Nicotine is a major constituent of smokeless tobacco and its addiction  in  smokeless  form is as dangerous as  smoking. As burn product of nicotine is  absent  but absorption from buccal mucosa leads to accumulation of  metabolites which  affects the cardiac parameters. To assess these effects  case control study   was designed. 50 ST consumers (cases) and 50 age and sex matched tobacco  non users (controls) were enrolled  .  Anthropometry , pulse rate, bp and  E.C.G .were recorded and serum cotinine level was assessed .

Strong positive relation (r>0.7) was observed between S. cotinine levels and duration of tobacco use, SBP, DBP and MAP. All correlations were significant statistically  (p<0.001). Moderate positive correlation (r=0.5 to 0.7) between S. cotinine levels and pulse rate and QTc interval was observed which is  significant statistically (p<0.001).