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Levels of toxins in oral tobacco products in the UK
  1. A McNeill1,
  2. R Bedi2,
  3. S Islam2,
  4. M N Alkhatib2,
  5. R West1
  1. 1Department of Epidemiology and Public Health, University College London, London, UK
  2. 2Department of Dental Public Health, King’s College London, London, UK
  1. Correspondence to:
 Professor Raman Bedi
 Department of Dental Public Health, King’s College London, Floor 2, Caldecot Road, Denmark Hill, Campus, London SE5 9RW, UK; r.bedi{at}


Objective: This study examined the constituents of smokeless tobacco products available in the UK and compared them with products available in India, Sweden, and the USA

Methods: Seven UK brands of smokeless tobacco, including a tooth cleaning powder, and four international brands of smokeless tobacco were tested for a range of toxins and known carcinogens, such as tobacco specific N-nitrosamines (TSNA), as well as nicotine availability.

Results: Ten of the 11 brands tested had detectable levels of tobacco specific nitrosamines, which are proven carcinogens, and levels varied 130-fold. All had detectable levels of benzo(a)pyrene, another proven carcinogen (with around 175-fold variation) and several toxic metals (with nearly 150-fold variation). Nicotine availability varied in the UK products from 0.1 mg/g to 63.2 mg/g. All the tobacco products tested are likely to be hazardous to users’ health, but the data indicate that it should be possible to reduce key toxins to non-detectable levels.

Conclusions: Smokeless tobacco products should be regulated and standards set for maximum levels of toxins and carcinogens.

  • BaP, benz(a) pyrene
  • NAB, N-nitrosoanabasine
  • NAT, N-nitrosoanatabine
  • NDMA, N-nitrosodimethylamine
  • NNK, 4(methylnitrosamino)-1-(3-pyridyl)–butanone
  • NNN, N-nitrosonornicotine
  • TSNA, tobacco specific nitrosamine
  • smokeless tobacco
  • tobacco toxins
  • transcultural tobacco products
  • toxin standards

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  • Funding for this work was provided by a grant from the Department of Health. Staff at the Department of Health (RB and initially also SI) who funded this work participated in the study design, data interpretation, report writing and in the decision to submit the paper for publication.

  • Competing interests: The authors have no competing interests to declare.