Naswar addiction emerges as growing threat to public health in KP: CM Afridi urged to take action
PESHAWAR (APP): When 42-year-old Khurshid Khan from Nowshera collapsed in agony from a throbbing pain shooting through his jaw, he never imagined his long-standing habit of naswar would land him on an operating table and deprived him of a tooth.
Hours after being rushed to a private clinic, Khurshid found himself in the Oral and Maxillofacial Surgery department at Govt hospital Pabbi after referral, facing the harsh consequences of an addiction he once considered harmless.
For Khurshid, naswar began as a coping mechanism in 2005, when the stress of postgraduate studies pushed him to experiment with what hostel mates assured him was a harmless stimulant. But a decade later, the habit has clawed deeply into his life, costing him health, confidence, and even a tooth.
“I tried quitting Naswar so many times but failed,” Khurshid shared tearfully after surgery. “Once it becomes a part of you, a person don’t even realize when it starts controlling his life.”
Dr. Tahir Khan, senior dental surgeon at Sardar Begium Dental College Peshawar said Khurshid’s molar was so severely decayed that root canal treatment was impossible. The gum infection had spread dangerously, forcing an emergency extraction and was referred to public hospital for immediate surgery.
“Naswar causes far more damage than people realize in Pakhtoon society,” Dr. Tahir explained. “It triggers severe gum infections, bone loss, jaw complications, and can lead to multiple tooth extractions, saying that’s just the beginning.”
He warned that the smokeless tobacco does not limit its harm to the mouth alone rather its chemicals can lead to disorder of stomach, heart complications and facial structure and, in advanced cases, exposes victims to oral and mouth cancers.
Despite such risks, naswar remains deeply entrenched in Khyber Pakhtunkhwa’s culture and hardly practical measures were taken to curb this business. Health experts estimated that nearly 70% of the province’s population uses naswar in some form mostly without understanding its dangers and great responsibility rests on the shoulders of CM Afridi to take action against naswar addiction.
Drawing from the Global Cancer Observatory, Dr. Tahir reiterated that Pakistan sees about 11,000 new cases of lip and oral cavity cancers in men every year, making it the most prevalent cancer among Pakistani males.
Nearly 10,000 deaths occur annually from these cancers, much of it linked to smokeless tobacco, poor dental hygiene, viral infections, and quack treatments.
Few users know the long history of the substance they tuck casually under their lip. History revealed that Naswar was first introduced in 15th-century Europe, where a French noblewoman reportedly used it as a remedy for migraines. With time, it migrated to South Asia, where it shifted from a medicinal aid to a commonly consumed form of tobacco.
Today, districts such as Charsadda, Swabi, Mardan, Dera Ismail Khan, and Bannu are well-known for producing high-quality naswar, much of which travels to Punjab, Sindh, and especially Karachi, where demand is high among migrants from KP.
Musawar Ahmed, a long-time naswar producer, detailed the preparation process, saying tobacco leaves are sun-dried, pulverized, and mixed with calcium hydroxide, dyes, plant ash, spices, and oils before being shaped into small green balls. Users either place moist naswar inside the mouth or inhale the dry form through the nose.
Dr Riaz Malik, principal officer at Pabbi Government Hospital, said that Naswar addiction was injurious to health, emphasizing that its pleasant smell masks a dangerous chemical cocktail. “Nicotine and other compounds in naswar affect the brain, damage oral tissues, and increase risks of lung, oral, stomach, and mouth cancers,” he said.
Public health experts observed that rising addiction not just to naswar but also hashish, ice, and cigarettes stems from poverty, unemployment, and limited recreational opportunities in KP. Many see drugs as a misguided escape from stress, social pressure, or economic instability.
To address the growing Naswar threats in KP, the Social Welfare Department established 12 rehabilitation and detoxification centres across Khyber Pakhtunkhwa, including in Peshawar, Mardan, Nowshera, Swat, Kohat, and D.I. Khan. Under the Drug-Free Peshawar initiative, naswar addicts are also receiving counselling and rehabilitation under the aegis of social welfare department.
Spokesman of the social welfare department told APP that continuous awareness campaigns through media, community networks, and especially religious scholars are vital to win fight against Naswar.
For Khurshid, the loss of a tooth is a painful reminder of how a simple habit spiralled into a serious health threat. His struggle highlights the experiences of hundreds of thousands across KP, many unaware of the slow damage accumulating beneath their gums.
As health professionals raise the alarm, the question remains that will awareness and intervention arrive fast enough to stem a growing public health crisis? Or will naswar continue its silent infiltration into the lives of the youth, the poor, and the unsuspecting? For now, Khurshid hopes others will learn from his pain and will quit naswar. “I wish I had stopped sooner,” he said quietly. “I don’t want anyone else to end up like me and be deprived of teeth.”
