Tobacco-specific nitrosamines in smokeless tobacco products marketed in India

Irina Stepanov, Stephen S. Hecht, Sreevidya Ramakrishnan, Prakash C. Gupta

Research output: Contribution to journalArticlepeer-review

94 Scopus citations


Smokeless tobacco products are a known cause of oral cancer in India. Carcinogenic tobacco-specific nitrosamines in these products are believed to be at least partially responsible for cancer induction, but there have been no recent analyses of their amounts. We quantified levels of 4 tobacco-specific nitrosamines, N′-nitrosonornicotine (NNN), N′-nitrosoanatabine (NAT), N′-nitrosoanabasine (NAB) and 4-(methylnitrosamino)-1-(3-pyridyl)- 1-butanone (NNK), in 32 products marketed currently in India. Levels of nitrate, nitrite and nicotine were also determined. The highest levels of tobacco-specific nitrosamines were found in certain brands of khaini, zarda and other smokeless tobacco products. Concentrations of NNN and NNK in these products ranged from 1.74-76.9 and 0.08-28.4 μg/g, respectively. Levels of tobacco-specific nitrosamines in gutka were generally somewhat lower than in these products, but still considerably higher than nitrosamine levels in food. Tobacco-specific nitrosamines were rarely detected in supari, which does not contain tobacco, or in tooth powders. The results of our study demonstrate that exposure to substantial amounts of carcinogenic tobacco-specific nitrosamines through use of smokeless tobacco products remains a major problem in India.

Original languageEnglish (US)
Pages (from-to)16-19
Number of pages4
JournalInternational Journal of Cancer
Issue number1
StatePublished - Aug 10 2005


  • Gutka
  • Indian tobacco
  • Khaini
  • Mishri
  • Oral cancer
  • Tobacco-specific nitrosamines
  • Zarda


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