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Smokeless tobacco use among ethnic minorities: A review

The use of smokeless tobacco by members of the UK South East Asian community is a major risk factor for oral cancer and periodontitis. In this article, Graham Cope and Leena Sankla describe the different forms of smokeless tobacco, how if affects the oral cavity and what dental nurses should do to p

Smokeless tobacco (ST) is any tobacco product that is placed in the mouth or nose and not burned. The types of ST products used in the UK often contain a mix of ingredients including areca (betel) nut, slaked lime, spices, flavourings and sweeteners. The areca nut is the fruit of the areca catechu tree and contains arecedaine, a hydrolyzed derivative of the alkaloid arecoline. This stimulates the central nervous system, giving a sensation of alertness, wellbeing and dizziness (Javed et al, 2010). Areca is included in a number of smokeless products, such as gutkha (or zarda), pan masala (or betel quid or paan), naswar and dry snuff (see Table 1 and Figure 1).

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