Smokeless tobacco 'a global burden', new study says

Smokeless tobacco poses a major threat to public health, reaffirm researchers from the University of York. Its use must be regulated by governments and public health authorities, through the proper implementation of the WHO Framework Convention on Tobacco Control, they continue.

In August 2015, six researchers from the University of York in the United Kingdom presented the first estimates of the burden of disease linked to smokeless tobacco use[1]. In 2020, after updating the results by these same researchers, it is clear that the global situation has worsened and that the need for regulation and prevention is becoming necessary.

Banned in the European Union, widespread worldwide

Whether chewed, sniffed or snorted, smokeless tobacco products are consumed on every continent inhabited by humans. The study, "Global burden of disease due to smokeless tobacco use among adults: an updated analysis of data from 127 countries," published Wednesday, August 12 in the journal BMC Medicine[2], reports globalized consumption present in all age groups (from 15 years old).

In 95 of the 127 countries where smokeless tobacco products are consumed, male consumption is the most prevalent. Female consumption, on the other hand, comes first in Mauritania where the rate stands at 28.3%.

In Europe, snus is mainly consumed in Sweden and Norway with respective rates of 25% and 20.1% in men and 7% and 6% in women. As a reminder, snus is banned within the European Union.

Smoke-free, but still dangerous for your health

To estimate the burden of disease associated with smokeless tobacco products, the University of York researchers used the same methodology as in the study published in 2015. They combined the analysis of national surveys on smoking habits with the available scientific literature on the health effects of smokeless tobacco products.

In 2015, these researchers highlighted the links between these tobacco products and the risks of cancers of the oral cavity, pharynx and esophagus as well as heart disease and risks of stroke. Since 2014, the scientific literature has expanded with new studies focusing in particular on cancers of the oral cavity, heart disease and stroke. These have been taken into account in updating the estimate.

The burden of disease associated with tobacco use was estimated in terms of lives shortened and disability-adjusted life years. Thus, smokeless tobacco takes 90,791 lives and reduces 2,556,810, due to cancers of the oral cavity, pharynx and esophagus. It takes 258,006 lives and reduces 6,135,017, due to heart disease.

Geographically, more than 85% of this load is concentrated in the South and Southeast Asia region. India, Pakistan and Bangladesh are the most affected countries[3].

A globalized problem expressed in diversity

Given, on the one hand, their harmfulness to health and, on the other hand, the fact that 300 million people consume them, smokeless tobacco products represent a global public health problem. Furthermore, this is a problem that has worsened between 2015 and 2020. The need to prevent health risks and regulate the consumption of these products is therefore clear.

However, measures taken to combat this burden of disease still lag far behind those taken to reduce cigarette consumption. Moreover, the term "smokeless tobacco product" refers to a multitude of products. This diversity due to preparation methods, compositions and health risks is, in fact, problematic for developing prevention and control policies.

However, the researchers point out that these smokeless products all have one thing in common: they are tobacco products. Therefore, they are covered by the WHO Framework Convention on Tobacco Control (FCTC) and a uniform application of the FCTC articles for all tobacco products should allow the development of control and prevention policies to reduce the consumption of smokeless tobacco products.

©Tobacco Free Generation

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[1] Siddiqi K, Shah S, Abbas SM, et al., Global burden of disease due to smokeless tobacco consumption in adults: analysis of data from 113 countries, BMC Med. 2015; 13: 194 (Published 2015 Aug 17. https://doi:10.1186/s12916-015-0424-2 - accessed 17 August 2020). [2] Siddiqi, K., Husain, S., Vidyasagaran, A. et al., Global burden of disease due to smokeless tobacco consumption in adults: an updated analysis of data from 127 countries, BMC Med 18, 222 (2020). https://doi.org/10.1186/s12916-020-01677-9 (accessed 17 August 2020). [3] University of York, Global deaths due to smokeless tobacco are up by a third, according to new study, www.scienceDaily.com (August 13, 2020 - accessed August 17, 2020). You may also be interested in these articles: DNF, Snus, a not-so-mild drug!, Tobacco-Free Generation (June 17, 2020 – accessed August 17, 2020). DNF, Sweden, a good student of the European Union?, Tobacco-Free Generation (June 23, 2020 - accessed August 17, 2020). DNF, After heated tobacco, it is now the turn of snuff to seek the status of “modified risk tobacco product”, Tobacco-Free Generation (July 21, 2020 - accessed August 17, 2020). DNF - For a Zero Tobacco World | MT