Neem (Azadirachta indica) as an Alternative Therapy for Tobacco Cessation.

Addictive tobacco habit, both oral use and smoking, continues to be a major public health problem despite the availability of pharmacotherapeutic cessation aids. Long lasting abstinence rates following tobacco cessation measures remain less than optimal Several alternative treatments have been studied for tobacco cessation including natural products, such as Avena sativa1, lobeline2, mint snuff3, black pepper extract4, St. John’s wort5 and herbal tea preparation6. Although there is a lack of convincing evidence of efficacy, patients do use above alternative herbal drugs. We recently came across an interesting case of a chronic tobacco chewer, who got rid of this habit by chewing tender neem leaves. As this observation has potential of developing a novel and effective remedy from herbal sources for achieving tobacco cessation we wish to share this experience with scientific community. A-55-year-old male, an avid tobacco chewer for the last 10 years presented to us for his anginal pain. In view of his hypertension, previous coronary episode, stable angina and central obesity, he was advised standard anti-ischaemic treatment along with strict life style measures like zero tobacco chewing, morning walk and appropriate diet. He was also advised to come for review a month later. On second visit after a month, he was symptomatically much better, his angina had almost disappeared and his craving for tobacco chewing was no more. During the course of examination we noticed that the patient had a peculiar and unpleasant oral smell which was definitely not there during his previous admission. When enquired that how could he get rid of tobacco chewing, he disclosed that he experimented chewing tender neem leaves (Azadirachta indica) to quell the urge of tobacco chewing. He has been chewing about 5 grams of neem leaves per day for about one month regularly. This had completely abolished his tobacco urge. However, it did leave a bad odour and bitter taste in his mouth. The neem (Azadirachta indica) tree, is an evergreen tree native to the Indian subcontinent. It has been popularly used for oral and cutaneous sepsis since centuries. Scientific studies have demonstrated neem to be having anti-proliferative, anti-oxidant, cytotoxic and antiinflammatory properties.7 A number of bioactive components commonly referred to as limonoids have been isolated from various parts of the neem tree, which include azadirachtin, salannin, meliantriol, and nimbin. Azadirachtin constitutes the major component. The bitter taste of the tender leaves lead this patient to chew the leaves intuitively to curb the urge of tobacco chewing and it turned out to be a successful attempt. Neem (Azadirachta indica) as an Alternative Therapy for Tobacco Cessation