Smokeless Tobacco


(or betel quid) – a preparation of betel leaf, areca nut, flavourings and spices, often with slaked lime, and tobacco. Chewed (and usually spat out). Commonly used throughoutSouth Asia.


a dry, granular, commercially manufactured version of paan, easy to put into small packets and carry around for use ‘anytime, anywhere’. Chewed, or kept in the mouth, and spat or swallowed. Banned in India.


a flaky mixture of tobacco, lime, spices and vegetable dyes. Chewed with chopped areca nut, or used in paan. Common throughout South Asia.


a blend of tobacco, oil, ash or slaked lime and other ingredients, according to regional preference. It is rolled into a ball and held in the mouth and sucked. Popular in Pakistan and in Central Asia (where it is called nasvay).

What is Smokeless Tobacco?

Smokeless tobacco (ST) refers to tobacco products that are consumed without being burnt.

Such products include ‘chewing tobacco’ (e.g. paan , gutkha or zarda ), as well as various other types of nasal and oral tobacco (like naswar ).

Smokeless tobacco is particularly popular in South Asia, where it is socially acceptable, even when cigarettes aren’t.


There are many different types of ST products and recipes, and they may be commercially manufactured or home-made. Very often, the tobacco is mixed with other ingredients, such as betel nuts (areca), herbs and spices. These make the products look and taste appealing, but some of the additives may themselves be harmful to health. Sometimes manufacturers (falsely) claim that their ST products freshen the breath, clean the teeth or have other health benefits.

Smokeless tobacco products have historically been assumed to be less harmful than cigarettes. Therefore, not very much research has been done on smokeless tobacco. However, ST can be highly addictive and is known to cause cancers of the mouth, pharynx and oesophagus, as well as leading to cardiovascular disease and pregnancy problems. Over 300 million people around the world use ST, causing an estimated 350,000 deaths per year. Smokeless tobacco is a global public health issue, but more than 80% of ST users live in South Asia; hence our focus on Bangladesh, India and Pakistan.

Policies that are designed to reduce the harm caused by tobacco products are already in place in many countries, but these are often applied less strictly to ST than to smoked forms of tobacco.