Emilie Meyer
Pan masala is a chewable intraoral product popular across South Asia, often used as a mouth freshener. It is a mixture of components such as areca nut, slaked lime, catechu, flavouring agents, and sweetening ingredients. While most pan masala products do not contain tobacco, some varieties do. In 2019, nicotine was found in seven pan masala brands in India, leading to their ban. The inclusion of tobacco in pan masala makes it addictive, and its regular use can bring about major health problems such as oral cancers, gum disease, and other serious conditions.
| Characteristics | Values |
|---|---|
| Does pan masala contain tobacco? | Some pan masala varieties contain tobacco, but most don't. |
| What is pan masala? | It is a preparation that includes a mixture of components such as areca nut, slaked lime, catechu, flavouring agents, and sweetening ingredients. |
| Is pan masala harmful? | Even though most pan masala varieties don't contain tobacco, they are not harmless. The inclusion of tobacco in pan masala makes it addictive, and its regular use can bring about major health problems such as oral cancers, gum disease, and other serious conditions. |
| What are the side effects of tobacco-free pan masala? | Tooth decay, gum diseases, oral cuts and ulcers, oral cancer, esophageal and gastrointestinal cancers, increased heart rate and blood pressure. |
| What are the side effects of pan masala with tobacco? | Oral cancers, gum disease, and other serious conditions. |
| Is pan masala banned? | In 2019, the Delhi government extended the ban for one more year on Pan Masala, Flavoured/Scented Tobacco, Kharra and similar products containing tobacco. |
| Has nicotine been found in pan masala brands? | Yes, nicotine has been found in some pan masala brands. |
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What You'll Learn
Pan masala is promoted as a mouth freshener
Pan masala is a famous chewable intraoral product in South Asia, promoted as a mouth freshener due to its refreshing and invigorating properties. It is a preparation that includes a mixture of components such as areca nut, slaked lime, catechu, flavouring agents, and sweetening ingredients. While most varieties of pan masala do not contain tobacco, some do. This has created a common misconception that non-tobacco pan masala is harmless. However, studies have shown that the odds of developing oral precancer in non-tobacco pan masala users was 20.71, with a high risk of it progressing to oral cancer.
The inclusion of tobacco in pan masala makes it addictive, and its regular use can bring about major health problems such as oral cancers, gum disease, and other serious conditions. Even without tobacco, pan masala can be highly dangerous to the body if consumed excessively. The areca nut in pan masala has the potential to cause a chronic, progressive condition characterised by stiffening of the oral mucosa, which significantly reduces mouth opening and causes eating, speaking, and hygiene problems. This condition is known as oral submucous fibrosis (OSMF) and is a precursor to oral cancer.
Tooth decay and gum disease are also common side effects of consuming pan masala due to the sweeteners present in it. If taken regularly, these sweeteners erode tooth enamel, increasing the susceptibility to cavities and periodontal diseases. Oral cuts and ulcers can also occur due to the abrasive ingredients in pan masala, which have chemical characteristics that cause oral lesions.
In India, pan masala and gutkha are popular products that are typically consumed throughout the day. Aggressive advertising and convenient packaging have contributed to the growth of the Indian pan masala market, which is expected to reach US$10,365 million by 2026. However, the sale, manufacture, distribution, and storage of gutka and its variants have been banned in many states and union territories due to health concerns. Despite this, gutka manufacturers have found ways to circumvent these bans, such as by separating the components like tobacco and selling them in separate pouches.
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Some pan masala varieties contain tobacco
Pan masala is a popular chewable intraoral product in South Asia, often promoted as a mouth freshener due to its refreshing properties. While some pan masala varieties contain tobacco, most do not. This has created a misconception that non-tobacco pan masala is harmless. However, the inclusion of tobacco in pan masala makes it more addictive, and its regular use can lead to serious health issues.
In 2019, nicotine was found in seven pan masala brands in India, including Rajnigandha, Supreme, Kamla Pasand, Rajshree, Rounak, Signature, and Madhu. The presence of nicotine in these products is concerning, as it poses health risks and contradicts the standards set by the Food Safety and Standards Authority of India (FSSAI), which specifies that pan masala should not contain nicotine or magnesium carbonate.
The state government of Bihar banned the sale, distribution, and production of nicotine-containing products in 2012. Despite this, some pan masala brands continued to add toxic chemicals, including nicotine, to their products. The discovery of nicotine in these brands has led to plans for legal action against the companies involved.
The addition of tobacco to pan masala has been a concern for health authorities. Tobacco manufacturers and policymakers often seek evidence of the carcinogenicity of new tobacco mixtures. Studies have indicated that pan masala containing tobacco (PM-T) is likely to be carcinogenic. The interpretation of PM-T's carcinogenicity is based on research on PM-T itself, similar mixtures, and the individual ingredients and their combined effects.
While the inclusion of tobacco in pan masala is a significant concern, it is important to note that even without tobacco, pan masala can have adverse health effects. The areca nut, a common ingredient in pan masala, is a major risk factor for oral cancer and has been linked to esophageal and gastrointestinal cancers. Excessive consumption of pan masala can lead to tooth decay and gum disease due to the sweeteners used. Therefore, it is important to understand the risks associated with pan masala, regardless of whether it contains tobacco or not.
