Misconceptions about intravaginal tobacco use

In some African countries (Gambia, Zambia), a belief has developed that the introduction of tobacco powder into the vagina would have medicinal effects or an impact on sexual health. The literature on this marginal phenomenon is rare and the health consequences are poorly documented.

There are many beliefs surrounding tobacco and its uses, whether they are about 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 springs 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 noted 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 people to insert them into the vagina, in order to cure many conditions such as hypertension, infertility, candidiasis, epilepsy, diabetes, osteoarthritis, pain, hernias or even nocturnal incontinence in children.

In Zambia, some users believe that the practice protects against respiratory diseases such as COVID-19 or that it can increase CD4 T cells in HIV patients. Some young women also believe that it can “rejuvenate” and “tighten” the vagina, in order to provide more sensation to their partner and enhance 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 many 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 diseases may result from intravaginal practice. The risks are all the greater 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 poorly documented; they would require more in-depth studies, both on a medical and social level.

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

M.F.

[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