Effect of vitamin C supplementation on autonomic function tests in smokeless tobacco chewers

Abstract

According to World Health Organization (WHO) report, tobacco is the single greatest cause of preventable death all over the world. Use of Smokeless Tobacco (ST) increases level of nicotine and autonomic effects throughout the day that are similar to smoking. Aim of the present study was to evaluate the effect of ST on valsalva ratio, Sustained Handgrip test (SHG), serum Cotinine (CTN) level and serum Vitamin C (VC) in ST chewers. Total 338 participants aged between 31 to 60 years were divided in two groups, ST chewers and ST non chewers (controls). ST chewers were further classified with respect to Smokeless Tobacco Chewing (STC) duration (years), frequency (times/day) and quantity (/day). Participants were asked to consume 1000 mg of vitamin C for 45 days. Valsalva ratio, SHG, serum CTN and serum VC levels were measured at the baseline study and after supplementation of VC. Valsalva ratio (p= 0.006), DBP rise in SHG (p=0.002) and serum VC (p<0.001) levels were significantly decreased however, serum CTN (p<0.001) level was significantly increased in ST chewers as compared to controls. VC supplementation did not show any significant change in valsalva ratio and SHG however, serum CTN (p<0.001) level was significantly decreased and serum VC (p<0.001) level was significantly increased in ST chewers as compared to baseline values. Increased STC duration, frequency and quantity did not show any significant change in valsalva ratio and DBP rise in SHG in ST chewers. The use of ST is associated with decreased sympathetic activity and serum VC level as well as increased serum CTN level in tobacco chewers as compared to controls.