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Pan masala is linked to oral cancers and gum disease
Pan masala is a mixture of dried betel nut, slaked lime, catechu, and several condiments or spices, according to taste, wrapped in a betel leaf. It is important to note that tobacco is not a typical ingredient in pan masala, though it may be consumed alongside it.
Pan masala has been strongly linked to oral cancers and gum disease. In a cross-sectional survey of 0.45 million people in North India, the odds of developing oral precancer in non-tobacco pan masala users was 20.71, compared to 88.07 for tobacco users. This indicates a high risk of oral precancer even when pan masala is consumed without tobacco. The study also found that pan masala chewers developed oral submucous fibrosis (SMF) in half the time as betel quid or areca nut chewers.
Another study found that 75% of oral cancer patients had risk habits, with 59% being chewers of betel quid and its substitutes, including gutkha and pan masala. The use of tobacco with lime, betel quid with tobacco, betel quid without tobacco, and areca nut have all been classified as carcinogenic to humans. As pan masala contains several of these ingredients, it is likely to contribute to oral cancer as well.
In addition to oral cancer, the use of pan masala has also been associated with gum disease. For example, jarda, a type of lime-flavoured tobacco that is sometimes mixed with pan masala, has been linked to serious gingival ulceration. Overall, the consumption of pan masala, especially when combined with tobacco, poses significant risks to oral health and has been implicated in a range of negative health outcomes.
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Pan masala was banned in Delhi in 2012
In September 2012, the State of Delhi banned the manufacture, storage, distribution, and sale of gutka and pan masala containing tobacco and/or nicotine. This ban was upheld by the Delhi High Court in April 2023.
The ban was issued by the Delhi government's Department of Food Safety and was in pursuance of a series of directions from the Supreme Court to ban 'gutkha' in the city. However, tobacco retailers started selling the components of 'gutkha' (betel nut and raw tobacco) in separate pouches, thus defeating the purpose of the ban.
Gutka is a highly addictive and harmful product that has been linked to oral cancer, oral submucous fibrosis, cardiovascular disease, and asthma. It is a mixture of sun-dried, roasted, finely chopped tobacco, areca nut, slaked lime, and catechu mixed with several other ingredients such as flavouring agents and sweeteners.
Pan masala, on the other hand, does not normally contain tobacco. It is all the things added to a pan that has been dehydrated. However, laboratory tests conducted by the Food and Drug Administration found magnesium carbonate in pan masala, which led to the State of Maharashtra banning it in July 2012.
The ban in Delhi was initially set for a period of one year, but it has since been extended. In 2019, the Delhi government extended the ban for another year on gutka, pan masala, flavoured/scented tobacco, kharra, and similar products containing tobacco.
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Smokeless tobacco contributes to 650,000 deaths each year
Smokeless tobacco products, such as gutka, contribute to a staggering 650,000 deaths annually worldwide, with a significant proportion occurring in Southeast Asia. This figure underscores the devastating impact of smokeless tobacco on global health.
Gutka, a smokeless tobacco product popular in India, has faced bans in multiple states and union territories as of 2013. The ban encompasses the sale, manufacture, distribution, and storage of gutka and its variants. Enforcement varies, with stricter implementation in regions like Mumbai and Delhi. Despite this, the illegal sale of gutka persists, and manufacturers have found ways to circumvent the restrictions.
Pan masala, a similar product, is often used as a loophole by tobacco companies to advertise and sell their products. While pan masala typically does not contain tobacco, manufacturers have been known to separate tobacco components and sell them in separate pouches alongside pan masala, encouraging consumers to mix them. This practice allows them to skirt advertising restrictions and target a wider audience.
The health risks associated with smokeless tobacco are significant. It is highly addictive and represents a major health risk, causing various adverse effects such as head and neck cancer, oral cancer, oral submucous fibrosis, oesophageal cancer, pancreatic cancer, cardiovascular disease, and asthma. The use of smokeless tobacco products, including gutka, has been linked to precancerous lesions in young children, with symptoms of cancer often appearing by high school or college age.
The impact of tobacco use extends beyond health concerns. It contributes to poverty by diverting household spending from essential needs to tobacco products. The addictive nature of tobacco makes it challenging for consumers to curb their spending. Additionally, the economic costs of tobacco use are substantial, including healthcare expenditures and lost productivity due to tobacco-related illnesses and deaths.
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Frequently asked questions
Although most pan masala does not contain tobacco, some varieties do. In 2019, seven out of 12 banned pan masala brands in India tested positive for nicotine.
Pan masala is a chewable intraoral product that is popular across South Asia. It is often promoted as a mouth freshener due to its invigorating and refreshing properties.
Yes, pan masala can be harmful even when it does not contain tobacco. Its ingredients, including areca nut, slaked lime, catechu, flavouring agents, and sweeteners, can cause tooth decay, gum disease, oral cuts and ulcers, and oral cancer.
