Lankaweb Health

Apparently in an attempt to deter public opinion against sudden increase in beedi smokers following tax increase of cigarette, Sri Lankan health minister has taken an unsubstantiated step by declaring beedis may pose less health risks than cigarettes even though there are ample scientific evidence to prove otherwise.

The observation was made at a press conference held in Colombo this afternoon (02).

He pointed out that smoking beedi may pose less health risks when it compared to cigarettes.

He went onto say that cigarette smoke contains some 22 key chemicals and other toxins while beedi only contains around four toxins.

The Minister also criticized the reports that beedi smoking has gone up after the recent cigarettes price hike. This must be some kind of a miracles research to come to a conclusion in less than a week,” he said. (http://adaderana.lk/news/37671/smoking-beedi-may-pose-less-health-risks-than-cigarettes-rajitha)

Now beedis are arriving on the shelves of convenience stores and gas stations across the United States too. Touted as new, cool, safe, and natural, the beedis are priced right for the teen budget – only $2.00 for a pack of 20.

Smoking beedis has been independently proven to cause:

• Cancer of the tongue (International Journal Cancer, 1989; 44(4):617-621)
• Cancer of the gums (British Journal of Cancer, 1989; 60:638-643)
• Cancer of the floor of the mouth (International Journal Cancer, 1989; 44(4):617-621)
• Other squamous cell oral cancers (Indian Journal of Cancer, 1997; 34:49-58)
• Cancer of the larynx (International Journal of Cancer, 1990;45:879-882)
• Cancer of the esophagus (International Journal of Cancer ,1991; 49:485-489)
• Lung cancer (Thorax, 1982; 37:343-347)
• High blood pressure (Journal of the Association of Physicians of India, 1995; 43:253-258)
• Coronary heart disease (Indian Heart Journal,1989; 41:62-65)
• Cancer of the stomach (Public Health2000;114:123–127)

• Beedi smoking increases the risk for oral cancer, lung cancer, stomach cancer, and esophageal cancer(Ref1,2,3,4).
• Beedi smoking is associated with a more than threefold increased risk for coronary heart disease and acute myocardial infarction (heart attack)(Ref1,5).
• Beedi smoking is associated with emphysema¹⁰ and a nearly fourfold increased risk for chronic bronchitis(Ref5).

The sweet-smelling smoke of beedis is dangerous–more dangerous than cigarettes. Each beedi cigarette is loaded with cancer-causing, chromosome-damaging, genetic poisons, far more than are found in a regular cigarette. The safe alternative” also contains two to three times the tar and nicotine of regular cigarettes. In a chilling experiment, smoke from regular cigarettes and beedis was given to Swiss albino mice. Beedi smoke reliably caused cancer in doses small enough that the regular cigarette smoke left the mice apparently healthy (Journal of Cancer Research and Clinical Oncology, 1988; 114:647-649).

Based on identical laboratory procedures used to determine nicotine content (in duplicate) and physical characteristics, it was found that the nicotine concentration in the tobacco of beedi cigarettes (21.2 mg/g) was significantly greater than the tobacco from the commercial filtered (16.3 mg/g) and unfiltered cigarettes (13.5 mg/g). Beedi cigarettes contain higher concentrations of nicotine than conventional cigarettes. Beedis also contain higher amounts of chemicals such as phenol, hydrogen cyanide, benzopyrenes, carbon monoxide, and ammonia.

1. Rahman M, Fukui T. Beedi Smoking and Health. Public Health 2000;114:123–7 [cited 2015 Nov 9].
2. Rahman M, Sakamoto J, Fukui T. Beedi Smoking and Oral Cancer: A Meta-Analysis. International Journal of Cancer 2003;106:600–4 [cited 2015 Nov 9].
3. Sankaranarayanan R, Duffy SW, Padmakumary G, Nair SM, Day NE, Padmanabhan TK. Risk Factors for Cancer of the Oesophagus in Kerala, India. International Journal of Cancer, 1991;49:485–9 [cited 2015 Nov 9].
4. Gupta PC, Asma S. Beedi Smoking and Public Health. [PDF–2.52 MB]New Delhi: Ministry of Health and Family Services, Government of India, 2008 [accessed 2015 Nov 9].
5. Pais P, Pogue J, Gerstein H, Zachariah E, Savitha D, Jayprakash S, Nayak, PR, Yusuf S. Risk Factors for Acute Myocardial Infarction in Indians: A Case-Control Study. Lancet 1996;348:358–63 [cited 2015 Nov 9].

