New Delhi: Chewing tobacco contributed to 2,51,000 deaths worldwide in 2023, with about 84% of these deaths being concentrated in South Asia, a recent study published in The Lancet Global Health journal found.
Published on 30 September, the study was conducted by the Institute for Health Metrics and Evaluation (IHME) and is part of the Global Burden of Disease Study 2023 (GBD 2023)
The researchers claim that the analysis “is the most comprehensive assessment to date of chewing tobacco-related health burden.”
The study covers 204 countries and territories from 1990 to 2023.
Despite decades of progress in tobacco control, the study finds that global tobacco use has remained relatively unchanged over the last two decades.
Around 241 million people, aged 15 years or older, used tobacco in 2023, creating a prevalence of 3.9 per cent tobacco usage globally. The usage rates were twice as high among men as among women, the study found.
Additionally, while no country recorded a significant decrease in the number of tobacco users, 24 countries saw significant increases.
The South Asian connection
South Asia bears an unequal burden of global tobacco use, with 14.6 per cent of people aged 15 years or older chewing tobacco products in 2023. This is significantly higher than the global average of 3.9 per cent. Researchers also found that 1 in 5 men and 1 in ten women in South Asia chewed tobacco in 2023.
While Nepal, Madagascar, and Yemen saw increases in the number of tobacco users between 1990 and 2023, Bangladesh saw the biggest uptick. According to the study, the country recorded 15 million new users in the stipulated time.
The study identified India as the country with the largest number of chewing tobacco users, with 105 million people accounting for two-thirds of users globally.
The use of tobacco exploded in the country in the 1980s when manufacturers began grinding it into powders and selling them in packets as gutkha.
Even though gutkha was banned in 2012, it is still widely available and consumed in the country.
“Chewing tobacco is not a uniform public health problem, and our findings show that a relatively small number of countries bear an overwhelming share of its health burden”, said Gabriela Gil, lead author and Research Scientist at IHME.
“Understanding how patterns of use differ within these populations is critical to designing more effective prevention and tobacco control strategies,” she added.
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What are the health risks?
Stroke accounted for the largest share of chewing tobacco-related health loss globally, at 55.9 disability-adjusted life-years (DALYs) per 100,000 people, the study showed.
Stroke was followed by lip and oral cavity cancer. Chewing tobacco was responsible for 17.3 per cent of lip and oral cavity cancer DALYs worldwide, rising to 30.5 per cent in South Asia.
Additionally, health loss attributed to chewing tobacco doubled between 1990 and 2023, increasing by 116% to 6.48 million DALYs globally.
Edited by Maryam Hassan