Investigation of oxidative stress and antioxidant vitamin levels in Maraş powder users and smokers

Year 2026, Volume: 17 Issue: 57 , 78 - 84 , 16.04.2026

Hasan Dağlı , Fatma İnanç Tolun , Adem Doğaner , Işıl Yağmur

https://doi.org/10.17944/interdiscip.1789099

https://izlik.org/JA94RP92TT

Abstract

Objective: Maraş powder is a smokeless tobacco product made by combining dried Nicotiana rustica leaves with wood ash and is used by placing it in the lower lip. In addition to nicotine’s local and systemic effects, excess free radicals contribute to oxidative injury. This study aimed to compare the oxidative stress markers and antioxidant vitamin levels among Maraş powder users, smokers, and healthy controls
Method: We enrolled 32 male Maraş powder users ( 1–2 grams, 3–6 times/day for at least one year), 32 male cigarette smokers (≥1 pack/day for at least one year), and 32 healthy male controls from Kahramanmaraş and nearby villages. After fasting (12 h) and abstaining from tobacco use for 8 h, venous blood samples were collected in the morning (08:00–10:00). Serum was stored at −80 °C. Using commercial colorimetric kits, Total Oxidant Status (TOS), Total Antioxidant Status (TAS), total thiol, and native thiol levels were measured. Vitamin A, C, and E levels were measured by ELISA. Statistical tests included Shapiro–Wilk, one-way analysis of variance (ANOVA), and Kruskal–Wallis tests, with significance set at p < 0.05.
Results: No significant differences were observed in the TAS, TOS, total thiol, or native thiol levels among the three groups (all p > 0.05). In contrast, vitamin A, C, and E levels differed significantly among the groups (p = 0.01 for vitamin A; p = 0.05 for vitamin C; p = 0.02 for vitamin E). Vitamin A levels were highest among Maraş powder users, and vitamin C and E levels were lowest among cigarette smokers.
Conclusion: Although Maraş powder and cigarette smoking did not significantly affect global oxidative stress markers or thiol levels in this sample, smoking was associated with lower vitamin C and E levels. Maraş powder users exhibited elevated vitamin A levels. Findings suggest that different forms of tobacco exposure may exert distinct effects on the antioxidant vitamin status. Future studies with larger sample sizes and dietary controls are required.

Keywords

Maraş powder; smokeless tobacco; oxidative stress; total antioxidant status (TAS); total oxidant status (TOS); thiol; vitamins A , C , E

Ethical Statement

The study was approved by the Scientific Research Ethics Committee of Kahramanmaraş Sutcu Imam University, Kahramanmaras, Turkey

Supporting Institution

Kahramanmaras Sutcu Imam University Scientific Research Council

Project Number

2018/4-20 M

Thanks

This study was supported by the Scientific Research Projects Coordination Unit of Kahramanmaraş Sütçü İmam University (KSÜ BAP). We would like to express our sincere gratitude for their financial and academic support.