Comparison of the nicotine content of tobacco used in beedis and conventional cigarettes

 Wallace Pickworth, PhD, NIDA, Intramural Research Program, Addiction Research Center, 5500 Nathan Shock Drive, Baltimore, MD 21224, USA

Abstract

OBJECTIVE To compare the nicotine content of 12 unfiltered brands of beedi cigarettes (hand rolled cigarettes imported from India) with 8 popular brands of filtered and unfiltered US and conventional cigarettes from India.

MAIN OUTCOME MEASURES Identical laboratory procedures were used to determine nicotine content (in duplicate) and physical characteristics.

RESULTS The nicotine concentration in the tobacco of beedi cigarettes (21.2 mg/g) was significantly greater than the tobacco from the commercial filtered (16.3 mg/g) and unfiltered cigarettes (13.5 mg/g).

CONCLUSIONS Beedi cigarettes contain higher concentrations of nicotine than conventional cigarettes. Therefore, it is logical to presume that beedi smokers are at risk of becoming nicotine dependent. These findings belie a popular belief among US teens that beedis are a safe alternative to commercial cigarettes.

A recent estimate of smoking initiation indicates that worldwide between 82 000 and 99 000 young people begin smoking each day.1In the USA, about 3000 teenagers begin smoking daily, nearly one million a year.2 Despite efforts aimed at decreasing teenage smoking, there has been an increase in smoking among that age group.3 Although many US teenage smokers prefer commercial cigarette brands such as Marlboro and Camels,4 others are attracted to alternative tobacco products such as beedis, cloves, and additive-free, natural tobacco cigarettes.5 6 In a national study, 2.4–5.0% of adolescents were using beedi cigarettes.5 A convenience sample from Boston indicates a higher prevalence with 16% of adolescents as current users.6 There is a notion among teenage smokers that alternative cigarettes have less health risks than conventional cigarettes.6

Beedis, an alternative type of cigarette, are manufactured in India and exported worldwide. Beedis consist of finely ground, sun dried tobacco rolled in a brown, tendu leaf. The leaf is from a broad leafed plant (Diospyrus melanoxylon orDiospyrus ebemum) native to India. Beedi cigarettes are similar in appearance to hand rolled marijuana cigarettes or joints. Most beedis are 60 mm in length, although some are 100 mm. Most beedis are unfiltered, although a few are filtered. Highly flavoured varieties of beedi cigarettes, including cherry, menthol, cinnamon, strawberry, vanilla, and raspberry, are widely available in retail outlets and on the internet. Flavour additives may partially account for the popularity of beedis among young consumers. Other explanations for beedi popularity among teens are that they are less expensive than commercially available cigarettes, they easily accessible, and they are trendy.6 7

Toxicological and epidemiological reports indicate that the smoke of beedis, like commercial cigarettes and cheroots, contains phenol, hydrogen cyanide, and benzo(a)pyrenes8 and total particulate matter, a measure directly related to the amount of carcinogenic material.9 Nair and colleagues identified carcinogenic tobacco specific nitrosamines from the smoke of beedis in concentrations similar to those of commercial cigarettes.10 Beedis also deliver considerable amounts of carbon monoxide. Blood carboxyhaemoglobin concentrations were raised in beedi smokers11 and the concentrations of carboxyhaemoglobin were correlated with self-assessed degree of smoke inhalation and number of beedis.12 Compared to the smoke of an unfiltered US cigarette, beedi smoke contained more carbon monoxide, ammonia, hydrogen cyanide, phenol, volatile phenols, benz(a)anthracene, and benzo(a)pyrene.13 14 These studies indicate that beedis are hazardous to health. Further, the delivery of nicotine in sufficient quantities initiates and sustains dependence,15which perpetuates the delivery of toxic components of smoke to the user.

