Snuff on the rise among Zambian women, increasing risks for cervical cancer

The use of snuff tobacco among young women in Zambia is increasing, heightening the risk of developing cervical cancer, already the most diagnosed cancer for women in the country.

Insunko is a powdered form of tobacco sold in Zambia that an increasing number of women believe enhances male sexual pleasure. Such a use heightens the risk of cervical cancer.

The tobacco industry has long packaged its products in different forms(link is external) to attract different market segments. 

One form of packing is ‘snuff’, often sold in sachets, both in moist and in dry, crushed powder form; it is proving particularly devastating in Zambia, due to the belief that it increases body temperatures and can make women more sexually desired by their male partners.

"This snuff kind of tobacco, locally known in Zambia as Insunko, has for a long time been the preserve of the elderly women in society who used it as a purported cure for headaches. Now it has become so popular among some Zambian women and girls, especially those of the sexually active age between 15 and 45, that its use is spreading like bushfire." 
– Brenda Chitindi, Executive Director, Tobacco Free Association of Zambia (TOFAZA)

Snuff is usually placed in the mouth between the lower lip and gum or in the cheek, where it slowly absorbs into the tissue. Many women and girls in Zambia, however, insert the insunko intravaginally, in the belief that it tightens their vaginas and helps stimulate their sexual drive. Some women who use snuff explain that Insunko also boosts their immune system and that it is good for maintaining normal blood pressure. Some men also use insunko, but its use is more prevalent among women and girls and gaining in popularity. 

These beliefs surrounding the sexual properties of insunko have been debunked; nevertheless, its growing use raises concerns among public health experts about the product’s side effects.

A recent investigation by The Daily Vox of South Africa(link is external) established that though snuff is not smoked, it is addictive and can be dangerous. The World Health Organization, for instance, warns that snuff causes(link is external) oral, oesophageal and pancreatic cancers, while women who use it intravaginally risk getting cervical cancer(link is external).

"Despite all these threats to health, the rate at which women and girls are buying and using this drug in Zambia is alarming," says Brenda Chitindi. “In Lusaka alone, the women and girls are allegedly buying Insunko from hair salons, bars, taverns, and markets; sachets cost 60-70 cents.”

“The fact that Insunko contributes to cervical cancer is particularly concerning as it is already by far the most diagnosed cancer in Zambia for women(link is external), accounting for 40% of all cancer cases, and the country continues to experience one of the highest rates of cervical cancer cases in the world relative to population.”
– Brenda Chitindi, Executive Director, Tobacco Free Association of Zambia (TOFAZA)

Active outreach by TOFAZA to raise awareness about the risks of Insunko

UICC member organization TOFAZA (Tobacco Free Association of Zambia) is widely recognized for its advocacy efforts(link is external) to raise awareness about the harms of tobacco – using in-person outreach as well as electronic means and social media – and introduce a tobacco bill for more effective tobacco control in Zambia. 

To fight the spread of insunko use, members of the organization visit markets and hair saloons where the product is sold and explain to women why they should not be taking it.  Their primary focus is in villages, where the use of insunko is more concerning than in larger urban areas. 

“It has been very difficult to fight the myths surrounding Insunko and get the right information across. But many women are now coming to understand, thanks to testimonies from a woman whose friend is who had been using insunko almost every day and is now very sick with cervical cancer.”
– Brenda Chitindi, Executive Director, Tobacco Free Association of Zambia (TOFAZA)

In terms of advocacy, Tofaza is driving the message that prevention is better than cure and is pushing public health authorities to improve and increase screening services as well as conduct widespread information campaigns. In addition, says Brenda, there is a need to increase the capacity of the cancer hospital in Zambia – “patients are sleeping on the floor because there is no more room,” she says.

With respect to tobacco control, Tofaza has been pressuring the government to pass a tobacco control bill, which has been stagnant since 2010 and participated in two reports on tobacco industry interference that has contributed to stalling the process. "With the new government elected in 2021, we hope there is now a new opportunity to get the bill passed,“ says Brenda.