Beware! Your favourite toothpaste could be laced with cancer-causing nicotine.
A study by the Delhi Institute of Pharmaceutical Sciences and Research (DIPSAR) has found that many of the toothpaste manufacturers are adulterating toothpastes and toothpowders with high quantity of nicotine.
"Out of the 24 brands of toothpastes studied in 2011, seven brands - Colgate Herbal, Himalaya, Neem paste, Neem Tulsi, RA Thermoseal, Sensoform and Stoline - were found to contain nicotine," said Professor S. S. Agarwal of DIPSAR, which is affiliated to the Delhi University and is funded by the Delhi government.
"Colgate Herbal and Neem Tulsi, also a herbal product, surprisingly had 18 and 10 mg of nicotine, which is equivalent to the quantity found in nine and five cigarettes respectively," Prof Agarwal added.
"Out of the ten brands of toothpowders examined, six - Dabur Red, Vicco, Musaka Gul, Payokil, Unadent and Alka Dantmanjan - were found to contain nicotine. Payokil was found to have the highest 16 mg of tobacco, which is equivalent of what a person consumes after smoking eight cigarettes," he said.
"Vicco was found to have used tobacco consecutively for three years in its toothpowder, while Dabur Red resumed mixing tobacco in 2011 after stopping it in 2008,"Prof Agarwal said.
The findings were, however, strongly refuted by the manufacturers of some of the dental creams and toothpowders named by DIPSAR. According to the Cigarettes and Other Tobacco Products Act, 2003, tobacco cannot be added to non-tobacco products like toothpastes and toothpowders.
Section 7(5) of the Act lays down that every tobacco package should have nicotine and tar contents along with the maximum permissible limits, which is not being done by these toothpaste manufacturers.
Moreover, as nicotine and tar are carcinogens, the manufacturers should mention them among contents along with their permissible limits on the packages to help people make an informed choice.
Prof Agarwal said that he has now written to the Union ministry of health and family welfare, drug controller-general of India and Delhi drug controller about the rampant tobacco adulteration in toothpowders and toothpastes. " Addition of tobacco is banned under central excise but it is still being added; do they forward it to the drug controller-general of India? Nicotine action is believed to be responsible for the drug induced feeling of pleasure and addiction, said Prof Agarwal.
Denying the presence of nicotine in his products, Sanjeev Pendharkar, Director, Vicco Laboratories said that the DIPSAR report was brought to their notice earlier as well. "The matter was also investigated by officers of the Drugs Control Administration, Goa. They did not find anything adverse and the samples drawn by them also did not show presence of nicotine," he asserted.
"We tested samples of Vicco Vajradanti paste and powder and the raw materials used in them. We found that both finished products and raw materials did not show presence of nicotine. The findings of DIPSAR are totally wrong. It has not disclosed the source of sampling. Our products do not contain any nicotine or fluoride," Pendharkar iterated.
He demanded tests in a government-approved laboratory and "our in-house laboratory," to substantiate his claim.
Refuting the findings of DIPSAR, a corporate official of the Himalaya Drug Company said, "We do not add nicotine to our toothpaste. Tests conducted have proved that our product is absolutely nicotine-free. The product was analysed for the presence of nicotine using highly sensitive Liquid Chromatography Mass Spectrometry (LC-MS) technique.
The results showed that nicotine was not detected. In polyherbals, many phytochemicals are present which can best be estimated by LCMS, hence we follow this sophisticated procedure."Asked for comments, a Dabur India spokesman said, "We would not be able to comment unless we see the study and the methodology used." Prof Agarwal stood by his findings. He said these companies "are lying just to safeguard their interests." He said he is ready to provide the companies with details of the methodology used.
"Nicotine in toothpastes can have the same ill effects as that in tobacco products like cigarettes and paan products. The nicotine is absorbed by the tongue and saliva in the mouth. It can lead to staining of teeth too and damage the whole enamel," warned Dr Rakesh Malhotra, senior dental surgeon, Centre for Advanced Dentistry. Toothpaste that contains nicotine can be as addictive as other nicotine products, he added. Nicotine can be absorbed by the lips, tongue, the floor of the mouth, the top roof of the mouth, cheeks and the gums leading to problems like oral inflammation and cancer.
