As per the GATS atlas. Atlanta: Centers for Disease Control and Prevention out of 248 million individuals globally who consume smokeless tobacco products, 206 million i.e. approx 83% of tobacco consumers are from India.

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Number of smokeless tobacco users in India, 2009

Smokeless tobacco is consumed through the mouth or nose, without combustion or burning.

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Chewing tobacco varieties include betel quid, chimo, gutkha, loose-leaf, plug, toombak, twist. These products are placed in the mouth, cheek, or inner lip and chewed or sucked, or, in the case of powders, applied to the gums or teeth. Betel quid consists of tobacco, areca nut, slaked lime, and flavorings wrapped in a betel leaf. Varieties of chewing tobacco also include gundi, hogesoppu, kadapam, kaddipudi, khiwam, mishri, patiwala, and zarda

Gutkha

Moist snuff is usually made from a mixture of fire-and-air-cured dark tobaccos. The cured tobacco is aged for at least one year before being taken for production. An alternative is available in the form of sachets (like a tea bag), where moist snuff is packed into a porous paper-like material. Other local moist products and varieties are iqmik (commonly used in Alaska), khaini, nass or naswar, and shammah.

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Snus is usually made from ground tobacco. Snus is typically taken either as a pinch that is placed in the vestibular area of the upper jaw or in pre-packaged, portion-sized quantities (sachets).

Dissolvables contain tobacco and numerous other agents that dissolve in the mouth and deliver nicotine via mucosal absorption.

Tobacco is the only legalized product which, even when used in moderation and exactly as the manufacturer intended, causes harm to the consumer.

The Oxford Medical Companion

Tobacco consumption was perceived to dominated by males but it’s not so now. As per a recent white paper published in the Indian Journal of Medical Research by Dr.Shalini Singh, Indian Council of Medical Research. In India, according to the latest GATS survey (2016-2017)12, 12.8 percent of women aged 15 yr and above were consuming any form of smokeless tobacco. Making 58.2 million women of India consuming any form of smokeless tobacco.

The States/ UT with high consumption of smokeless tobacco in India (in descending order) are Tripura, Manipur, Odisha, Assam, Arunachal Pradesh, Nagaland, Chhattisgarh, Jharkhand, Mizoram, Uttar Pradesh, Madhya Pradesh, Maharashtra, and Bihar.

The focus on women and girls is essential for a better future of India, and Sustainable Development of ensuring healthy lives and promote well-being for all.