Hemoglobin Status and Iron Deficiency in Non-Smoking Nicotine Consumers in Selected Area of Sugarcane Cutter Workers in Kolhapur and Pune District

The prevalence of anemia and its association with nutritional deficiency is known, but underlaying factors such as socio-cultural factors, nicotine consumption and consumption of food groups that inhibits absorption of iron by hemoglobin remains poorly studied. This study investigated the relationship between tobacco use, hemoglobin (Hb) levels, and nutritional status among sugarcane cutters in Kolhapur and Pune districts of Maharashtra. Total 86 participants were considered as final sampling population [Kolhapur (N=48), Pune (N=38)]. Out of 86 participants, 54 were non-smoking but tobacco chewing nicotine consumers and 32 were nicotine non-consumers. The percentage of oxygen-saturated hemoglobin were measured using pulse oximeter and the hemoglobin measurements were recorded via the Hemo Spark Blood Hemoglobin Measuring Meter. Tobacco consumption patterns were assessed through questionnaire referred from Global Adult Tobacco Survey, the Fagerstrom Test for Nicotine Dependence Smokeless-Tobacco and the Tobacco Staining Index, which categorized dental stains based on visual assessment. Tobacco consumers has a higher prevalence of severe anemia compared to non-consumers. Out of 54 chewing tobacco consumers, 34 were anemic, with 12 individuals falling into severe anemia category. In contrast, out of 32 non-tobacco consumers, 13 were anemic, with only 3 individuals falling into severe anemia category. Individuals who are chronic tobacco consumers with high GATS and TSI scores showed significantly lower hemoglobin levels. Dietary assessment showed that 15 tobacco users consumed high amount of iron inhibitor food products like tea, coffee and calcium rich food products had lowest mean hemoglobin value of 8.78 g/dL. 38 anemic individuals had education only up to primary level or were illiterate which limits their access to health related problems. Among females, 17 participants reported anemic and practicing cultural fasting at least once a week. This revels that, chronic smokeless tobacco use, along with poor nutrition and socio-cultural practices, is significantly associated with prevalence and severity of anemia.