Asian Journal of Immunology

Dry nasal snuff, commonly known as “Chhikni” in India, is a smokeless tobacco preparation prepared from dried powdered tobacco which could be inhaled, "sniffed" or "snuffed" into the nasal cavity [1]. The inhalation of nasal snuff (smokeless tobacco) is a common addiction in rural India. In the western world, there is a resurgence of interest in the use of nasal snuff. Very few cases have been reported regarding long-term effects of nasal snuff on lung parenchyma. We hereby present the case of a 67-year-old woman who developed chronic hypersensitivity pneumonitis because of sniffing dry snuff. She sniffed dry snuff for 30 years about four to five times a day. She was successfully treated with corticosteroids and was discharged on home based minimal O₂ support. This case report aims to emphasizes on the respiratory complications associated with snuffing noxious substances and considering hypersensitivity pneumonitis as a possibility.