Tobacco water: a special form of tobacco use in the Mizoram and Manipur states of India.

Background: Tuibur and hidakphu are watery tobacco products made by passing tobacco smoke through water. These have neither been described in the health literature nor are there any reports of epidemiological studies on these products. We collected information on the use of these products in Mizoram and Manipur.

Methods: We conducted two surveys. In the first, we spoke to personnel involved in tobacco water manufacturing, marketing and sale. In the second, we carried out a house to house survey of adults on the attitude and behaviour towards the use of tobacco products in 25 randomly selected villages each in Aizawl district of Mizoram and Churchandpur district of Manipur.

Results: About 7% of persons surveyed in Aizawl (872 of 12 185) and Churchandpur (139 of 2137) used tobacco water, which is stored and sold in bottles. It is sipped and retained in the mouth for 5-10 minutes and then spat out. Among tobacco water users, about 90% of users in Churchandpur and about 40% in Aizawl sipped tobacco water more than 5 times a day. The use of other tobacco products in both districts was also high.

Conclusion: The use of tobacco water has been a part of the culture of some communities in Mizoram and Manipur for a long time. These communities also have a very high incidence of tobacco use. To discourage the use of such tobacco products, these communities should be educated about the harmful effects of tobacco use on a priority.