A review on harmful effects of pan masala.

Pan masala (PM) is a mixture of areca nut with slaked lime, catechu and other flavoring agents. It is widely available and used by all the sections of the Indian society. It is genotoxic as it increases sister chromatin exchange and chromatin aberrations. Among humans, it is a leading cause of oral submucous fibrosis that often progresses to oral cancer. Among experimental animals, it leads to neoplastic lesions in lung, liver and stomach. It is hepatotoxic leading to increased level of enzymes, deranged carbohydrate and lipid metabolism. It is harmful to kidneys and testes leading to increased creatinine and sperm deformities respectively. PM is a very harmful substance affecting almost all organ systems, and there is immediate need for a national policy on complete ban on the production, storage, sale and marketing of PM.

Compliance to Gutka ban and other provisons of COTPA in Mumbai.

BACKGROUND: Cigarettes and other tobacco products act 2003 (COTPA) is the principal law governing tobacco control in India. Government of Maharashtra in one of its landmark decisions also banned manufacturing, sale and distribution of gutka and pan masala since July 2012. The desired impact and level of enforcement of the COTPA legislation and the gutka and pan masala ban in Maharashtra State, however, needs assessment. Among the many provisions within COTPA, the present study seeks to assess compliance to implementation and enforcement of Section 5 and 6 of COTPA including compliance to gutka and pan masala ban in Mumbai, India. METHODOLOGY: Six educational institutes (EI) within the Mumbai metropolitan region were selected in a two stage random sampling process. Area around each EI was manually mapped and all the tobacco products selling outlets with in the 100 yards distance were listed by trained Field Social Investigators and were observed to determine compliance for Section 5 and Section 6 of the COTPA legislation and for gutka and pan masala ban. The vendors/shop owners manning these outlets were also interviewed for their personal sociodemographic details, self‑tobacco use, awareness and perception about ill‑effects of tobacco and existing tobacco control legislation in the country. RESULTS: A total of 222 tobacco retail outlets were listed within 100 yards of the EI in violation to the provisions of Section 6 of COTPA, of which 72 (32.4%) were selling tobacco products on mobile structures. About 53.2% of the tobacco vendors were also users of some form of tobacco. Whereas, nearly 217 (97.7%) vendors were aware about the gutka and pan masala ban in the State, only 48.2% were aware about the existence of COTPA legislation. None of the EI had a display board prohibiting the sale of tobacco products within a radius of 100 yards of their EI. Only 56.3% tobacco outlets had complied with the mandatory warning display boards indicating tobacco products will not be sold to people below 18 years of age. With regards to point of sale advertisement only 25.2% compliance was noted for display of health warning boards at the point of sale. Nearly 48.6% tobacco outlets exhibited >2 display boards and another 43.2% exhibited hoardings with brand pack photo, brand name in violation to the provision under Section 5. Violation by visible stacking and open display of tobacco products for sale was observed at 51.3% of tobacco outlets. While 41% of tobacco outlets were found displaying gutka and pan masala packets in violation to the ban. CONCLUSIONS: Enacting of the law without robust measures for enforcement has led to widespread noncompliance to the provisions with in the tobacco control legislation in the metropolitan city of Mumbai. Strong and sustainable measures needs to be incorporated both by civic administration and public health departments for its forceful implementation.

Impact of 'gutkha and pan masala ban' in the state of Maharashtra on users and vendors.

BACKGROUND: Gutkha and pan masala contain harmful and carcinogenic chemicals. Hence, Maharashtra Government banned their manufacture, storage, distribution and sale on 19th July 2012 for a year. OBJECTIVES: The objective of this study is to determine the impact of the ban on gutkha and pan masala on its users and vendors. MATERIALS AND METHODS: A cross‑ sectional study was conducted among gutkha and/or pan masala users and tobacco vendors in the selected area of Mumbai city, 4‑6 months after the implementation of the ban. The parameters studied included knowledge regarding the ban, usage or discontinuation of use of the banned products, product availability, withdrawal symptoms among quitters, etc., RESULTS: A total of 68 users and five tobacco vendors were enrolled in this study. Although all users were aware about the ban on gutkha, very few knew about the ban on pan masala. Only 5.9% of users knew that currently the ban had been declared for only 1 year. Electronic media was the main source of information regarding the ban as reported by 45.6% users. All users and vendors were in favor of the ban. After the ban, 23.53% gutkha users quit their habit while 55.88% reduced their gutkha consumption. Non‑availability of gutkha was the most important reason stated by the gutkha users for quitting or reducing the consumption. In spite of the ban, gutkha is still available in the market, but at an increased cost or in a different form. CONCLUSION: Nearly 23.53% of gutkha users have quit their habit post‑ban despite its availability through illegal sources.

