Objective: Through the years, tobacco has been used in many ways. While the most common way of consumption is through smoking cigarettes, smokeless use by chewing or nasal snuffing are also quite common. Smokeless tobacco, also named “Maras powder”, is generally used as a substitute to reduce or quit smoking. The effects of smokeless tobacco use on the immune system, respiratory system and cardiovascular system have been extensively researched. In our study, we aimed to investigate the effects of Maras powder on the respiratory, electrocardiogram (ECG) findings and biochemical methods.

Methods: One hundred and forty-nine cases were included and the cases were classified into the following four groups: only using Maras powder; using Maras powder and smoking; only smoking and control group neither smoking nor using Maras powder. Physical examination findings, ECG findings, results of pulmonary function tests, results of biochemical analysis including complete blood count and lipid profile of all participants were recorded on admission.

Results: The risk of mouth sores was 7.9 times higher in the Maras powder group due to direct contact to the oral mucosa. There is a relationship between the daily use frequency of smokeless tobacco and the development of oral wounds, but the total period of use or the duration in mouth was not related to this situation. The ECG findings of both the smoking and Maras powder consuming group was found to be significantly higher than the control group.

Conclusion: The smokeless tobacco use, which is considered as an alternative way of quitting smoking, does not have adverse effects on respiratory functions. However, it is an important risk factor for many life-threatening health conditions such as ECG abnormalities and occurrence of oral lesions. Social awareness must be created for smokeless tobacco use in order to fight this habitual threat to public health.