Pawar V. S, Sontakke A, Pawar A. A, Kakade S. Assessment of Serum Cotinine and Oxidative Stress Markers in Tobacco Users. Biomed Pharmacol J 2019;12(2).

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Manuscript received on :14-Mar-2019
Manuscript accepted on :04-May-2019
Published online on: 20-05-2019

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Reviewed by: Liudmila Spirinaa
Second Review by: Asmaa Fathi

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Vaishali S. Pawar*¹, Ajit Sontakke¹, Anuja A Pawar¹ and Satish Kakade²

¹Department of Biochemistry, KIMSDU, Karad, Maharashtra, India, Pincode- 415539, India.

²Department of Community Medicine, KIMSDU, Karad, Maharashtra, Pincode-415539, India.

Corresponding Author E-mail: drvspawar269@gmail.com

DOI : https://dx.doi.org/10.13005/bpj/1677

Abstract

Augmented production of free radicals associated with smoking with decrease in antioxidant levels and increase in peroxidation of biomolecules have been shown in various studies. The studies with smokeless tobacco use having depictive data were lacking. To estimate serum cotinine (CTN) levels and oxidative stress markers in tobacco smokers and smokeless tobacco users and to compare them with tobacco nonusers. This cross sectional study was performed in 180 study subjects divided into 6 groups - tobacco smokers, tobacco chewers, tobacco mishri users, dual tobacco chewers and mishri users, dual smokers and smokeless tobacco users and tobacco nonusers. Serum CTN levels were estimated. Oxidative stress was estimated by Malondialdehyde (MDA) and enzymatic antioxidant Superoxide Dismutase (SOD). Serum MDA levels were significantly high and erythrocytic SOD levels were significantly low in tobacco users than tobacco nonusers (P<0.001). There was a significant negative relationship between cotinine and SOD, a significant positive relation between cotinine and MDA in tobacco users. There was a significant negative relationship between duration of tobacco use and SOD, a significant positive relation between duration of tobacco use and MDA. There was a significant negative relationship between amount of tobacco use and SOD. Tobacco users with longer duration of tobacco use with increased levels of serum cotinine have increased oxidative stress which can be a risk factor for many diseases. Tobacco chewing equally increases oxidative stress as that of smoking.

Keywords

Malondialdehyde; Serum Cotinine Levels; Smokeless Tobacco Users; Superoxide Dismutase;Tobacco Smokers

Introduction

According to WHO report, tobacco is responsible for an extensive amount of morbidity and mortality among middle-aged adults worldwide and for causing more than 5 million deaths every year.¹ Smoking and smokeless tobacco products are the two main forms of tobacco use.² India is one of the largest producer and second highest consumer of tobacco in the world with 229 million tobacco users, mainly in the form of smokeless tobacco (SLT).^2,3

Global Adult Tobacco Survey India (GATS-India) 2009-2010 observed that prevalence of smokeless tobacco use (26%) is significantly more than that of smoking (14%).⁴ Smoking is available as cigarettes, beedis, cigars, cheroots etc. SLT is available as gutkha, khaini, pan masala, mawa or snuff or mishri, gul, bajjar, gudakhu (used for application to the teeth and gums).² The use of SLT in India is escalating as they are cheap, socially acceptable and easily available with addictive habit.²

After absorption of tobacco constituents in the blood circulation, it affects almost all organs causing increased risk of atherosclerosis, hypertension, chronic obstructive pulmonary disease, cancers etc.⁵  Adverse effects of tobacco use have been associated to the different effects of chemical constituents of it on biological systems. Although the underlying mechanisms involved in the pathogenesis of diseases associated with tobacco use are not exactly known, free radical induced damage has been suggested to play a major role.⁶

Tobacco contains 5,000 compounds, most of which are well known sources of free radicals,⁷ when they get absorbed in blood circulation, causes changes in cells resulting in incre