We have been discussing the serious and sometimes death-dealing effects of smoking tobacco in its various forms. Each modality has its own peculiar health hazard as well as the general ones that come from nicotine addiction and tobacco use. This is true of the smokeless use of this noxious plant.

In the West there has been an alarming increase in the use of snuff and chewing tobacco over the past two decades, especially among teenagers and young adult males. The most popular form of this use is moist snuff. Snuff is a very fine pulverized tobacco leaf that is inserted into the nostrils and sniffed into the upper nasal and air passages. Moist snuff may be sniffed or chewed. It is proven that cancers of the nasal linings and upper airways are very common in snuff sniffers, and it is difficult even to ponder the pain and trauma associated with this disease and its treatment. Snuffing also causes chronic sinusitis, tracheitis, laryngitis, and often erosion of the septum of the nose. Snuff still is causative in cardiovascular disease and may even cause stress and possible anomalies in unborn children of pregnant female users.

Frequent users of smokeless tobacco, especially chewing tobacco, are subject to gingival recession and gingival infection. Often the teeth fall out of the jaw with no unusual trauma. Leukoplakia and oral cancers are also common, as are cancers in the upper gastrointestinal tract. Because of the loosening of the teeth, it is often impossible for these people to get a nutritionally adequate diet, thus adding to their susceptibility to malignancy and other diseases.

The immediate result of chewing tobacco and/or snuff is increased salivation and the necessity to spit out this mouth load of saliva. This adds another hazard, the sociological one, as the obnoxious spittle may transmit many disease carrying germs outside the body and thus spread infections that are common to these users. The chewing of tobacco is common in the East and especially in India. Many times chewers will add betel quid to a mouthful of tobacco. It has already been shown that the use of the betel nut (Areca) is carcinogenic. It seems to be causative in the high incidence of cancer of the upper digestive tract, especially among men in India who mix tobacco and betel. The unsightly spitting of red-tinged saliva is all too often seen in India, especially in and around her temples. It is esthetically disgusting to see the oduvars, religious musicians, singing praises to the Deity while interrupting each verse with a spit and a cough.

In the West, head and neck squamous cell (tobacco related) cancers are 2-4% of the total cancer burden. In India this figure becomes 40% of total cancers, bringing a great health burden upon the nation. Most of the head and neck cancers we see are preventable by consuming a diet high in vegetables and fruits and eliminating smoking, chewing and snuffing of tobacco. Since habits are difficult to break, public health officials are, through education and the enlistment of dental personnel, trying to prevent people from starting.

Before leaving the subject of tobacco and its hazards we must also note that secondhand smoke, air that is polluted with the smoke of tobacco, is also carcinogenic and may also cause all of the diseases we've discussed. This is especially true for children who must constantly breathe the polluted air, as in the home environment.

Dr. Devananda Tandavan, MD, is a member of the American Medical Association, the International College of Surgeons, the Society of Nuclear Medicine, the American Federation of Astrologers, the International Reiki Association, the International Center of Homeopathy- and more. Send your questions to Hinduism Today, 107 Kaholalele Road, Kapaa, Hawaii 96746 USA.