Histological and ultrastructural studies on the toxic effect of pan masala and its amelioration by Elettaria cardamomum / 中国天然药物

AIM@#To investigate the histological and ultrastructural changes observed in pan masala intoxicated mammalian testes under the effect of cardamom.@*METHODS@#Male Swiss mice were given pan masala orally at a dose of 2% of the feed and cardamom at a dose of 0.2% of the feed. They were divided into three groups, control (Group I), pan masala-treated (Group II), and a combination of pan masala and cardamom-treated group (Group III). Histologically, the testes of Group II mice displayed degeneration of tubular epithelium, disruption of spermatogenesis, and a marked reduction in germ cells.@*RESULTS@#When cardamom was given, damage was less with fewer distorted cells and also improvement with normal tubules and spermatid differentiation in Group III. Ultrastructurally, pan masala-treated testes showed cytoplasmic vacuolation, shrinkage and pyknotic nuclei of spermatogonia, and abnormal acrosomal granules.@*CONCLUSION@#When cardamom was given, the amelioration process was more evident showing a comparable morphology with control.

Local responses to the Maharashtra gutka and pan masala ban: A report from Mumbai.

Background: The Maharashtra government has banned the production, sale, distribution and storage of gutka, and pan masala in the Maharashtra State due to the increasing burden of cancer and reproductive health problems attributable to the use of these products. In view of this, it is important to understand the way producers', sellers' and users' are adapting to the ban. Objective: During the two months following the ban (July 19 th through Sept 30, 2012), a research team studying smokeless tobacco use and promotion in a low income community of Mumbai conducted rapid surveillance to assess the impact of the ban in the study community. Materials and Methods: Assessment involved documenting new points of sale, informal observations of tobacco use, and interviews with thirteen shop owners and eight gutka users'. Overall changes in accessibility, availability, patterns of use of tobacco products, perception of ban, social norms and surveillance activities were assessed. Results: Tobacco companies were marketing new products that resembled gutka, under similar brand logos. Surveillance, financial and social cost of selling gutka or using it in public have had an immediate effect on reducing local supply, demand and use and increasing stigma associated with its use. There was an increased recognition of ill-effects of gutka on cancer among sellers' but not overall. Conclusions : To reduce the overall consumption of tobacco in the community, it is critical to include programs that create awareness about effects of smokeless tobacco on health and sustain surveillance levels. This would maintain requirements of the ban, and sustain limits on accessibility, availability and use of these products in the community and other similar communities.

Effects of Indian Pan Masala (Plain and Blended - PMP & PMT) on testis after long term feeding (PO) in mice.

Pan masala plain (PMP) with or without tobacco (PMT) cause testis impairment. Three sets of mice (n = 60), 2% PMP and PMT diet were fed for12 & 13 months. Further six sets of mice in two groups plus control (n=20) received by oral feeding (PO) a commercial brand PM (at doses of 8, 40 and 100 mg/kg b.w. in olive 0il by oral administration as a single dose) and zarda (PMT) too was given same doses and the controls were kept at staple diet only and by oral administration 0.5 ml vehicle for a period of 3 months. The animals were sacrificed (n=10) after 2 weeks and 3 months to study graded dose effects of PM plain and blend on sperm abnormalities. The plain and zarda group showed graded dose related elevated sperm abnormalities compared to control. The damages were high with 100 mg zarda group after 3 months period. The plain and Zarda group when compared, dose-duration wise, at each dose level, and in between two test groups, showed significant structural and functional changes of sperm head and mutilations. The sperm head anomalies were maximum in 12 and 13 months PMP and zarda fed groups in terms of morphology and other abnormalities. The damage is more in 13 months fed mice (p<0.01) and 12 months fed mice (p<0.05) when compared to the control group. Both the groups of PM, showed different types of sperm head abnormalities i.e., banana, beak, hammer shaped, amorphous etc. Testis of 12 and 13 months PMP and PMT groups were processed for histopathology. It was found that PMP and PMT inducts no effects after 2 weeks exposure, whereas caused liver tumor after 56 weeks exposure. PMP and PMT in comparison, and both significantly effect mouse testis showing degenerative changes in seminiferous tubules and interstitial tissue being more prominently effected in PMT group. .