Changes in Cardiovascular system among smokeless tobacco users attending tertiary care hospital in Andhra Pradesh, India

  • Dr. B Annaji Assistant Professor, Department of General Medicine, Great Eastern Medical School and Hospital, Ragolu, Srikakulam, Andhra Pradesh, India
  • Dr. P Sreedevi Assistant professor, Department of General Medicine, Great Eastern Medical School and Hospital, Ragolu, Srikakulam, Andhra Pradesh, India
  • Dr. K Sudheer Professor, Department of General Medicine, Great Eastern Medical School and Hospital, Ragolu, Srikakulam, Andhra Pradesh, India
Keywords: Pulse rate, Smokeless tobacco, Systolic blood pressure, Diastolic blood pressure


Background: Tobacco can be consumed as cigarettes and also as smokeless tobacco. Smokeless tobacco is a harmful tobacco product that contains over 3,000 chemicals, 7 including 28 known carcinogens (cancer-causing agents). Various forms of smokeless tobacco (mainly snuff and chewing tobacco) cause an immediate increase in heart rate and blood pressure. However, the relationship between smokeless tobacco uses on blood pressure remains unknown, especially in tertiary level hospitals. Our aim is to find out the smokeless tobacco use influence on cardiovascular parameters, for instance, pulse rate and blood pressure.

Methods: This cross-sectional study was carried out to assess cardiovascular changes among adult male smokeless tobacco (ST) users. For this purpose, 50 male respondents were selected. The participants were selected from the medicine outpatient department of Great Eastern Medical School and Hospital, Srikakulam, Andhra Pradesh. Pulse rate and blood pressure were measured and ST uses behavior was assessed using self-reports. Statistical analysis was done by SPSS20.

Results: In this study, the mean (±SD) of pulse rate was 83.2±12.3 beats/min. The mean (±SD) of systolic blood pressure was 158.72±24.84 mm of Hg and the mean (±SD) of diastolic blood pressure was 98.78±9.87 mm of Hg in smokeless tobacco users.

Conclusion: Mean systolic and diastolic blood pressures were higher in smokeless tobacco users in the tertiary level hospital. However, the mean pulse rate was within the normal range.


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World Health Organization (WHO) (2011) Who report on the global tobacco epidemic, 2011. Warning about the dangers of tobacco. Geneva, Switzerland: World Health Organization. Retrieved from

Ezzati M, Lopez AD. Regional, disease specific patterns of smoking-attributable mortality in 2000. Tob Control. 2004;13:388–395.

World Health Organization (WHO) (2007) Impact of Tobacco-Related Illnesses in Bangladesh. New Delhi, India: World Health Organization, South East Asia Region.

Gupta PC, Ray CS. Smokeless tobacco and health in India and South Asia. Respirology. 2003;8:419–431.

Kuper H, Adam O & Buffett P. Tobacco use, cancer causation and public health impact. Journal of Internal Medicine. 2002; 251:455–466.

Benowitz, N. L, Pharmacology of smokeless tobacco use: Nicotine addiction and nicotine-related health consequences.

In D. R. Shopland (Ed.), Smokeless tobacco or health: An international perspective (Smoking and Tobacco Control Monograph 2, NIH Publication No. 93-3461). Bethesda, MD: National Institutes of Health, U.S. Department of Health and Human Services, 199

Asplund K, “Smokeless tobacco and cardiovascular disease”, Prog Cardiovasc Dis. 2003;45 (5):383–94.

Boucher BJ, Mannan N. Metabolic effects of the consumption of Areca catechu.Addict Biol. 2002;7:103–10.

Westman, E, Does smokeless tobacco cause hypertension, Southern Medical Journal, 88, 716–720. As cited in Gupta,R., Gurm, H., & Bartholomew, J. (2004). Smokeless tobacco and cardiovascular risk. Archives of Internal Medicine. 1995;164:1845–1849.

