Objective: A different kind of smokeless tobacco known as Maras powder has a widespread usage in the southern and southeastern regions of Turkey, particularly the cities of Kahramanmaras, Gaziantep, and Adıyaman. It is made of a tobacco species called Nicotiana rustica L. and wood ash. Sun-dried leaves of the Nicotiana rustica plant are powdered and mixed with the ash in a proportion of 1:2 or 1:3. The nicotine content of N. rustica is 6–10 times higher than that of N. tabacum L., and by encasing it in the mandibular or labial groove of the mouth that has many capillary vessels, nicotine is quickly absorbed into the circulation. Oral tobacco use effects blood nicotine levels that are 15 times higher than those seen in cigarette smoking. The aim of this study was to characterize the usage of Maras powder among a nonclinical male group.
Methods: The study group consisted of 50 males aged between 26 and 48 years. A socio-demographic form and a questionnaire (these forms consisted of questions that were prepared by the authors to obtain information about the demographic characteristics of the participants and to identify some characteristics of usage), the Addiction Profile Index (BAPI-T) and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders–4th Edition were given to the participants. SPSS software was used for the descriptive statistical analysis. The values were presented as mean±SD and as percentages; p values <0.05 were considered to be statistically significant.
Results: The mean age of the participants was 36.0±8.07 years and the mean usage time of Maras powder was 8.6±2.71. All participants came from a low socioeconomic level. The underlying reasons for Maras Powder usage are “relaxing” (100%), “influence of friends” (26%), “usage convenience” (50%) and “quit smoking” (76%). API is reviewed as a valid and reliable questionnaire and is used as a severity scale including different components of dependency. It is composed of a checklist of variable substances and craving, motivation, and total score subscales. There was no other substance use determined except for cigarette. Seven subjects in the study group were using both Maras powder and smoking cigarette. There was no statistical significance between the duration of Maras powder usage and cigarette smoking. The total score of API was 4.7±1.56 and 50% of the participants were assessed in high risk group
Conclusion: Recent studies have only assessed smoking but have not included other forms of tobacco use and have furthermore not documented the degree of nicotine dependence in smokeless forms. Because of the misconception that Maras powder is less detrimental to health than the other nicotine forms, and as a consequence of this study showing high dependency of this substance, we suggest that we have to focus on tobacco use rather than limiting our attention only to cigarette smoking.