Although some studies have been conducted to establish nicotine and tar levels of beedis on a standard smoking machine, the nicotine concentration of tobacco in beedis has not been examined.13Given the large variety of beedi cigarettes available, it is uncertain how applicable the results of previous studies are to the products currently available. In the present study, the nicotine content and other physical characteristics of 12 popular brands of unfiltered beedi cigarettes, three Indian and four US commercial filtered cigarettes, and a non-filtered additive-free” cigarette (American Spirit) were compared.

Methods

Commercial cigarettes and beedis (tables 1 and 2) were obtained from local retail outlets for the study. Tobacco weights of the cigarettes were based on an average of 10 cigarettes, while the tobacco weights of the beedis were based on an average of 20 beedis. For each brand of beedi cigarette, the tobacco was removed from the wrapping, weighed, and pooled for chemical analysis (in duplicate). Two samples were taken from the pooled resource and analysed. These results were averaged for an overall total.

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Table 1

Characteristics of beedi cigarettes

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Table 2

Characteristics of commercial cigarettes

The amount of nicotine was determined using a Hewlett Packard 6890 gas chromatograph equipped with an autosampler and a flame ionisation detector using methods described elsewhere.16 17 Briefly, a Hewlett Packard HP1 methyl silicon column (0.53 mm inner diameter, 0.88 μm film thickness, 30 m length) was used. The injector was set at 300°C, using a 1 μl pulsed splitless injection. The oven was set isothermally at 120°C and the detector was set at 250°C. Helium (7.6 ml/min) was used as the carrier gas. This method has a limit of detection of 350 pg and a limit of quantitation of 4.5 ng. Linearity was established from 3.3 μg/ml to 480 μg/ml, and the range was from 4.5 μg/ml to 435 μg/ml.

The gas chromatography samples were prepared by weighing 100 mg of tobacco and adding 10 ml of 1% potassium hydroxide (KOH) in methanol. The solutions were sonicated for eight hours, keeping the solution temperature below 45°C. After sonication, the samples were centrifuged for five minutes. The supernatant was then used for gas chromatography analysis. Nicotine standards were prepared in 1% KOH in methanol. A calibration curve was constructed using linear regression of peak area versus concentration of the standards. The amount of nicotine in the samples was calculated from the calibration curve. Concentrations of nicotine were statistically compared using the Student t test.

Results

As shown in table 1, the 12 brands of beedi cigarettes had an average weight of 506 mg per cigarette. The tobacco weight averaged 215 mg. The tendu leaf wrapping accounted for 51.2–65.5% of the total cigarette weight. This supports prior findings that the tendu leaf is responsible for, on average, 60% of the total weight of a beedi.14 The nicotine concentration of the tobacco from the beedi cigarettes averaged 21.2 mg/g compared to the tobacco from filtered and unfiltered commercial cigarettes (table 2) that averaged 16.3 mg/g and 13.5 mg/g, respectively. Statistical comparisons of the nicotine concentrations revealed that the beedis contained tobacco significantly more concentrated in nicotine than the filtered (t(15) = 2.59, p = 0.02) and the unfiltered (t(13) = 3.87, p = 0.002) cigarettes. The weight of commercial filtered and unfiltered commercial cigarettes averaged 940 mg and 917 mg, respectively. The tobacco content of commercial filtered and unfiltered commercial cigarettes averaged 739 mg and 861 mg, respectively. Commercial cigarettes in the present study contained similar concentrations and amounts of nicotine to those reported in other studies.18 The overall average nicotine concentration of beedis (21.2 mg/g) was larger than any of the commercial brands of cigarettes (filtered or unfiltered). However, Irie Menthol beedis had an average nicotine concentration (15.5 mg/g) that was lower than American Spirit and several filtered commercial brands.

