Written by Dr Priya Patel

The wide popularity of chewing tobacco has raised many alarming concerns for health experts in most countries around the world. According to recent health studies the number of oral cancer patients is increasing day by day in India, with smokeless tobacco at its heart. The use of tobacco in India can be traced back to ancient periods of times when it had been used with betel leaf however; the use of tobacco has been increased up to a great extent after the production of readymade sachets.

History of Tobacco in India:

Tobacco was introduced in India about 400 years ago by Portuguese merchants. Before that, Indians were also using locally grown tobacco product. India is considered as the second largest tobacco producer in the world today. The perfect weather condition, fertile soli, frequent rainfall and sufficient sun shine has created a favorable atmosphere for the growth of tobacco tree. There are different varieties of tobacco produced in India and some of them are also being exported to foreign countries. All these kinds of tobacco can be classified into 3 main categories.

• Leaf tobacco
• Chewing (smokeless tobacco) products
• Smoking products

Excessive production and use of tobacco products has increased the chance of oral cancer in the country. India is seen as one of the biggest tobacco markets in world today. There have been several steps taken by India to reduce the usage of tobacco products. According to National Sample Survey (NSS), the use of tobacco has been decreased up to a great extent in the following few years. Still there are lots of attempts to be made to make India a tobacco free country.

Smokeless tobacco damage in India:

India ranks second in the number of tobacco users in the world next to China. There are around 275 millions people using such toxic product in the country. Unlike China, India has more numbers of smokeless tobacco users (around 206 millions).

– Study published in 17th Aug 2012 in “The Lancet” Newspaper –

The major form of smokeless tobacco used in India is chewing products and leafs. Leaf tobacco has been used in many Indian subcontinents these days. During 2008-10, around 23% men in India were smokers, which was quite less as compared to other countries like U.K, U.S and Russia. India has nearly 33% male smokeless tobacco users.

GUTKHA: A chewing tobacco brand in India

Gutkha is a common tobacco chewing product used widely in India. Although the brand doesn’t say that it contains Tobacco; it is quite injurious to the body and can cause deadly disease like oral cancer in the later stage. It is available in small sachets also which can be purchased from local stores. Some Gutkha products are used as only mouth fresheners whereas some other types are also used with chocolate flavor.

Diseases caused by Smokeless tobacco:

Using tobacco regularly can bring in several health issues starting from general mouth infection to deadly oral cancer. The products are quite popular among children of 15-17 years of age. Following are few important diseases caused by such toxic products.

Oral Cancer:

The study by medical experts has revealed that excess use of tobacco products can cause deadly disease like oral cancer in individuals. The chances of pre-cancerous growth in children below 11-12 years of age have become a major concern for many health experts. The disease has 10 years of incubation period and it can appear any time during that time frame. Oral cancer is really a lethal disease and it should be identified at the beginning stage. You need to visit a good health clinic in your city in order to come out from the complications. Don’t forget to consult an experienced health expert as he or she can identify the stage of disease at the right time.


Sub-mucous fibrosis (SMF) is another major health issue caused by use of smokeless tobacco. Using such toxic substance for longer period of time produces a hardened structure at mouth lining which then turns into mouth cancer in the later stage. If such hardening structure appears in your mouth, it is really important to take appropriate measures right from the initial stage of disease. You need to consult an experienced health specialist as he can identify the main cause behind the disease and suggest the right measure to heal it effectively.

After the formation of SMF within the mouth region, the patient faces difficulty while opening and closing the mouth. The problem deepens with the passage of time and in some cases, the patient becomes unable to eat solid foods. This happens when the muscles in mouth becomes contracted and prevents it to open. Those patients are fed only with liquefied foods.

Prevention tips to make India free from oral cancer:

• Since the main reason for oral cancer is excessive use of smokeless or chewing tobacco products, you need to avoid them. It might be difficult for you to stay away from tobacco products in the first stage but it would turn into a habit after few days.

• Brush and floss your teeth regularly. Clean your mouth by using a good mouth rinse product. This would help you to get rid from poor hygiene conditions and you can eliminate the chances of oral cancer as well.

• You need to follow regular exercises as that would help in blood circulation around the arteries and veins. This would also help to drain away all toxic substances present in the cells in the form of sweat.

• Incase you found hardened structure inside your mouth; you should consult a good health specialist immediately. Doctors have suggested that 99% of oral cancers can be cured if those are identified right at their beginning stage.

• Don’t forget to consult a good and experienced dental or oral professional if you experience any sign or symptom of oral cancer.

• Children from the age group 15-20 years use tobacco products in excess amounts. It is the primary responsibility of all parents to teach their children about the harmful effects of oral cancer.


THE HINDU: 206 million Indians use smokeless tobacco: study

Economic history of tobacco production in India

BBC: Cancer epidemic on the way


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 https://www.dentalhealth.org/