The number of global deaths due to smokeless tobacco has increased by a third in seven years to an estimated 350,000 people, according to Addressing Smokeless Tobacco Use & Building Research Capacity in South Asia (ASTRA) at the University of York.
ASTRA is now calling on governments and public health bodies to regulate the production and sale of smokeless tobacco. The group says that a ban on spitting in public places also will discourage smokeless tobacco use and may reduce the transmission of COVID-19.
“The study has come at a time when COVID-19 is affecting almost all aspects of our lives. Chewing tobacco increases saliva production and leads to compulsive spitting,” said Karman Siddiqi, PhD, of the Department of Health Sciences at Hull York Medical School.
“There are concerns that spitting, a behavior common among those who chew tobacco, is likely to transmit the virus to others,” Siddiqi said. “In acknowledgement of this, India for example has already taken a positive step by banning spitting in public places to reduce the transmission of COVID-19.”
The researchers estimate that in 2017, smokeless tobacco resulted in more than 90,000 deaths due to cancers of the mouth, pharynx, and esophagus and accounted for more than 258,000 deaths from heart disease. Millions more have their lives shortened by ill health due to the effects of chewing tobacco-based products, the researchers added.
The researchers compiled the figures using data from 127 countries and extracted from the 2017 Global Burden of Disease Study and surveys such as the Global Adult Tobacco Survey.
South and Southeast Asia continue to be hotspots, with India accounting for 70% of the global disease burden due to smokeless tobacco, while Pakistan accounts for 7% and Bangladesh accounts for 5%.
“Smokeless tobacco is used by almost a quarter of tobacco users and most of them live in India, Pakistan, and Bangladesh. In the UK, South Asian communities also consumer smokeless tobacco products, which too needs to be regulated just like cigarettes,” Siddiqi said.
“We have an international policy in the form of the World Health Organization’s Framework Convention for Tobacco Control to regulate the supply and demand of tobacco products. We need to apply this framework to smokeless tobacco with the same rigor as it is applied to cigarettes,” he said.
The study, “Global Burden of Disease Due to Smokeless Tobacco Consumption in Adults: An Updated Analysis of Data from 127 Countries,” was published by BMC Medicine.