"Oral ingestion of nicotine can lead to oral cancer and cancer causing agents can also get into the lining of the stomach, esophagus and into the bladder," Dr Malhotra said. Other side- effects of nicotine consumption include drooling. Children are particularly impacted by this, and may even report a burning sensation in the mouth.
According to Dr R C Jiloha of the psychiatry department, G. B. Pant Hospital, "Nicotine is distributed throughout the body, mostly to skeletal muscles and binds to the receptors in the brain, where it influences the cerebral metabolism."
Health hazards
It can also be absorbed by the lips, tongue, floor of the mouth, top roof of the mouth, cheeks and gums leading to problems such as oral inflammation and cancer. "Oral ingestion of nicotine can lead to oral cancer and cancer causing agents can also get into the lining of the stomach, esophagus and the bladder," he added.
"Toothpastes containing nicotine can have the same ill effects hitherto attributed to tobacco products such as cigarettes and paan masala . The nicotine in the toothpaste is absorbed by the tongue and saliva in the mouth. It can lead to staining of teeth too and damage the whole enamel," Dr Rakesh Malhotra, senior dental surgeon, said.
The highest amount of nicotine at 18 milligram/gram (mg/g) was found in Colgate Herbal products while 10 mg/g of nicotine was found in Neem Tulsi brand.
| S. No | Brand | Nicotine found in dental care products in 2008 (mg/g) | Nicotine found in dental care products in 2011 (mg/g) | Manufacturer |
| 1. | Vicco | 0.002 | 0.05 | Vicco laboratories, Goa |
| 2. | Alka dant manjan | - | 1.0 | Dev Chemical Works Pvt. Ltd., New Delhi |
| 3. | Yunadant | nil | 1.7 | Aayam Herbal And Research, Jaipur, Rajasthan |
| 4. | Dabur Red | 5.75 | 0.01 | Dabur India Limited, Solan, Himachal Pradesh |
| 5. | Payo kil | nil | 16 | Gurukul Kangri Pharmacy, Haridwar, Uttarakhand |
| 6. | Colgate Herbal | nil | 18 | Colgate Palmolive India Limited, Mumbai, Maharashtra |
| 7. | Neem Tulsi | nil | 10 | Ayur Siddha Limited, Kangra, Himachal Pradesh |
| 8. | Stoline Paste | nil | 0.06 | Group pharmaceuticals limited, Kolar, Karnataka |
| 9. | Himalaya | nil | 0.029 | Himalaya Drug Company, Bengaluru, Karnataka |
| 10. | Sensoform | nil | 0.065 | Indoco Remebies Limited, Solan, Himachal Pradesh |
"Nicotine content in one cigarette is between two and three mg/g. In one of the dental care products we found the nicotine content was equivalent to that of nine cigarettes," says Professor S S Agrawal, project director at DIPSAR.
According to the Cigarette and Other Tobacco Products Act, 2003, no non-tobacco product can contain tobacco and nicotine.
Earlier studies have found tobacco and nicotine in toothpowders. "But this is the first study that has found nicotine in toothpastes," says P C Gupta, director, Healis Institute of Public Health, an organisation dedicated to improving public health in India and other developing countries.
In a study published in the British Medical Journal in 2004 Gupta stated that various tobacco products are used as dentrifice in India.
"Many companies take advantage of a misconception widely prevalent in India that tobacco is good for teeth," Gupta says. The companies, therefore, package and position their products as dental care products, he adds. "A laboratory test of five samples of red tooth powder that did not declare tobacco as an ingredient found tobacco content of 9.3-248 mg/g of tooth powder," the study stated.
"Nicotine in the toothpastes and toothpowders gets absorbed in the body when it directly comes in contact with the skin. This makes the product addictive," Gupta notes.
