ArticleNicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco2018
The Poorest of Poor Suffer the Greatest Burden From Smokeless Tobacco Use: A Study From 140 Countries.
Article in Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
54 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Behavioral Interventions for Tobacco Cessation in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Pooled it
- Risk factors for inadequate and excessive gestational weight gain in 25 low- and middle-income countries: An individual-level participant meta-analysis.PLoS medicine · 2023Pooled it
- Impact of sudanese chewing tobacco toombak on oral bacteria - a culture-based pilot study.Clinical oral investigations · 2026Article
- Mixed Methods Process Evaluation of Behavioral Support and Nicotine Replacement Therapy for Smokeless Tobacco Cessation in Bangladesh, India, and Pakistan.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026Article
- Urban-rural disparities in oral nicotine pouch sales and flavors in the United States.The International journal on drug policy · 2026Article
- Commercial determinants of oral health in India: implications for research and policy- a perspective.Frontiers in oral health · 2026Article
- The disease burden attributable to tobacco use in China and its provinces from 1990-2023: an analysis from the Global Burden of Disease Study 2023.Military Medical Research · 2026Article
- The Relationship Between Smokeless Tobacco and the Incidence of Oral Cancer: A Systematic Review Study.Addiction & health · 2025Review
- Traditional medicine, environmental exposures, and cultural practices in cancer risk: insights from low- and middle-income countries.Frontiers in oncology · 2025Review
- The effect of smokeless tobacco (SLT) excise taxes on SLT use among youth.The International journal on drug policy · 2025Article
- Evaluation of post-extraction healing after atraumatic extraction in gutka chewers and non-gutka chewers using the modified inflammation proliferation remodeling scale.BMC oral health · 2024Article
- Microbial community and functions involved in smokeless tobacco product: a metagenomic approach.Applied microbiology and biotechnology · 2024Article
- Article
- Smokeless and combustible tobacco use among 148,944 South Asian adults: a cross-sectional study of South Asia Biobank.BMC public health · 2023Article
- Prevalence of and Factors Associated With Tobacco Dependence Among Adolescents Aged 12-16 Years Who Were Currently Smoking Tobacco in 125 Countries or Territories, 2012-2019.American journal of public health · 2023Article
- Fungal Community Composition and Function Associated with Loose Smokeless Tobacco Products.Current microbiology · 2023Article
- Article
- Smokeless Tobacco and Current Preoperative Fasting Guidelines, Time to Find the Missing Link.Advanced biomedical research · 2023Article
- Smokeless tobacco consumption and its association with risk factors of chronic kidney disease in rural and peri-urban Bangladesh.Tobacco induced diseases · 2023Article
- Perceptions of novel warnings compared with current warning on tobacco packs, and warnings on cigarette sticks: A cross-sectional survey of college students in Southern India.Tobacco induced diseases · 2023Article
Corrections and comments
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9 authors.
Funding
Abstract
Background: The full extent of global smokeless tobacco (SLT) use and its association with key demographic factors such as gender, place of residence, and household or country income status is not yet known. Methods: The global burden of SLT use among adults was estimated using nationally representative data of 140 countries by gender and country income group. Countries were grouped in Group 1 (low and low-middle income countries combined) and Group 2 (upper middle and high income countries combined). The number of male and female SLT users was calculated using prevalence and population estimates of corresponding age groups. Results: Nearly one in 10 males and one in 20 females used SLT in some form. SLT use prevalence was significantly higher among males (p < .001) and females (p < .001) in Group 1 countries compared with their counterparts in Group 2 countries. However, for both Group 1 (p < .01) and Group 2 (p < .01), males were more likely to use SLT than females. Nearly 91% of a total 356 million adult SLT users resided in Group 1 countries, with 81.6% in countries of WHO South-East Asia region (SEAR). In SEAR and African region, SLT use was higher in rural areas and poorest communities. Conclusion: The majority of the burden of SLT use is on lower and lower middle income countries with the greatest burden on the poorest segments of the population in these countries. Implications: This study brings the comprehensive information on epidemiology of SLT use among adults at global level. Ninety percent of SLT burden is in low and low-middle income group of countries and more specifically among the poorest group in such countries. These countries need to have strategies to implement different provisions of the WHO Framework Convention on Tobacco Control. The program in such countries should be targeted towards the poorest communities for effective SLT control.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.