Smokeless Tobacco

News blog readers will have seen our recent blog post on the dangerous areca nut that is often chewed with tobacco. Siddiqi and colleagues have carried out a massive survey of the use of “smokeless tobacco” worldwide, yielding data from 113 countries.[1] Smokeless tobacco is heavily consumed in South and South East Asia, and some African and Nordic countries. The authors conducted an extensive meta-analysis of the effects of oral tobacco – a task made complex by the many different preparations. For example, versions used in Nordic countries, South Africa and North America seem innocuous, whereas versions used in Asia are highly carcinogenic, even after controlling for alcohol and smoking. Of course, much of the toxicity may come not from the tobacco, but from the areca nut that often accompanies it and which releases large amounts of cancer and fibrosis-inducing copper.

— Richard Lilford, CLAHRC WM Director


  1. Siddiqi K, Shah A, Abbas SM, Vidyasagaran A, Jawad M, Dogar O, Sheikh A. Global burden of disease due to smokeless tobacco consumption in adults: analysis of data from 113 countries. BMC Medicine. 2015. 13:194.

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