title: Analysis of Tobacco-Specific Nitrosamines in the Common Smokeless Tobacco Afzal in Oman.
abstract: OBJECTIVE
  There is a lack of awareness regarding the carcinogenicity of Afzal, an illegal smokeless tobacco product (STP) widely used among the Omani youth. Previous research has shown that certain types of tobacco-specific nitrosamines (TSNAs) are associated with oral and lung cancers. This study therefore aimed to assess levels of four common TSNAs in a randomly selected sample of Afzal.
  
  
  METHODS
  This study was carried out at Sultan Qaboos University in Muscat, Oman, between April and September 2013. A random sample of Afzal was analysed for four types of TSNAs using high-performance liquid chromatography-tandem mass spectrometry. The four types of TSNAs analysed were 4-(N-nitrosomethylamino)-1-(3-pyridyl)-1-butanone (NNK), N-nitrosonornicotine (NNN), N-nitrosoanatabine (NAT) and N-nitrosoanabasine (NAB). As a reference product, a sample of laboratory-manufactured American moist snuff (Centers for Disease Control and Prevention, Atlanta, Georgia, USA) was also used to confirm the accuracy and precision of the analysis.
  
  
  RESULTS
  The analysis revealed total TSNA levels of 3.573 μg/g in the Afzal sample. Mean levels of NNN, NNK, NAT and NAB were 1.205, 1.015, 0.809 and 0.545 μg/g, respectively.
  
  
  CONCLUSIONS
  Levels of the two most abundant TSNAs (NNN and NNK) found in the Afzal sample exceeded international regulatory limits. Afzal users therefore need to be educated regarding the potential health risks associated with their STP use. Stricter implementation of current legislation is recommended to reduce the availability and usage of Afzal in Oman.
authors.affiliation: Department of Biology, College of Science, Sultan Qaboos University, Muscat, Oman.
authors.forename: Nawal
authors.initials: N
authors.lastname: Al-Mukhaini
authors.affiliation: Department of Biology, College of Science, Sultan Qaboos University, Muscat, Oman.
authors.forename: Taher
authors.initials: T
authors.lastname: Ba-Omar
authors.affiliation: Department of Biology, College of Science, Sultan Qaboos University, Muscat, Oman.
authors.forename: Elsadig A
authors.initials: EA
authors.lastname: Eltayeb
authors.affiliation: Department of Biology, College of Science, Sultan Qaboos University, Muscat, Oman.
authors.forename: Aisha A
authors.initials: AA
authors.lastname: Al-Shehi
keywords: Carcinogenesis; Liquid Chromatography; Nitrosamines; Oman; Smokeless Tobaccos; Tandem Mass Spectrometry