Misconceptions about intravaginal tobacco use

In some African countries (Gambia, Zambia), a belief has developed that inserting tobacco powder into the vagina has medicinal effects or an impact on sexual health. Literature on this marginal phenomenon is sparse, and the health consequences are poorly documented.

There are many beliefs surrounding tobacco and its uses, whether they concern health effects or strategies intended to minimize the negative consequences of smoking. Tobacco manufacturers themselves have maintained certain beliefs in their advertising, playing on the elements of seduction, thinness and protective effects on health (filters, tobaccos supposedly milder, “lighter”, less irritating…).

New beliefs may, however, emerge, as indicated by this practice observed in certain African countries and which seems relatively recent: it consists of inserting tobacco powder mixed with other substances into the vagina.[1].

Medicinal Promises and Sexual Beliefs

Referred to as "taba" or "tabaa" in Gambia and "insunko" in Zambia, these tobacco products are usually consumed orally and are placed between the lip and gum. Some vendors sometimes present them as traditional medicines and encourage their insertion into the vagina, with the aim of curing numerous ailments such as hypertension, infertility, candidiasis, epilepsy, diabetes, osteoarthritis, pain, hernias and even bedwetting in children.

In Zambia, some users believe the practice protects against respiratory illnesses like COVID-19 or can increase CD4 T cell counts in HIV patients. Some young women also believe it "rejuvenates" and "tightens" the vagina, providing more sensation for their partner and enhancing sexual pleasure.

Health consequences still unknown

The health effects of these practices are not yet clearly identified. Like other oral tobacco products (chewing tobacco, snus), these tobacco powders contain numerous toxic substances (arsenic, nitrosamines, cadmium, chromium, manganese, copper), some of which are carcinogenic. They cause oral cancers resulting from dermal contact with the oral mucosa, tongue, and palate, which suggests that vaginal infections may result from intravaginal practice. The risks are further increased since tobacco powders prepared for intravaginal use may also include other substances such as alcohol, shea butter, caustic soda, ash, cannabis, or certain indigenous plants.

This practice, which seems marginal, and its possible consequences on health remain very little documented; they would require more in-depth studies, both on a medical and social level.

Keywords: Tobacco powder, intravaginal use, Zambia, Gambia.

MF

[1] Cham B, Sey Corr R, Weaver SR, et al. Intravaginal insertion of tobacco among women in sub-Saharan Africa. Tob Control Epub ahead of print: 18 April 2023. doi:10.1136/tc-2022-057831