Smokeless tobacco is tobacco or a tobacco product that is used by means other than smoking. These uses include chewing, sniffing, placing the product between the teeth and gum, or application to the skin.
"Nearly 85 per cent of the total burden attributable to smokeless tobacco (SLT) use was in South-east Asia, with India alone accounting for 74 per cent of the global burden, followed by Bangladesh (five per cent)," says the study that assessed the impact of smokeless tobacco on adults in 115 countries. The study also found that SLT consumption was higher among males than females.
According to Kamran Siddiqi, senior lecturer in epidemiology and public health at University of York in England, "It is possible that these figures are underestimated and future studies may reveal that the impact is even bigger. We need a global effort to try and address and control smokeless tobacco".
Mr. Siddiqi further says that South-east Asia was a hotspot and in particular India which accounts for around 75% of the global disease burden. The international policy to regulate the production, sale, composition and marketing of these products is not in place as of cigarettes.
India is the second largest producer of tobacco after China. SLT use is an imminent public health problem, which is contributing to high disease burden on the nation.
Government of India (GoI) has taken various initiatives for tobacco control in the country. Assam was the first Indian state to ban consumption of all forms of smokeless tobacco. The advocacy for tobacco control by the civil society and community led initiatives has acted in synergy with tobacco control policies of the Government.
Although different levels of success have been achieved by the states, non-prioritization of tobacco control at the sub national level still exists and effective implementation of tobacco control policies remains largely a challenge. Despite bans on advertising, sale to minors and smoking in public places, over one in three adults use some form of tobacco in India. “Hard-hitting anti-tobacco advertisements and graphic pack warnings – especially those that include pictures – reduce the number of children who begin smoking and increase the number of smokers who quit”, says the WHO.