Dental Principal of Village Dental Practice, Dr. Priya Patel, examines the increasing ‘epidemic’ threat of smokeless tobacco in India, along with the dangers of continual use.

Innumerable Indians are addicted to nicotine in various forms. Some smoke, while others chew tobacco. Many live under a myth that chewing ‘gutka’ is less harmful than smoking cigarettes. But not many are aware that this smokeless tobacco is a powerful ingredient for your slow death.


A smokeless tobacco is that tobacco that is not burned when it is consumed or used. It is also known as chewing tobacco, dip (suck), and even snuff. You might have come across people who would chew or suck tobacco in mouth and once the juices are built they would spit it out. They fail to understand that even if they do not swallow the tobacco or its juice the nicotine in tobacco would be absorbed by their lining of mouth.

People in several regions of India share a long history of consuming various smokeless tobacco products. A survey conducted in 2010 by NCRP (National Cancer Registry Program) states that out of three inhabitants of Madhya Pradesh one consumes a preparation of crushed betel nut, acacia extract and tobacco. It is more worrying to note that the age group of people consuming this harmful preparation is 15 years and more.

Children under 15: The habit of consuming ‘gutka’ or tobacco is common amongst five million children in India. About 50% of children in Karnataka, below the age of 10 have experimented with ‘gutka’ or tobacco. When interrogated for this habit they will push it on their parents or grandparents. Imitating the harmful habit of elders in family and society has become a common scene states a study by Tata Memorial Hospital and Tata Institute of Fundamental Research, Mumbai. Global Youth Tobacco Survey has a shocking result of 8% boys and 2% girls between the age group of 13 – 15 consume tobacco.

Adult Smokeless Tobacco Users: Various pieces of research have revealed that India has the highest rates of oral cancer across the globe. The NCRP study has reported approximately 35,000 cases related to oral cancer in one state – Madhya Pradesh. You can imagine roughly what the number will be for the entire nation! A Global Adult Tobacco Survey has stated in its results that 40% males and 16% females in Karnataka use tobacco.


Remember that smokeless tobacco contains nicotine that is present in cigarettes too. Holding of an average sized dip or even chewing tobacco for 30 minutes or more will pass the nicotine equivalent to three cigarettes. The use of tobacco has long back established its risk factors. Yet there are many men as well as women who continue to consume tobacco. It is noticed that approximately 50% of men and 11% of women between the age group of 15 to 49 consume some or the other form of tobacco. This addiction is becoming more of a habit for the tobacco consumers. There are several health complications that smokeless tobacco can pose to an individual.

Oral Cancer: Cancers of oral cavity is the biggest threat that smokeless tobacco pose. Oral cancer usually includes cancers in several parts of mouth, pharynx or voice box and the throat. This type of cancer has been established to be the trickiest cancer to treat. This cancer can easily branch out to various parts of a person’s body.

When a surgery is prescribed it is not only extensive but also disfiguring. But there is no assured success to this mode of treatment. More than 8,000 people die every year due to mouth cancer. Users of the tobacco especially the smokeless ones are four times at risk of oral cancer.

Gum recession: This problem is not just unsightly but also increases the risk of a person gaining cavities on their tooth roots. Chewing tobacco also results in sensitivity in teeth. When you visit your dentist you will come to know that gum recession is that dental complication that is difficult to treat.

Hypertension: Smokeless tobacco will increase the risk of hypertension in a person. The nicotine present in the tobacco will narrow the veins of a person making it severe for the person. The increase in blood pressure can result in various other health complications.

Heart diseases: Nicotine in the tobacco reduces the supply of oxygen to a person’s heart. This will make the person vulnerable to heart complications like acute cardiac, severe pain in chest, damage to the muscles of heart etc.

Ulcers: It is impossible for any person to restrict the intake of tobacco juice. No matter how much care is taken some portion of the juice is accidently swallowed. This would irritate the stomach and digestion process leading to ulcers. Apart from severe complications there are also everyday problems that frequent tobacco chewers will have to face.

Bad breath: The smell that is left behind in the mouth of smokeless tobacco consumers is not pleasing. In fact the person sitting next to the smokeless tobacco consumers would find it very unpleasant and experience disgusting odour.

Stained Teeth: Tobacco chewers are easy to spot. It is because along with bad breath they get staining on their teeth too. The worst thing is that it is impossible to remove the stains with toothpaste and toothbrush. Professional cleaning might offer a temporary solution. But if the person does not abstain from chewing tobacco then the stains will reappear.

Changes in Mouth: Many smokeless tobacco consumers notice their mouth undergoing several changes. They see sores, lumps, red and white patches inside their mouth. These are the signs of damage that has been caused by the nicotine in the tobacco. The white and the red patches are the initial signs of cancer of the mouth. If such signs are ignored or left untreated then the person could face the severe consequences of oral cancer.

It is high time that the adults realise the consequence of their hazardous habit. Not only does their habit their own health but also the health of their children. The only solution to the above mentioned complications is abstinence from tobacco or any substitutes like ‘gutka’, ‘paan masala’ etc.

Please visit, a campaign-based website by Dr Patel, which provides information to people about oral health and oral cancer in India. You can also follow Dr. Patel on Twitter.


Oral Health Foundation

The Oral Health Foundation is a charity that works to improve oral health by providing education, advice, and support to millions of people every year, changing lives for the better. Our mission is to support others in achieving a healthier life through better oral health. Our vision is to live in a world where everybody has a healthy mouth and is free of dental disease. Poor oral health can have a harmful and devastating effect on a person’s life – both for their physical health and mental wellbeing. We are determined to help more people achieve good oral health and have a better quality of life. Sadly, oral disease remains common, across the life course. We are taking the challenge to reduce the harm caused by poor oral health and the responsibility to create a healthier future for everybody. We do this because we believe that everybody deserves to have good oral health. To make sure this happens, by 2024, we will:

    • Work towards decreasing the prevalence of oral disease across communities.
    • Increase the number of people accessing our help and information services.
    • Diversify our range of resources to reach more communities.
    • Successfully campaign for policies which help people achieve healthier lives.
    • Generate new and nurture existing income streams that enable us to deliver our charitable objectives.

We are going to achieve success by:

    • Running awareness campaigns like National Smile Month and Mouth Cancer Action Month.
    • Giving anybody who needs it direct support through our Dental Helpline.
    • Influencing policy on subjects like dental access, sugar, and tobacco.
    • Providing consumer advice on oral health care products and working alongside manufacturers to make sure products do what they claim to do.
    • Creating resources and information that communicates positive oral health messages.
    • Working alongside others who share our passion for health and wellbeing.

To find out more about us, visit our website at

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