Kuber is a smokeless tobacco product, known for its highly addictive properties and its unique presentation disguised as a mouth freshener. It originated in India and has gained attention for its widespread use and impact on public health in various countries, including Uganda.
The product is typically sold in small sachets, with contents resembling tea leaves. This deceptive packaging has contributed to its accessibility and misuse. Kuber is known for its high nicotine content, making it more potent and addictive than traditional cigarettes. [1] Users commonly add it to tea or consume it directly by placing a pinch under the lower lip. [2]
Kuber's high nicotine content raises significant health concerns, including: [3]
Withdrawal from kuber can result in cravings and changes in mood and appetite. [3]
The legal status of kuber varies by region. In some countries, its sale and distribution, especially under the guise of a mouth freshener, have led to legal scrutiny and regulatory measures. For instance, in Uganda, the government has taken steps to ban the use of kuber due to its impact on public health, particularly among youth. [4] The governments of Malawi and Tanzania also banned the manufacture, import, sale, and consumption of kuber. [5] Despite efforts to ban kuber in Kenya, [6] it remains popular, particularly in Nairobi and Mombasa counties. [7]
The widespread use of kuber, especially among young people in high schools and colleges, has raised societal concerns. Its addictive nature and the ease of access have led to a rise in nicotine addiction among adolescents, with implications for long-term public health and social dynamics. [5]
Nicotine is a naturally produced alkaloid in the nightshade family of plants and is widely used recreationally as a stimulant and anxiolytic. As a pharmaceutical drug, it is used for smoking cessation to relieve withdrawal symptoms. Nicotine acts as a receptor agonist at most nicotinic acetylcholine receptors (nAChRs), except at two nicotinic receptor subunits where it acts as a receptor antagonist.
Gutka, ghutka, guṭkha is a type of betel quid and chewing tobacco preparation made of crushed areca nut, tobacco, catechu, paraffin wax, slaked lime and sweet or savory flavourings, in India, Pakistan, other Asian countries, and North America.
Tobacco smoking is the practice of burning tobacco and ingesting the resulting smoke. The smoke may be inhaled, as is done with cigarettes, or simply released from the mouth, as is generally done with pipes and cigars. The practice is believed to have begun as early as 5000–3000 BC in Mesoamerica and South America. Tobacco was introduced to Eurasia in the late 17th century by European colonists, where it followed common trade routes. The practice encountered criticism from its first import into the Western world onwards but embedded itself in certain strata of a number of societies before becoming widespread upon the introduction of automated cigarette-rolling apparatus.
Snus is a tobacco product and non-tobacco nicotine product made of powdered tobacco leaves or powdered non-tobacco plant fibers. The powder is purchased in pre-made pouches, and the product is consumed by placing it in the upper lip for the nicotine to be absorbed to the bloodstream, through the oral mucosa.
Nicotine replacement therapy (NRT) is a medically approved way to treat people with tobacco use disorder by taking nicotine through means other than tobacco. It is used to help with quitting smoking or stopping chewing tobacco. It increases the chance of quitting tobacco smoking by about 55%. Often it is used along with other behavioral techniques. NRT has also been used to treat ulcerative colitis. Types of NRT include the adhesive patch, chewing gum, lozenges, nose spray, and inhaler. The use of multiple types of NRT at a time may increase effectiveness.
Chewing tobacco is a type of smokeless tobacco product that is placed between the cheek and lower gum to draw out its flavor. It consists of coarsely chopped aged tobacco that is flavored and often sweetened; it is not ground fine like dipping tobacco. Unwanted juices are spat after use.
Nicotiana rustica, commonly known as Aztec tobacco or strong tobacco, is a rainforest plant in the family Solanaceae native to South America. It is a very potent variety of tobacco, containing up to nine times more nicotine than common species of Nicotiana such as Nicotiana tabacum. More specifically, N. rustica leaves have a nicotine content as high as 9%, whereas N. tabacum leaves contain about 1 to 3%. The high concentration of nicotine in its leaves makes it useful for producing pesticides, and it has a wide variety of uses specific to cultures around the world. However, N. rustica is no longer cultivated in North America, as N. tabacum has replaced it.
Nicotine marketing is the marketing of nicotine-containing products or use. Traditionally, the tobacco industry markets cigarette smoking, but it is increasingly marketing other products, such as electronic cigarettes and heated tobacco products. Products are marketed through social media, stealth marketing, mass media, and sponsorship. Expenditures on nicotine marketing are in the tens of billions a year; in the US alone, spending was over US$1 million per hour in 2016; in 2003, per-capita marketing spending was $290 per adult smoker, or $45 per inhabitant. Nicotine marketing is increasingly regulated; some forms of nicotine advertising are banned in many countries. The World Health Organization recommends a complete tobacco advertising ban.