References

• Aral M, Ekerbicer HC, Celik M, Ciragil P, Gul M. Comparison of effects of smoking and smokeless tobacco “Maras powder” use on humoral immune system parameters. Mediators Inflamm. 2006;2006:1–4. https://doi.org/10.1155/MI/2006/8501
• Kilinc M, Okur E, Kurutas EB, Guler Fİ, Yildirim İ. The effects of Maras powder (smokeless tobacco) on oxidative stress in users. Cell Biochem Funct. 2004;22:233–6. https://doi.org/10.1002/cbf.1093
• Pan B, Jin X, Jun L, Qiu S, Zheng Q, Pan M. The relationship between smoking and stroke: a meta-analysis. Medicine. 2019;98(12). https://doi.org/10.1097/MD.0000000000014872
• Jankowski M, Brożek G, Lawson J, Skoczyński S, Zejda JE. E-smoking: Emerging public health problem? Int J Occup Med Environ Health. 2017;30(3):329–44. https://doi.org/10.13075/ijomeh.1896.01046
• Ayçiçek A, Erel Ö, Koçyiğit A. Decreased total antioxidant capacity and increased oxidative stress in passive smoker infants and their mothers. Pediatr Int. 2005;47:635–9. https://doi.org/10.1111/j.1442-200x.2005.02137.x
• Karademirci MM, Kutlu R, Kilinc İ. Relationship between smoking and total antioxidant status, total oxidant status, oxidative stress index, vit C, vit E. Clin Respir J. 2018;1–7. https://doi.org/10.1111/crj.12757
• Stead M, Angus K, Holme I, Cohen D, Tait G, PESCE European Research Team. Factors influencing European GPs’ engagement in smoking cessation: a multi-country literature review. Br J Gen Pract. 2009;59(566):682–90. https://doi.org/10.3399/bjgp09X454007
• Mahgoub SA, El-Mekkawy RM, Abd El-Hack ME, El-Ghareeb WR, Suliman GM, Alowaimer AN, Swelum AA. Inactivation of Listeria monocytogenes in ready-to-eat smoked turkey meat by combination with packaging atmosphere, oregano essential oil and cold temperature. AMB Express. 2019;9:1–9. https://doi.org/10.1186/s13568-019-0775-8
• Taş B, Güre AO. The effect of Maras powder and smoking on the microRNA deregulation of oral mucosa. J Appl Oral Sci. 2020;28. https://doi.org/10.1590/1678-7757-2019-0382
• Kurtul N, Çil MY, Paçacı S. Serum total sialic acid levels in smokers and users of smokeless tobacco in form of oral powder (Maraş powder). J Biomed Sci. 2005;12:559–63. https://doi.org/10.1007/s11373-005-4563-x
• Zhao F, Guo L, Wang X, Zhang Y. Correlation of oxidative stress-related biomarkers with postmenopausal osteoporosis: a systematic review and meta-analysis. Arch Osteoporos. 2021;16:1–10. https://doi.org/10.1007/s11657-020-00854-w
• Aslan R, Kutlu R, Civi S, Tasyurek E. The correlation of the total antioxidant status (TAS), total oxidant status (TOS) and paraoxonase activity (PON1) with smoking. Clin Biochem. 2014;47(6):393–7. https://doi.org/10.1016/j.clinbiochem.2013.10.002
• Ergin Tuncay M, Atagun MI, Erel O. Thiol disulfide homeostasis in psychiatric disorders: A comprehensive review. Prog Neuropsychopharmacol Biol Psychiatry. 2023. https://doi.org/10.1016/j.pnpbp.2023.110719
• Erel O, Erdoğan S. Thiol-disulfide homeostasis: an integrated approach with biochemical and clinical aspects. Turk J Med Sci. 2020;50(10):1728–38https://doi.org/10.3906/sag-2003-64
• Dinc ME, Ozdemir C, Ayan NN, Bozan N, Ulusoy S, Koca C, Erel O. Thiol/disulfide homeostasis as a novel indicator of oxidative stress in obstructive sleep apnea patients. Laryngoscope. 2017;127(7)-50 https://doi.org/10.1002/lary.26444
• Kara İ, Cınar OF, Doğaner A, Yıldız MG, Sağıroğlu S, Bilal N, Orhan I. Does Maras powder affect the nasal mucociliary clearance? Eur Arch Otorhinolaryngol. 2022;279(12):5701–6. https://doi.org/10.1007/s00405-022-07487-4
• Jaya DS. Cigarette smoking and the oxidative stress induced biochemical changes. Int J Dev Res. 2023;13(03). Badran M, Laher I. Waterpipe (shisha, hookah) smoking, oxidative stress and hidden disease potential. Redox Biol. 2020;34:101455. https://doi.org/10.1016/j.redox.2020.101455
• Göçer K, Öztürk B, Kaniyolu M, Tekinalp M. Effect of Smokeless Tobacco (Maras Powder) on the Epicardial Fat Thickness and Ventricular Repolarization Parameters. Medicina. 2023;59(6):1127. https://doi.org/10.3390/medicina59061127
• Benkő P, Jee S, Kaszler N, Fehér A, Gémes K. Polyamines treatment during pollen germination and pollen tube elongation in tobacco modulate reactive oxygen species and nitric oxide homeostasis. J Plant Physiol. 2020;244:153085. https://doi.org/10.1016/j.jplph.2019.153085
• Necip A, Mesut IŞIK, Güzel A, Takim K, Kaygisiz F. LC-MS/MS analysis, antioxidant properties and inhibition effect on some important metabolic enzymes of Nicotiana rustica L. Kahramanmaraş Sütçü İmam Üniversitesi
• Tarım ve Doğa Dergisi. 2021;24(5):930–8. https://doi.org/10.18016/ ksutarimdoga.vi.856514 https://doi.org/10.18016/ksutarimdoga.vi.856514
• Park SL, Le Marchand L, Cheng G, Balbo S, Chen M, Carmella SG, ... Hecht SS. Quantitation of DNA adducts resulting from acrolein exposure and lipid peroxidation in oral cells of cigarette smokers from three racial/ethnic groups with differing risks for lung cancer. Chem Res Toxicol. 2022;35(10):1914–22. https://doi.org/10.1021/acs.chemrestox.2c00171
• Caliri AW, Tommasi S, Besaratinia A. Relationships among smoking, oxidative stress, inflammation, macromolecular damage, and cancer. Mutat Res Rev Mutat Res. 2021;787:108365. https://doi.org/10.1016/j.mrrev.2021.108365
• Duthie GG. Antioxidant status in smokers. In: Vitamin E in health and disease. CRC Press; 2023. p. 711–4. https://doi.org/10.1201/9781003418160-63
• Astori E, Garavaglia ML, Colombo G, Landoni L, Portinaro NM, Milzani A, Dalle-Donne I. Antioxidants in smokers. Nutr Res Rev. 2022;35(1):70–97. https://doi.org/10.1017/S0954422421000093
• Carr AC, Lykkesfeldt J. Factors affecting the vitamin C dose-concentration relationship: Implications for global vitamin C dietary recommendations. Nutrients. 2023;15(7):1657. https://doi.org/10.3390/nu15071657
• Packer L, Kagan VE. Vitamin E: The antioxidant harvesting center of membranes and lipoproteins. In: Vitamin E in health and disease. CRC Press; 2023. p. 179–92. https://doi.org/10.1201/9781003418160-20
• Gey KF. Vitamin E and Other Essential Antioxidants Regarding Coronary Heart Disease: Risk Assessment Studies: Epidemiological Basis of the Antioxidant Hypothesis of Cardiovascular Disease. In: Vitamin E in health and disease. CRC Press; 2023. p. 589–634. https://doi.org/10.1201/9781003418160-56
• Khadim RM, Al-Fartusie FS. Antioxidant vitamins and their effect on immune system. In: Journal of Physics: Conference Series. IOP Publishing; 2021 Mar. p. 012065 https://doi.org/10.1088/1742-6596/1853/1/012065
• Meydani SN, Blumberg JB. Vitamin E and the immune response. In: Nutrient modulation of the immune response. CRC Press; 2020. p. 223–38. https://doi.org/10.1201/9781003066644-16