Effect of snuff on nasal mucosa

Am J Otolaryngol. May-Jun 2005;26(3):151-6. doi: 10.1016/j.amjoto.2004.11.008.


Purpose: The inhalation of nasal snuff (powdered tobacco) is a common addiction in the Indian subcontinent. In the western world, there is a resurgence of interest in nasal snuff because it does have the morbidity associated with smoked tobacco. Very few studies have reported the long-term effects of snuff on nasal mucosa. The objective of the present study was to investigate the effect of long-term use of snuff on the nasal mucosa.

Materials and methods: We conducted a retrospective study on 29 snuff users. We investigated the reasons for initiation of this particular form of addiction along with the clinical signs and symptoms of long-term snuff usage. At the time of the study, all patients complained of one or more nasal symptoms. Nasal obstruction and nasal discharge taken together were reported by 62.5% of patients. Gross mucosal edema of the septum and turbinates was the main finding on nasal examination. The absolute eosinophil count and total serum immunoglobulin E were elevated in 62.5% and 66.7% of patients, respectively. On skin prick test, 41% of patients reacted positively to snuff and 25% to tobacco. Histopathologic examination of the turbinates (16 patients) showed squamous metaplasia, capillary proliferation, capillary and venous dilatation, inflammatory cell reaction, subepithelial edema, and fibrosis.

Conclusions: Much has been written about the advantages of nasal snuff over products that deliver tobacco smoke. Our study shows that snuff users, after long-term abuse, develop a form of chronic rhinitis, as a consequence of which they develop blocked and stuffy noses. We conclude that nasal snuff is not a suitable substitute for smoked tobacco because it does not avoid ill health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chronic Disease
  • Cotinine / blood
  • Humans
  • Middle Aged
  • Nasal Mucosa / diagnostic imaging
  • Nasal Mucosa / drug effects*
  • Nasal Mucosa / pathology
  • Retrospective Studies
  • Rhinitis / etiology
  • Rhinitis / pathology
  • Tobacco, Smokeless / pharmacology*
  • Tomography, X-Ray Computed
  • Turbinates / diagnostic imaging
  • Turbinates / pathology


  • Cotinine