Better Health Channel, Stroke prevention for high risk groups [Online]. [cited 2008 Aug 7]; Reviewed on: http:// Stoke_prevention_for_high_risk_groups, July 05,2011

Heart Clinic, Smoking and High Blood Pressure [Online], [cited 2008 Aug 12]; Reviewed on; July 10, 2011

Ilgenli TF, Akpinar O, Acute effects of smoking on right ventricular function. Swiss med wkly. 2007;137:91.

Benowitz NL. Sodium intake from smokeless tobacco. N Engl J Med.1988;319:873– 874.

Valeriano J, Tucker P, Kattah J. An unusual cause of hypokalemic muscle weakness. Neurology. 1983; 33:1242–1243.

American Cancer Society. Smokeless tobacco: Highly addictive and no safer than smoking. Retrieved December 28,2004 from content/PED_10_2x_Smokeless_Tobacco_and_Cancer.asp?sitearea=PED

IARC Working Group on the Evaluation of Carcinogenic Risks to Humans., World Health Organization.,International Agency for Research on Cancer. Betel-quid and areca-nut chewing and some areca-nut-derived nitrosamines. Lyon,France: IARC Press; 2004.

Knekt P, Alfthan G, Aromaa A, et al. Homocysteine and major coronary events: a prospective population study amongst women. J Intern Med. 2001;249:461–65.

Benowitz NL, Porchet H, Sheiner L, et al. Nicotine absorption and cardiovascular effects with smokeless tobacco

use: comparison with cigarettes and nicotine gum. Clin Pharmacol Ther. 1988;44(1):23–28.

UK’s Action on Smoking & Health (ASH) Accessed on July 31, 2007.

Haddock, C. K., Weg, M. V., DeBon, M., Klesges, R. C.,Talcott, G. W., Lando, H., et al., Evidence that smokeless tobacco use is a gateway for smoking initiation in youth adult males. Preventive Medicine. 2001;32: 262–267.

Siegel D, Benowitz N, Ernster VL, Grady DG, Hauck WW, “Smokeless tobacco, cardiovascular risk factors, and nicotine

and cotinine levels in professional baseball players”. Am J Public Health, March. 1992;82(3):417–21.

Wolk R, Shamsuzzaman AS, Svatikova A, Huyber CM, Huck C, Narkiewicz K, Somers VK. Hemodynamic and autonomic

effects of smokeless tobacco in healthy young men. J Am Coll Cardiol. 2005;45:910–914.

Bolinder GM, Ahlborg BO, Lindell JH. Use of smokeless tobacco: blood pressure elevation and other health hazards

found in a large-scale population survey. J Intern Med. 1992; 232(4):327-34.

Lloyd-Jones D, Adams R, Carnethon M, et al.,Heart disease and stroke statistics—2009 update. A Report from the

American Heart Association Statistics Committee and Stroke Statistics Subcommittee.Circulation. 2009; 119:e21– e181.

Hergens MP, Lambe M, Pershagen G, Ye W. Risk of hypertension amongst Swedish male snuff users: a prospective study. J Intern Med. 2008;264(2):187-194.

Gupta BK, Kaushik A, Panwar RB, et al., “Cardiovascular risk factors in tobacco-chewers: a controlled study”. J Assoc Physicians India, January, 2007; 55: 27–31.

Hergens MP, Alfredsson PL, Bolinder G. Long-term use of Swedish moist snuff and the risk of myocardial infarction amongst men. J Intern Med. 2007;262:351–9.

Ernster VL, Grady DS, Greene JC. Smokeless tobacco use and health effects among baseball players. JAMA. 1990; 264:218–24.

Khurana M, Sharma D, Khandelwal PD. Lipid profile in smokers and tobacco chewers—a comparative study. J Assoc Physicians India. 2000;48:895–7.

How to Cite
Dr. B Annaji, Dr. P Sreedevi, Dr. K Sudheer. Changes in Cardiovascular system among smokeless tobacco users attending tertiary care hospital in Andhra Pradesh, India. Int J Med Res Rev [Internet]. 2020Aug.31 [cited 2020Sep.21];8(4):326-30. Available from:
Original Article