Reverse smoking and chronic obstructive lung disease.

Reverse smoking is a popular habit peculiarly prevalent among adults of southeastern coastal towns and villages of India. The smoking device is hand made. A few dried twigs of home grown tobacco are rolled crudely in a semi-dried tobacco leaf. The finished product is called 'chutta'. The average weight of the hand rolled chuttas varies between 1.5 g for the small one and 7.5 g for the big chuttas. During smoking the lighted end of the chutta is kept inside the mouth during inhalation. An average adult may smoke three to four chuttas per day. Reverse smoking was first highlighted by Reddy and Rao (1957) who reported a high occurrence of oropharyngeal carcinomas in chutta smokers. The cancerous changes were attributed to the heat generated inside the oral cavity and burning of tobacco (Reddy & Rao 1957). The present study was carried out to examine the frequency of symptoms of chronic respiratory disease and changes in lung function associated with this form of smoking habit.