title: Effects of smokeless tobacco (Maras powder) use on carotid intima media thickness.
abstract: BACKGROUND
  The aim of this study was to investigate the effects of smokeless tobacco (Maras powder, Nicotiana rustica Linn) on carotid intima media thickness.
  
  
  METHODS
  The study included 32 Maras powder users presenting to our Family Medicine outpatient clinic and 30 non-users of Maras powder as a control group. Carotid intima media thickness was measured by duplex ultrasonography.
  
  
  RESULTS
  The mean age of the Maras powder users was 45.4±11.3 years and the mean age of the control group was 46.3+11.6 years. All the participants were male. The mean duration of Maras powder use was 27.3±11.6 years. Carotid intima media thickness was 0.73±0.20 mm in the Maras powder users and 0.49±0.14 mm in the controls. It was significantly higher in the Maras powder users (p<0.001). Blood pressure measured before Maras powder use in Maras powder users was similar to that measured in the control group (p>0.05). Systolic blood pressure and diastolic blood pressure values were also similar between MP users before using Maras powder and controls (p>0.05). Systolic blood pressures were 136.6±12.4 mmHg and 109.7±9.7 mmHg after 30-60 minutes using Maras powder in the Maras powder users and in the controls, respectively. Diastolic blood pressures were 87.2±6.1 mmHg and 62.8±8.1 mmHg after 30-60 minutes using Maras powder in the Maras powder users and the controls, respectively. Both systolic and diastolic blood pressures after 30-60 minutes using Maras powder were significantly higher in the Maras powder users (p<0.001). Carotid intima media thickness was significantly correlated with systolic blood pressure (r=0.613, p<0.001) and diastolic blood pressure (r=0.612, p<0.001).
  
  
  CONCLUSIONS
  Carotid intima media thickness was higher in Maras powder users than in nonusers of the powder. Increased carotid intima media thickness can be associated with an immediate increase in systolic and diastolic blood pressures. Therefore, attempts to increase public awareness about smoking should also be directed towards prevention of Maras powder use.
authors.affiliation: Department of Family Medicine, Kahramanmaras Sutcuimam University, Medical Faculty, Kahramanmaras, Turkey.
authors.forename: Mustafa Haki
authors.initials: MH
authors.lastname: Sucakli
authors.forename: Fuat
authors.initials: F
authors.lastname: Ozkan
authors.forename: Mehmet Fatih
authors.initials: MF
authors.lastname: Inci
authors.forename: Mustafa
authors.initials: M
authors.lastname: Celik
authors.forename: Hamit Sirri
authors.initials: HS
authors.lastname: Keten
authors.forename: Orhan
authors.initials: O
authors.lastname: Bozoglan
mesh_terms: D001794:Blood Pressure / Q000187:drug effects; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000187:drug effects*; D059168:Carotid Intima-Media Thickness / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D006801:Humans; D008297:Male; D018709:Statistics, Nonparametric; D014030:Tobacco, Smokeless / Q000009:adverse effects*; D014421:Turkey