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Abstract
With cigarette smoking declining in the modern world, the tobacco industry has to look for other products that can keep the old customers and attract new ones. Different forms of smokeless tobacco are currently massively promoted and are gaining in importance. Dry nasal snuff - the oldest known form of tobacco in Europe - is one of them. The health risks associated with it are different to those attributed to smoking and oral wet snuff. The nicotine contained leads to dependency. Its resorption rate is similar to that of smoking, so it could be seen as an adequate substitutional therapy. The risk for cardiovascular diseases is lower, compared to that for smokers. Chronic abuse leads to morphological and functional changes in the nasal mucosa. Although it contains substances that are potentially carcinogenic, at present, there is no firm evidence, relating the use of nasal snuff to a higher incidence of head and neck or other malignancies.
Key words: Tobacco, Smokeless; Nicotine; Nasal Mucosa
Introduction
Smoking is a widely recognized major risk factor for lung cancer, upper aerodigestive tract neoplasms and other malignancies, cardiovascular, gastrointestinal and neurological diseases.1-6 The large majority of smokers are well aware of the devastating effects of this habit on their health and wish to quit. Modern society's intolerance to smoking grows and many different restrictions have been currently imposed on smokers both in the occupational and social environments.7,8 Quitting smoking is the optimal way out, but it is difficult to achieve, because of the effects of nicotine withdrawal. An acceptable alternative to quitting is to have strategies for reducing the harmful effects of smoking. These may be based on the substitution of cigarette smoking for other ways of nicotine delivery. There are currently four pharmaceutical forms of nicotine replacement - patches, gum, nasal spray and inhaler.9,10 'Natural' smokeless tobacco products (tobacco is administered without being burned) are supposed to be helpful as well.6,11-13 Such products have been massively promoted by the tobacco industry in the last decade and now they present the only growing market segment.14-17 One of them is nasal snuff - probably one of the oldest forms of tobacco use. The aim of the present paper is to make an overview of the health consequences of nasal...