Ever since the ban on Pan masala, gutuka, Mawa, or Kharra was enforced in few states of India the debate started that a innocent bystander has been made a casualty against nations war against Tobacco. The common perception generated by Pan masala companies in their T.V commercials are pure exotic spices and herbs which only provide freshness, aroma and fragrance even the labels of packs does not disclose the harmful effects of ingredients added to generate addiction ,kick in their products. The brands available in the market fancy with various ingredients like Kesar, Elliachi which are consumed daily by millions of Indian as spice or flavoring agent. Brands which claim themselves to be free from Tobacco contain 2.26gm of Nicotine per 100 gm of Pan Masala. In fact a famous Pan masala brand tested by FSSAI contained high level of nicotine along with altered levels of pH to facilitate rapid absorption of nicotine in blood, delivering to the consumer required kick. The intention of these companies is clearly to make consumers addicted to their Pan masala who unknowingly fall into the trap of seemingly safe and convenient option then quid or cigarette. The prevalence of usage of for Pan masala and gutuka is on rise in younger generation which get easily influenced by the marketing ploy of these companies and later suffer from oral squamous fibrosis and oral cancers. The health hazards of Pan masala and gutuka are not limited to oral diseases alone but include high blood pressure, asthma, allergies, to birth defects in pregnant ladies. To understand the deleterious impact of Pan masala & gutuka on health we need to understand impact of the commonly found harmful ingredients in Panmasala
Use of tobacco in chewable form Gutuka or Pan masala accounts for most oral cancers. Not only this studies have shown that about 7 % to 27% of regular tobacco chewers have gum recession & bone loss around teeth. Tobacco can irritate or destroy the gum tissue. Chewing tobacco releases around 28 cancer causing chemicals in mouth known as carcinogens medically. The main carcinogen is Tobacco specific nitrosamines along with lesser known chemicals like formaldehyde, acetaldehyde, arsenic, benzopyrene, nickel , & cadmium. Although Nicotine is absorbed more slowly from chewing tobacco than from cigarettes, 3 to 4 times more nicotine is absorbed from chewing tobacco than from a cigarette, and the nicotine from chewing tobacco remains longer in the blood stream. Nicotine is the substance responsible for tobacco addiction.
The most notable cancers related to Tobacco chewing are - Cheeks, Gums, Lips, tongue, floor and roof of mouth.
Other health risks associated with chewing of Tobacco in Pan masala and Gutuka are Leukoplakia - it is a condition in which thick white patches form on the tongue and the lining of the cheeks of the mouth. This could lead to cancer if left unattended.
Gum diseases and gum recession (pulling away of the gum tissue from teeth) Teeth damage, decay, and loss.
Areca nut or Betel nut
The most abundant ingredient of Pan masala or Gutuka composed of tannins, alkaloids, fats, free fatty acids, polysaccharides, fibers and minerals. The most important of them are alkaloids which are arecoline, arecaidine, arecolidine, guavacine, and guvacoline. The arecoline present in areca nut give rise to N-nitrosamines which are potentially carcinogenic and can cause cancer of mouth, cheeks etc. Not only this arecoline effects central nervous system producing tremors in limbs. It generates the sense of wellbeing, euphoria and salivation.
(1) It aggravates existing medical conditions like neuronal injury, cardiac diseases, liver disorders, asthma, obesity, diabetes, and hyperlipidemia.
(2) It effects the endocrine system and leads to hypothyroidism, prostate hyperplasia and infertility.
(3) It seriously effects the pregnant women and leads to birth defect in fetus.
In study conduct on repeated application of slaked lime on hamster cheek it induced epithelial atypia. A similar study when repeated on rats lead to severe epithelial hyperplasia in all the tissues.It is added in Panmasala, Gutuka and Paan to aid quick absorption of Nicotine as it increases the pH of mouth. It causes burning sensation in mouth on taking warm or slightly spicy food.