Discussion

The beedis tested contained less tobacco than other cigarettes. However, their tobacco contains significantly higher concentrations of nicotine than the tobacco of commercial cigarettes. One measure of the addictive potential of tobacco products is the amount of nicotine available to the consumer. Benowitz and Henningfield have theorised that a minimum threshold level of nicotine delivery is necessary to initiate and sustain dependence.15 Although cigarette manufacturers describe their products as ultra lights,” lights” and full flavor” cigarettes, the nicotine content of the tobacco rods are similar.18 Cigarette smokers can titrate the amount of nicotine they obtain from a cigarette by changing their smoking behaviour.19 20 Smokers may titrate the amount of nicotine delivery from beedis just as they adjust the nicotine delivery from commercial cigarettes. However, preliminary results from a clinical study that measured plasma nicotine concentrations indicate that higher concentrations of nicotine were seen after smoking beedi cigarettes (Pickworth et al, 11th World Congress on Tobacco OR Health, abstract, 2000, unpublished data).

Beedi cigarettes are smoked differently than commercial cigarettes. For example, beedi cigarettes must be re-lit several times because they self-extinguish21 if they are not puffed at least two times a minute.14 The time to smoke and number of puffs were significantly greater while smoking a Sher beedi than commercial cigarette smoking in a clinical study (Malson and Stanton, Eastern Psychological Association, abstract, 2000, unpublished data). Finally, there is less air dilution through the tendu leaf than conventional cigarettes.7 Low combustibility forces a smoker to inhale more deeply resulting in greater delivery of carbon monoxide, nicotine, and other components of tobacco smoke.8 13 All of these factors may exaggerate the health risks associated with nicotine and other components of beedi smoke.

In addition to the well documented accounts of the toxic chemicals in beedi smoke, their delivery of nicotine poses a risk for the development of dependence. All smoked tobacco products have a potential abuse liability and the ability to initiate and sustain nicotine dependence.22 Even rapid delivery nicotine replacement products such as the gum and the nasal spray have a potential for abuse.23 The dependence potential of beedis is further evident in India where beedi smoking accounts for 40% of tobacco consumption.24

A recent study of urban US youth indicated that 40% had smoked beedis at least once and 16% were current users.6 There were no significant differences between race, ethnicity, and sex. Better taste” was the reason most often endorsed for preference of beedis over commercial cigarettes.6 Highly flavoured smokeless tobacco products tend to appeal to a youthful market.25The flavouring additives may mask the harshness of the concentrated nicotine in the beedis and may allow for deeper inhalation while smoking. Teens are drawn to beedi cigarettes because they are highly flavoured and marketed as alternative products. Furthermore, teens are also attracted to beedi cigarettes because they are trendy, cheaper, and easier to buy than commercial cigarettes.5 6

Our interest in this research was to examine the nicotine concentrations of tobacco of several (12) popular brands of beedis. Because of the inherent variability in the production of a hand rolled tobacco product, another study could be conducted to determine the tobacco content and nicotine concentration within a single brand of beedi cigarettes. Other studies are needed to demonstrate the effect of beedi smoking on plasma concentrations of nicotine, exhaled carbon monoxide, and other physiologic effects.

In summary, results show that the nicotine concentration of the tobacco of beedi cigarettes is higher than the concentration of nicotine in commercial cigarettes. As a result of the nicotine exposure, beedi smokers are at risk for tobacco dependence. These findings refute the notion among US teens that beedi smoking is a safe alternative to commercial cigarettes.

What this paper adds

Beedis are hand rolled cigarettes from India that are popular among US teenagers. Some adolescents believe beedis are healthy alternatives to conventional cigarettes. The nicotine content and delivery characteristics from beedis have not been published. These are important determinants of abuse liability.

The present study showed that the tobacco in beedi cigarettes has a higher concentration of nicotine than the tobacco in filtered and unfiltered commercial cigarettes. Like conventional cigarettes, beedi cigarettes have the potential to initiate and sustain tobacco dependence. This belies the notion of US teenagers that beedis are a safe alternative to cigarettes.

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