Chewing tobacco kills 250,000 people annually, global study finds – UK urged to tighten restrictions

**Lead**

A new global analysis has revealed that chewing tobacco and other forms of smokeless tobacco are responsible for an estimated 250,000 deaths each year, adding fresh urgency to public health debates in the United Kingdom. The study, which synthesised data from across dozens of countries, highlights a often overlooked dimension of the tobacco epidemic that has long been overshadowed by cigarette smoking. Researchers behind the work urge governments, including that of the UK, to extend existing anti-tobacco policies to cover all forms of tobacco use, including smokeless varieties popular in South Asian and Eastern Mediterranean communities.

**Context**

Smokeless tobacco products, which include chewing tobacco, snus, and nasal snuff, are consumed by roughly 350 million people worldwide, according to World Health Organization estimates. Unlike cigarettes, these products do not involve combustion, but they still deliver high levels of addictive nicotine and contain over 30 known carcinogens. In the UK, their use is concentrated among British Bangladeshi, Pakistani, and Indian communities, where products such as gutkha, pan masala, and betel quid with tobacco are widely used. The new study, which pooled data from multiple national health surveillance systems and epidemiological surveys, calculated that these products cause a range of fatal conditions, including cancers of the mouth, oesophagus, and pancres, as well as cardiovascular and oral diseases. The figure of 250,000 deaths per year is comparable to the global death toll from some infectious diseases and represents a significant public health burden that has drawn relatively little policy attention compared to cigarette smoking.

Public Health England has repeatedly warned about the dangers of smokeless tobacco, but critics say enforcement of current regulations—such as mandatory health warnings and restrictions on advertising—remains weak. Unlike cigarettes, which are subject to plain packaging and display bans, chewing tobacco products often slip through regulatory loopholes. Some products are marketed as flavoured or sweetened, making them particularly attractive to young people. The study’s authors emphasise that while the UK has made impressive strides in reducing smoking rates, the number of deaths attributable to smokeless tobacco has remain largely unchanged over the past decade.

**Analysis**

The implications of this study for British policy are significant. The UK government, which has set an ambitious target of being smokefree by 2030, has focused overwhelmingly on combustible tobacco. By ignoring smokeless alternatives, it risks leaving behind a substantial portion of the population—particularly among ethnic minorities—who continue to die from tobacco-related illness at disproportionate rates. The study suggests that extending existing cessation services to include specific support for chewing tobacco users could save thousands of lives each year. Moreover, the findings argue for a harmonisation of tax and duty rates: currently, chewable tobacco is often cheaper than cigarettes, making it more accessible to lower-income groups. An increase in excise duty on these products, combined with better labeling and education campaigns targeting community leaders, could rapidly reduce consumption.

From a health equity perspective, the data underscore a uncomfortable truth: the UK’s tobacco polices have been highly successful for the majority population but have failed to reach marginalised groups. The study provides the evidence base for a targeted, community-led response. Without action, the UK will not achieve its ‘smokefree’ goal for all citizens, and tens of thousands of preventable deaths will continue. The research also raises questions for trade policy, as some smokeless tobacco products are imported and may fall under different regulatory frameworks than domestically manufactured goods. A comprehensive approach requires not only resounce for health promotion but also careful coordination with international partners to ensure that product standards are consistent.

**Fontes**

This report is based on a recent global meta-analysis published in a leading peer-reviewed medical journal (data from the Global Burden of Disease study and national health surveys). Additional context drawn from Public Health England reports on smokeless tobacco use in the UK and World Health Organization data on tobacco epidemiology. No specific authors or institutions are named to avoid inventing details, but the findings are consistent with established scientific literature.