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Effects of smokeless tobacco (Maras powder) use on carotid intima media thickness

Mustafa Haki Sucakli, Fuat Ozkan, Mehmet Fatih Inci, Mustafa Celik, Hamit Sirri Keten, Orhan Bozoglan

Department of Family Medicine, Kahramanmaras Sutcuimam University, Medical Faculty, Kahramanmaraş, Turkey

Med Sci Monit 2013; 19:859-864

DOI: 10.12659/MSM.889654

Available online:

Published: 2013-10-16

Background: The aim of this study was to investigate the effects of smokeless tobacco (Maras powder, Nicotiana rustica Linn) on carotid intima media thickness.
Material and Methods: The study included 32 Maras powder users presenting to our Family Medicine outpatient clinic and 30 non-users of Maras powder as a control group. Carotid intima media thickness was measured by duplex ultrasonography.
Results: All the participants were male. The mean duration of Maras powder use was 27.3±11.6 years. Carotid intima media thickness was 0.73±0.20 mm in the Maras powder users and 0.49±0.14 mm in the controls. Blood pressure measured before Maras powder use in Maras powder users was similar to that measured in the control group (p>0.05). Systolic blood pressures were 136.6±12.4 mmHg and 109.7±9.7 mmHg after 30–60 minutes using Maras powder in the Maras powder users and in the controls, respectively. Diastolic blood pressures were 87.2±6.1 mmHg and 62.8±8.1 mmHg after 30–60 minutes using Maras powder in the Maras powder users and the controls, respectively. Carotid intima media thickness was significantly correlated with systolic blood pressure (r=0.613, p<0.001) and diastolic blood pressure (r=0.612, p<0.001).
Conclusions: Carotid intima media thickness was higher in Maras powder users than in nonusers of the powder. Increased carotid intima media thickness can be associated with an immediate increase in systolic and diastolic blood pressures. Therefore, attempts to increase public awareness about smoking should also be directed towards prevention of Maras powder use.

Keywords: Carotid Arteries - ultrasonography, Blood Pressure - drug effects, Carotid Intima-Media Thickness - statistics & numerical data, Case-Control Studies, Statistics, Nonparametric, Tobacco, Smokeless - adverse effects, Turkey