NEW DELHI — India is facing a catastrophic public health crisis driven not by smoke, but by the silent, widespread consumption of smokeless tobacco (SLT). According to data released in a comprehensive public health briefing, India is now home to nearly 20 crore adult users of smokeless tobacco. This represents a staggering 21.4% of the entire adult population, making India the epicenter of a global epidemic.
The health consequences are devastating. A landmark study published in The Lancet Oncology reveals that out of 120,200 global oral cancer cases tied to smokeless tobacco and areca nut use, a shocking 83,400 cases—nearly 70%—occur in India alone.
A Diverse and Lethal Market
Unlike Western nations where smokeless tobacco is primarily limited to snuff or dip, India boasts a highly diverse and unregulated market. Products are chewed, sucked, or applied directly to the oral cavity.
Data from the Global Adult Tobacco Survey (GATS-2) highlights the breakdown of individual product popularity among Indian adults:
- Khaini: 11.2% (Used by 1 in every 9 adults)
- Gutkha: 6.8%
- Betel quid with tobacco: 5.8%
- Oral application (Mishri/Gul/Gudakhu):3.8%
- Paan masala with tobacco: 2.8%
- Snuff: 0.6%
The Myth of the “Safer Alternative”
Public health experts are aggressively dismantling the misconception that smokeless options are safer than smoking. Clinical data shows that while cigarettes deliver nicotine faster, the total nicotine absorption (AUC) between smoking and chewing is nearly identical.













