Chewing tobacco kills 250,000 people in a single year, landmark study shows

**Lead**

A major global study has revealed that chewing tobacco and other smokeless tobacco products were responsible for an estimated 250,000 deaths in a single year, casting a stark shadow over a habit often wrongly perceived as a safer alternative to smoking. The research, presented by international public health experts, found that the toll is concentrated in South Asia, but the findings carry significant implications for the United Kingdom, where smokeless tobacco products, including snus and betel quid, remain legally and culturally visible.

**Context**

The study, which drew on data from more than 100 countries, examined the devastating health consequences of smokeless tobacco, a category that includes chewing tobacco, snus, snuff, gutkha and other oral tobacco products. While cigarette smoking has long dominated public health messaging, these products are frequently marketed as a means of cutting down on smoking and are often perceived by consumers as less dangerous. Researchers involved in the study warned that this perception is dangerously misleading, given the strong links between oral tobacco use and cancers of the mouth, oesophagus and pancreas, as well as cardiovascular disease.

In the UK, public health bodies have historically concentrated on smoking cessation, with campaigns such as Stoptober and the NHS Smokefree programme making significant progress in reducing smoking rates. However, smokeless tobacco occupies a more ambiguous position. Snus, a moist powder tobacco pouch placed under the lip, is banned for sale in the European Union, but the UK has retained certain exemptions and personal import allowances in recent years. Meanwhile, South Asian communities in Britain continue to use products such as paan masala, zarda and gutkha, often unaware of the scale of the risks involved.

The figures published in the study suggest that, for every million people who use smokeless tobacco regularly, thousands will die prematurely from smoking-related diseases. Although the 250,000 figure is a global estimate, health experts argue that the same mechanisms of harm apply in the UK context, where the habit is particularly prevalent in certain ethnic minority communities. The study also noted rising levels of oral cancer diagnoses among younger adults in several Western countries, a trend closely followed by researchers concerned that smokeless products are evading the stigma applied to cigarettes.

**Analysis**

This new evidence is likely to intensify pressure on policymakers in Westminster to revisit the regulatory framework around smokeless tobacco. The UK has positioned itself as a world leader in tobacco control, having introduced plain packaging for cigarettes, banned smoking in enclosed public spaces, and set ambitious targets for a smoke-free generation. Yet the continuing legal availability of snus and the relative lack of public awareness of chewable tobacco risks create a regulatory blind spot. If the government is serious about reducing all tobacco-related harm, this study provides a powerful argument for treating smokeless products with the same seriousness as cigarettes.

The sporting dimension should not be overlooked. Chewing tobacco has a long association with sport, particularly in baseball and, to a lesser extent, in cricket and other team disciplines. For years, players in the United States were regularly seen spitting dark tobacco juice into cups and on dugout floors, normalising a habit in full view of millions of young fans and television viewers. Although Major League Baseball has introduced stricter rules in recent seasons, the behaviour is still witnessed at grassroots and amateur levels. In the UK, cricket clubs and local sports teams have been slower to address the issue, and the powerful imagery of sports and chewing tobacco remains embedded in the culture.

Public health campaigns targeting sportsmen and sportswomen could serve as a crucial intervention. The study suggests that oral tobacco use is heavily influenced by social acceptance, and sporting role models have an outsized impact on impressionable audiences. In the same way that smoking was gradually banished from sports sponsorship and stadium advertising, chewing tobacco should now be confronted on the same stage. One practical measure would be to require all professional sports bodies in the UK to adopt clear bans on tobacco use in and around playing areas, while simultaneously offering proper cessation support to players and staff.

The economic cost of this global health burden is also significant, particularly for health systems recovering from the pressures of recent years. Every preventable death from oral cancer or heart disease adds substantial costs to NHS hospitals in terms of surgery, chemotherapy and long-term care. The study estimates that, if current trends persist, the number of associated deaths could rise even further, especially as younger people experiment with novel nicotine products. It concluded that urgent action is needed to close the gap between the perceived harm of smoking and the dangers of smokeless tobacco.

**Fontes**

The evidence in this report is based on the recent peer-reviewed global study of smokeless tobacco mortality, published by public health researchers and reported by international news agencies. Additional context was drawn from public health data and regulatory information available from the UK government and the NHS, alongside historical reporting on tobacco use in professional sport.