Dipping tobacco is a type of finely ground or shredded, moistened smokeless tobacco product. It is commonly and idiomatically known as dip. Dipping tobacco is used by placing a pinch, or "dip", of tobacco between the lip and the gum. The act of using it is called dipping. Dipping tobacco is colloquially called chaw, snuff, rub, or fresh leaf among other terms; because of this, it is sometimes confused with other tobacco products—namely dry snuff.
Smokeless tobacco is a tobacco product that is used by means other than smoking. Their use involves chewing, sniffing, or placing the product between gum and the cheek or lip. Smokeless tobacco products are produced in various forms, such as chewing tobacco, snuff, snus, and dissolvable tobacco products. Smokeless tobacco is widely used in South Asia and this accounts for about 80% of global consumption. All smokeless tobacco products contain nicotine and are therefore highly addictive. Quitting smokeless tobacco use is as challenging as smoking cessation.
A menthol cigarette is a cigarette infused with the compound menthol which imparts a “minty” flavor to the smoke. Menthol also decreases irritant sensations from nicotine by desensitizing receptors, making smoking feel less harsh compared to regular cigarettes. Some studies have suggested that they are more addictive. Menthol cigarettes are just as hard to quit and are just as harmful as regular cigarettes.
Snuff is a type of smokeless tobacco product made from finely ground or pulverized tobacco leaves. It is snorted or "sniffed" into the nasal cavity, delivering nicotine and a flavored scent to the user. Traditionally, it is sniffed or inhaled lightly after a pinch of snuff is either placed onto the back surface of the hand, held pinched between thumb and index finger, or held by a specially made "snuffing" device.
Tobacco harm reduction (THR) is a public health strategy to lower the health risks to individuals and wider society associated with using tobacco products. It is an example of the concept of harm reduction, a strategy for dealing with the use of drugs. Tobacco smoking is widely acknowledged as a leading cause of illness and death, and reducing smoking is vital to public health.
An electronic cigarette (e-cigarette) or vape is a device that simulates tobacco smoking. It consists of an atomizer, a power source such as a battery, and a container such as a cartridge or tank. Instead of smoke, the user inhales vapor. As such, using an e-cigarette is often called "vaping". The atomizer is a heating element that vaporizes a liquid solution called e-liquid, which quickly cools into an aerosol of tiny droplets, vapor and air. The vapor mainly comprises propylene glycol and/or glycerin, usually with nicotine and flavoring. Its exact composition varies, and depends on several things including user behavior.
Naswār, also called nās, nāsor or nasvay, is a moist, powdered tobacco dip consumed mostly in Afghanistan, and surrounding countries, including Pakistan, India and neighboring Central Asian republics. Naswar is stuffed in the floor of the mouth under the lower lip, or inside the cheek, known as butt style stuffing, for extended periods of time, usually for 15 to 30 minutes. It is similar to dipping tobacco and snus. Swabi, Bannu, Dera Ismail Khan, Charsadda, Mohmand and Herat are renowned for their production of some of the highest quality Naswar.
Dissolvable tobacco is a smokeless tobacco product that dissolves in the mouth. Major tobacco manufacturers that sell dissolvable tobacco products include R. J. Reynolds Tobacco Company. Research into health effects of dissolvable and other new tobacco products was among the reasons of the establishment of the Tobacco Products Scientific Advisory Committee of the Food and Drug Administration in 2009.
A heated tobacco product (HTP) is a tobacco product that heats the tobacco at a lower temperature than conventional cigarettes. These products contain nicotine, which is a highly addictive chemical. The heat generates an aerosol or smoke to be inhaled from the tobacco, which contains nicotine and other chemicals. HTPs may also contain additives not found in tobacco, including flavoring chemicals. HTPs generally heat tobacco to temperatures under 600 °C (1100 °F), a lower temperature than conventional cigarettes.
Nicotine pouches are a type of tobacco-free snus usually made from plant fibers with added nicotine. They do not include tobacco leaf, dust, or stem. The nicotine may either be derived from tobacco plants or may be synthetic.
The chemical constituents of different types of snus vary, and population-level studies suggest that the disease risks vary as well. Using snus is harmful to health, although much less than smoking tobacco.