Global Tobacco Control Updates

Smokeless Tobacco Use Has a Significant Impact on Global Health
04 Nov 2015
Research Alert

An analysis published in BMC Medicine estimates the global burden of adult smokeless tobacco use for the first time ever. The analysis is based on data from the 2010 Global Burden of Disease study and systematic reviews of country-specific prevalence and epidemiological studies related to smokeless tobacco use worldwide. Estimates of the overall burden of disease of smokeless tobacco use in terms of number of deaths and disability-adjusted-life-years (DALYs) were calculated for 113 countries. DALYs are the number of years lost due to ill-health, disability or early death.


  • In 2010, adult smokeless tobacco use was estimated to have led to 6.4 million DALYs lost and 266,592 deaths. This includes:
    • 1.7 million DALYs lost and 62,283 deaths due to cancers of the mouth, pharynx, and esophagus; and 
    • 4.7 million DALYs lost and 204,309 deaths due to ischemic heart disease.
  • Three-quarters of the DALYs lost and deaths were among males.
  • Over 85% of the total burden was in the WHO South-East Asia Region.
    • India alone accounted for an estimated 74% of the global burden, and Bangladesh accounted for 5%.

Key Messages

  • Smokeless tobacco use causes serious health conditions, disability and death.
  • The WHO Framework Convention on Tobacco Control obligates Parties to protect health by acting to prevent and reduce the use of tobacco products including smokeless tobacco. 
  • Policies to prevent and reduce smokeless tobacco should include tax measures that increase the price of smokeless tobacco products, comprehensive marketing bans, graphic warning labels on product packages, and product regulation.

Full Citation: Siddiqi K, Shah S, Abbas SM, Vidyasagaran A, Jawad M, Dogar O, Sheikh A. Global burden of disease due to smokeless tobacco consumption in adults: analysis of data from 113 countries. BMC Medicine. 2015 August: 13(194).

Full study [English only] available from:

Additional Resources:

BMC Medicine is an online, peer reviewed medical journal produced by BioMed Central, an open-access science, technology, and medical publisher.

If you have questions about the study or how you may use it in your advocacy efforts, please contact


graphic warning labels, smokeless