Khalid Mahmood, Iftikhar Haider Naqvi, Gulrayz Ahmed, Aamer Mahmood, Noor Baig, Masooma Jumma.
Snuffed tobacco mightier than smoked tobacco: frequency determination of upper and lower respiratory tract diseases.
Pak J Chest Med Jan ;21(2):54-60.

Objective: To assess the frequency of upper and lower respiratory tract diseases in people addicted to snuffed tobacco. Methods: A retrospective cross sectional study conducted from patient data, who presented at the outpatient departments at Civil Hospital, Karachi and Ankleseria Hospital, Karachi for a period of 6 months from January 2014 to June 2014. A total of 131 patients were screened who were using snuff tobacco for variable period of time and presented with a series of signs and symptoms. 70 patients were included in the study, after meeting the eligibility criteria. A detailed history, physical examination, ENT examination and baselines investigations were recovered from patient record. Data was entered and frequencies were calculated. Results: Out of 70 patients, 41 (58.5%) were males while 29 (41.5%) were females. 63 (90%) of the patients presented with cough, 52 (74.3%) with productive cough, 20 (28.5%) with dyspnoea, 11 (15.7%) with fever, 3 (4.3 %) with bleeding from nose and mouth, 8 (11 .4%) with facial pain and 4 (5.7%) with weight loss. On the basis of history, examination and investigations, 31(44.3%) of the patients were diagnosed as COPD, 10 (14.3%) as pharyngitis, 12 (17.1%) as sinusitis, 7 (10%) as nasal polyps or nasal ulcers, 06 (8.5 %) as pneumonia. 2 patients (2.85%) were diagnosed as lung cancer and 2 patients (2.85%) were diagnosed as nasopharyngeal carcinoma. Conclusion: Snuffed tobacco can cause diseases of upper & lower respiratory tract and can also lead to more grievous pathologies like lung cancer and nasopharyngeal carcinoma.

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