SMOKELESS TOBACCO USERS SHOW DECREASED LUNG FUNCTION WITH A HIGH NEUTROPHIL TO LYMPHOCYTE RATIO – A CROSS-SECTIONAL STUDY

Abstract

Background: Smokeless tobacco products are highly addictive and contain over 4,000 chemical compounds with 30 known carcinogens. These products are known to be strongly linked with various systemic and localized health conditions. Smokeless tobacco users' pulmonary function hasn't been thoroughly documented yet. The purpose of the study was to assess the lung function tests associated with inflammatory markers among smokeless tobacco users.

Material and methods: 80 subjects were recruited, 40 from the smokeless tobacco user group and 40 from the control group with no tobacco use. Nicotine dependence was assessed using the Fagerstrom Nicotine Dependence scale (FTND-ST). Lung function tests, White blood cell counts, neutrophil lymphocyte ratio (NLR), and high-sensitivity C-reactive protein (hs-CRP) levels were measured in all participants.

Results: Lung function parameters, which include FVC, FEV1, FEV1/FVC%, PEFR, and FEF 25–75% were significantly reduced in smokeless tobacco users. Smokeless tobacco users had significantly higher levels of inflammatory markers, including WBC, NLR, and hs-CRP, than controls. Further, NLR levels were elevated in the significant nicotine-dependent group derived from FTND-ST compared to users with low and moderate dependence. However, no correlation was found between the inflammatory markers and pulmonary function test results.

Conclusion:This study concluded that smokeless tobacco use can cause lung function deterioration with an increase in inflammatory markers.