SynthesisNature communications2024
Health effects associated with chewing tobacco: a Burden of Proof study.
Synthesis in Nature communications, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Health effects associated with exposure of children to physical violence, psychological violence and neglect: a Burden of Proof study.Nature human behaviour · 2025Pooled it
- A systematic review with a Burden of Proof meta-analysis of health effects of long-term ambient fine particulate matter (PMNature aging · 2025Pooled it
- Comparative burden and projections of chewing tobacco-attributable lip/oral cavity and esophageal cancers: global and China-specific trends, 2000-2036.Annals of medicine · 2026Article
- Sex inequality in disease burden attributable to smoking, secondhand smoke and chewing tobacco: A systematic analysis for the Global Burden of Disease Study 2023.EClinicalMedicine · 2026Article
- Article
- Smoking-attributable hospitalisation costs in Europe: an econometric analysis of the European Health Interview Survey, 2019.BMJ public health · 2026Article
- Health effects associated with alcohol consumption: a Burden of Proof study.Nature health · 2026Article
- Assessing sustainability effects of tobacco use and control in global supply chains.Nature communications · 2025Article
- Comparative effects of alternate tobacco products and traditional tobacco smoking on various organ/systems: A guide to regulators and health policy makers.Toxicology reports · 2025Review
- Global, regional, and national burden of lip and oral cavity cancer and projections to 2036.BMC cancer · 2025Article
- Analysis of the mortality trends of laryngeal cancer attributable to smoking worldwide from 1990 to 2021 and projections up to 2036.World journal of surgical oncology · 2025Article
- Global variations and socioeconomic inequalities in lifetime risk of lip, oral cavity, and pharyngeal cancer: a population-based systematic analysis of GLOBOCAN 2022.International journal of surgery (London, England) · 2025Article
- Release Monitoring and Detection of Formulated Solid Nanoparticle-Conjugated Nicotine in Blood and Urine Using Electrochemical Technique.Analytical science advances · 2025Article
- Salivary EGF: EGFR ratio as potential early diagnostic biomarker for oral cancer detection in tobacco chewers: a preliminary cross-sectional study.BMC oral health · 2025Article
- Global, regional, and national burden of esophageal cancer: a systematic analysis of the Global Burden of Disease Study 2021.Biomarker research · 2025Article
- Global, regional, and national burden of laryngeal cancer in middle-aged and older adults from 1990 to 2021: an analysis of age and sex differences and attributable risk factors.Frontiers in public health · 2025Article
- Burden of digestive system neoplasms in middle-aged and elderly adults: Temporal trends and geographic disparities (1990-2021).PloS one · 2025Article
- Anti-Skin Aging and Cytotoxic Effects of Methanol-ExtractedPlants (Basel, Switzerland) · 2024Article
- Anti-Skin Aging Potential, Antibacterial Activity, Inhibition of Single-Stranded DNA-Binding Protein, and Cytotoxic Effects of Acetone-ExtractedPlants (Basel, Switzerland) · 2024Article
- Antivenom slithers back to life.Nature biotechnology · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Chewing tobacco use poses serious health risks; yet it has not received as much attention as other tobacco-related products. This study synthesizes existing evidence regarding the health impacts of chewing tobacco while accounting for various sources of uncertainty. We conducted a systematic review and meta-analysis of chewing tobacco and seven health outcomes, drawing on 103 studies published from 1970 to 2023. We use a Burden of Proof meta-analysis to generate conservative risk estimates and find weak-to-moderate evidence that tobacco chewers have an increased risk of stroke, lip and oral cavity cancer, esophageal cancer, nasopharynx cancer, other pharynx cancer, and laryngeal cancer. We additionally find insufficient evidence of an association between chewing tobacco and ischemic heart disease. Our findings highlight a need for policy makers, researchers, and communities at risk to devote greater attention to chewing tobacco by both advancing tobacco control efforts and investing in strengthening the existing evidence base.
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Registered trials
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.