Chewing Tobacco's Toll: 251K

A new global study has measured the toll of smokeless tobacco. Researchers estimate chewing tobacco caused roughly 251,000 deaths in 2023, even as its use has barely budged over three decades despite major gains against cigarette smoking, the Independent reports. Published in the Lancet, the analysis from the Institute for Health Metrics and Evaluation finds about 241 million people 15 and older used chewing tobacco that year, with no meaningful drop since 1990 and rising use in 24 countries.

The habit is concentrated in South Asia, where about one in five men and one in 10 women chew; India alone accounts for 105 million users and about 104,000 of the deaths. Stroke was the leading cause of death and disability, followed by cancers of the mouth, throat, and esophagus. The US is the only non-Asian country in the top 10, with 5.9 million users of "dip." Researchers say chewing tobacco has largely slipped through the cracks of tobacco control campaigns, remains more socially acceptable than smoking for women in some countries, and demands targeted policies if those numbers are going to change.