine Tob Res. 2000 Aug;2(3):263–274. doi: 10.1080/14622200050147538. [DOI] [PubMed] [Google Scholar]
  14. Kozlowski L. T., Strasser A. A., Giovino G. A., Erickson P. A., Terza J. V. Applying the risk/use equilibrium: use medicinal nicotine now for harm reduction. Tob Control. 2001 Sep;10(3):201–203. doi: 10.1136/tc.10.3.201. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Malson J. L., Sims K., Murty R., Pickworth W. B. Comparison of the nicotine content of tobacco used in bidis and conventional cigarettes. Tob Control. 2001 Jun;10(2):181–183. doi: 10.1136/tc.10.2.181. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Pankow James F., Tavakoli Ameer D., Luo Wentai, Isabelle Lorne M. Percent free base nicotine in the tobacco smoke particulate matter of selected commercial and reference cigarettes. Chem Res Toxicol. 2003 Aug;16(8):1014–1018. doi: 10.1021/tx0340596. [DOI] [PubMed] [Google Scholar]
  17. Peltzer K., Phaswana N., Malaka D. Smokeless tobacco use among adults in the Northern Province of South Africa: qualitative data from focus groups. Subst Use Misuse. 2001 Mar;36(4):447–462. doi: 10.1081/ja-100102636. [DOI] [PubMed] [Google Scholar]
  18. Peltzer K. Smokeless tobacco use among urban white and black South Africans. Psychol Rep. 1999 Dec;85(3 Pt 1):933–934. doi: 10.2466/pr0.1999.85.3.933. [DOI] [PubMed] [Google Scholar]
  19. Peltzer Karl. Smokeless tobacco and cigarette use among black secondary school students in South Africa. Subst Use Misuse. 2003 Jun;38(7):1003–1016. doi: 10.1081/ja-120017621. [DOI] [PubMed] [Google Scholar]
  20. Rodu Brad, Cole Philip. Smokeless tobacco use and cancer of the upper respiratory tract. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002 May;93(5):511–515. doi: 10.1067/moe.2002.123497. [DOI] [PubMed] [Google Scholar]
  21. Schroeder K. L., Chen M. S., Jr, Iaderosa G. R., Glover E. D., Edmundson E. W. Proposed definition of a smokeless tobacco user based on "potential" nicotine consumption. Addict Behav. 1988;13(4):395–400. doi: 10.1016/0306-4603(88)90047-0. [DOI] [PubMed] [Google Scholar]
  22. Schroeder K. L., Chen M. S., Jr Smokeless tobacco and blood pressure. N Engl J Med. 1985 Apr 4;312(14):919–919. doi: 10.1056/nejm198504043121411. [DOI] [PubMed] [Google Scholar]
  23. Sterling T. D., Rosenbaum W. L., Weinkam J. J. Analysis of the relationship between smokeless tobacco and cancer based on data from the National Mortality Followback Survey. J Clin Epidemiol. 1992 Mar;45(3):223–231. doi: 10.1016/0895-4356(92)90082-x. [DOI] [PubMed] [Google Scholar]
  24. Steyn Krisela, Bradshaw Debbie, Norman Rosana, Laubscher Ria, Saloojee Yussuf. Tobacco use in South Africans during 1998: the first demographic and health survey. J Cardiovasc Risk. 2002 Jun;9(3):161–170. doi: 10.1177/174182670200900305. [DOI] [PubMed] [Google Scholar]
  25. Tomar S. L., Henningfield J. E. Review of the evidence that pH is a determinant of nicotine dosage from oral use of smokeless tobacco. Tob Control. 1997 Autumn;6(3):219–225. doi: 10.1136/tc.6.3.219. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Winn D. M., Blot W. J., Shy C. M., Pickle L. W., Toledo A., Fraumeni J. F., Jr Snuff dipping and oral cancer among women in the southern United States. N Engl J Med. 1981 Mar 26;304(13):745–749. doi: 10.1056/NEJM198103263041301. [DOI] [PubMed] [Google Scholar]
  27. van Walbeek Corné. Recent trends in smoking prevalence in South Africa--some evidence from AMPS data. S Afr Med J. 2002 Jun;92(6):468–472. [PubMed] [Google Scholar]

Articles from Tobacco Control are provided here courtesy of BMJ Publishing Group

RESOURCES