Ntsu, once used exclusively by traditional healers to connect with their ancestors, is gaining popularity among youth who are struggling to resist this form of smokeless tobacco.
According to Dr Mxolisi Xulu, a medical intern at the Mandela Academic Hospital in Mthatha, snuff tobacco, also known as ntsu in South Africa, was historically African tobacco typically used by those with ancestral callings.
He explains that according to western medicine, to produce snuff, tobacco is dried and finely ground. They classify snuff as wet or dry. Dry snuff is inhaled nasally while the wet version is inserted between the lower lip and gums. The nicotine is then absorbed by the lining of the gums and lips.
‘It creates a spiritual connection’
Muzi Khanyis’amathongo Canca, a traditional healer from Centane in the Eastern Cape, explains that smoking is often a way to cool yourself, but that snuff has miraculous effects. He says snuff is not just a smoking herb, but also a medicinal one that may be used to spiritually connect with your people.
“Our ancestors would cultivate their own smoking plant using an inqawe (smoking pipe), and the plant would eventually become isixhaxha (a paste made from a smoking pipe).”
Canca adds that the isixhaxha would be inserted between the gums and lips, similar to how some individuals use snuff today.
Canca says that while amagqirha is conducted by people, it is sometimes necessary to smoke snuff to maintain concentration, particularly during ixesha lokuhlola/lokuvumisa (the process of divination).
Widely used in SA
According to Xulu, ntsu is often used by women, although males, particularly traditional healers, are more likely to use it.
“In SA there are traditional homemade and commercial or industrial snuff products. According to my knowledge, snuff is produced from dried-up aloe, ash and water. These are easily accessible ingredients, especially in rural areas.
“Most people believe that snuff tobacco is harmless, or it has minimal side effects compared to cigarettes. Researchers have found that snuff has more nicotine, making users more addicted to it.”
Xulu says snuff in South Africa is widely used by young women. Now it is taken nasally, orally between the lower lip and gums, and even vaginally.
Beware of the dangers
According to the Centers for Disease Control and Prevention (CDC), snuff raises the risk of several types of cancer including oral, oesophagal, and pancreatitis cancer. Furthermore, it increases the risk of heart disease. It has been associated with chronic bronchitis and it can worsen TB symptoms, explains Xulu.
“When used vaginally it can cause cervical cancer, premature birth, and stillbirth in a pregnant woman. Its oral use can stain the teeth, cause mouth odours, tooth decay and gum infections.”
“To [ntsu] users, it is advisable to visit the dentist often. It is important to keep it away from children, as it can cause nicotine poisoning in case a child incidentally ingests it,” Xulu warns.
He says it is possible to stop using although it might be challenging because of addiction.
Nicotine replacement therapy (NRT) in conjunction with counselling and other strategies like social support can be useful. NRT will help you manage withdrawal symptoms. Common tobacco withdrawal symptoms are depression, anxiety, restlessness, insomnia, lack of concentration etc. Quitting snuff can prevent you from getting cancer, heart disease and oral disease.
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