Deaths due to smokeless tobacco use rising in India, warns study

Researchers, including those from the University of York in the UK, said the study comes at a time when there are concerns that spitting, a behaviour common among those who chew tobacco, is likely to transmit the COVID-19 virus. The study, published in the journal BMC Medicine, calls for governments and public health bodies to regulate the production and sale of smokeless tobacco.

The number of deaths globally due to smokeless tobacco has gone up by a third in seven years to an estimated 3,50,000 people, according to a new study which says India continues to be a hotspot accounting for about 70 percent of the global disease burden due to its use. Researchers, including those from the University of York in the UK, said the study comes at a time when there are concerns that spitting, a behavior common among those who chew tobacco, are likely to transmit the COVID-19 virus. 

The study, published in the journal BMC Medicine, calls for governments and public health bodies to regulate the production and sale of smokeless tobacco. According to scientists, a ban on spitting in public places will also discourage smokeless tobacco use and may reduce the transmission of COVID-19. "The study has come at a time when COVID-19 is affecting almost all aspects of our lives. Chewing tobacco increases saliva production and leads to compulsive spitting," said Kamran Siddiqi, a co-author of the study from the University of York.

"There are concerns that spitting -- a behavior common among those who chew tobacco -- is likely to transmit the virus to others," Siddiqi said. The research estimates that in 2017 alone smokeless tobacco resulted in more than 90,000 deaths due to cancers of the mouth, pharynx, and esophagus, as well as accounting for more than 2,58,000 deaths from heart disease. It noted that millions more have their lives shortened by ill-health due to the effects of chewing tobacco-based products.

The researchers compiled the figures using data from 127 countries and extracted from the 2017 Global Burden of Disease Study and surveys such as the Global Adult Tobacco Survey. Siddiqi said South and South-East Asia continue to be a hotspot with India accounting for 70 percent, Pakistan for 7 percent, and Bangladesh for 5 percent of the global disease burden due to smokeless tobacco.

"Smokeless tobacco is used by almost a quarter of tobacco users and most of them live in India, Pakistan, and Bangladesh. In the UK, South Asian communities also consume smokeless tobacco products which too needs to be regulated just like cigarettes," Siddiqi said. "We have an international policy in the form of the World Health Organisation's Framework Convention for Tobacco Control, to regulate the supply and demand of tobacco products. We need to apply this framework to smokeless tobacco with the same rigor as it is applied to cigarettes," he added.

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