Smokeless Tobacco and Public Health: A Global Perspective provides a snapshot of current knowledge and data sources on smokeless tobacco (ST) use, characteristics of products, and related policy efforts. It outlines what is currently known about the changing ST product market, industry marketing efforts, and economic and policy factors; and provides an overview of the current state of scientific knowledge, public health information, and policy initiatives focused on ST in each major region of the world. The report aims to identify gaps and needs related to monitoring and surveillance of ST products and other information collection, and make recommendations for strengthening international collaboration and building a scientific basis for ST product control and regulation.
An accompanying series of product factsheets (PDF, 3.8 MB) describes the characteristics and use of specific ST products and gives an indication of the wide variety and complexity of the ST product landscape.
Report factsheet (PDF, 383 KB)
Full Report (PDF 17.2 MB)
Executive Summary (PDF, 1.6 MB)
Individual Chapters
- Acknowledgments (PDF, 298 KB)
- Glossary (PDF, 259 KB)
- Chapter 1—The Global Challenge of Smokeless Tobacco (PDF, 416 KB)
- Introduction
- The Global Challenge
- Report Framework and Process
- Report Background
- Major Conclusions
- Chapter Summaries and Key Findings
- References
- Chapter 2—Global Prevalence of Smokeless Tobacco Use Among Youth and Adults (PDF, 1.8 MB)
- Introduction
- Sources of Data
- Smokeless Tobacco Use Prevalence
- Prevalence and Other Characteristics of Use
- Prevalence Data for Adults and Sociodemographic Variables in Four Countries
- Gaps and Limitations of the Current Evidence Base
- Summary and Conclusions
- References
- Chapter 3—A Global View of Smokeless Tobacco Products (PDF, 1.6 MB)
- Global Diversity of Smokeless Tobacco Products
- Smokeless Tobacco Product Ingredients
- Toxic and Carcinogenic Agents in Smokeless Tobacco Products
- Gaps and Limitations of the Current Evidence Base
- Summary and Conclusions
- References
- Chapter 4—Health Consequences of Smokeless Tobacco Use (PDF, 1.2 MB)
- Introduction
- Adverse Health Consequences: Mechanisms
- Adverse Health Consequences: Cancer
- Adverse Health Consequences: Cardiovascular Effects
- Adverse Health Consequences: Miscellaneous Other Diseases and Conditions
- The Health Consequences and Disease Burden of Smokeless Tobacco Products
- Gaps and Limitations in the Current Evidence Base
- Summary and Conclusions
- References
- Chapter 5—The Economics of Smokeless Tobacco (PDF, 970 KB)
- Introduction
- Smokeless Tobacco and Cigarette Markets
- Globalization of Smokeless Tobacco Markets
- Modern Markets
- Traditional Markets
- Gaps and Limitations
- Summary and Conclusions
- References
- Chapter 6—Changing Smokeless Tobacco Products and Marketing Practices by Industry (PDF, 1.1 MB)
- Introduction
- Product
- Promotion
- Placement
- Price
- Summary and Conclusions
- References
- Chapter 7—Prevention and Cessation Interventions (PDF, 536 KB)
- Interventions for Smokeless Tobacco Use
- Interventions to Prevent Smokeless Tobacco Use Among Young People
- Smokeless Tobacco Cessation
- Gaps and Limitations
- Summary and Conclusions
- References
- Chapter 8—Smokeless Tobacco Regulation and Policy (PDF, 487 KB)
- The Role of Regulation and Policy
- The Global Community and Smokeless Tobacco Regulation
- Key Provisions of the FCTC
- Description and Analysis of Key Tobacco Control Policy Interventions
- Regulatory Experience of Countries and WHO Regions
- Challenges and Recommendations for Regulation and Policy
- References
- Chapter 9—Smokeless Tobacco Use in the Region of the Americas (PDF, 1 MB)
- Description of the Region
- Prevalence of Smokeless Tobacco Use
- Types of Smokeless Tobacco Products and Patterns of Use
- Toxicity and Nicotine Profiles of Products
- Health Problems Associated With Product Use
- Marketing and Production Practices of Industry
- Interventions and Policies
- Summary and Conclusions
- References
- Chapter 10—Smokeless Tobacco Use in the European Region (PDF, 731 KB)
- Description of the Region
- Prevalence of Smokeless Tobacco Use
- Types of Smokeless Tobacco Products and Patterns of Use
- Toxicity and Nicotine Profiles of Products
- Health Problems Associated With Use
- Marketing and Production Practices of Industry
- Current Policy and Interventions
- Summary and Conclusions
- References
- Chapter 11—Smokeless Tobacco Use in the Eastern Mediterranean Region (PDF, 1.1 MB)
- Description of the Region
- Prevalence of Smokeless Tobacco Use
- Types of Products and Patterns of Use
- Toxicity and Nicotine Profiles of Products
- Health Problems Associated With Product Use
- Marketing and Production Practices of Industry
- Current Policy and Interventions
- Summary and Conclusions
- References
- Chapter 12—Smokeless Tobacco Use in the African Region (PDF, 864 KB)
- Description of the Region
- Prevalence of Smokeless Tobacco Use
- Types of Products and Patterns of Use
- Toxicity and Nicotine Profiles
- Health Problems Associated With Product Use
- Marketing and Production Practices of Industry
- Current Policy and Interventions
- Summary and Conclusions
- References
- Chapter 13—Smokeless Tobacco Use in the South-East Asia Region (PDF, 1 MB)
- Description of the Region
- Types of Products and Patterns of Use
- Prevalence of Smokeless Tobacco Use
- Toxicity and Nicotine Profiles of Products
- Health Problems Associated With Product Use
- Marketing and Production Practices of Industry
- Current Policy and Interventions
- Summary and Conclusions
- References
- Chapter 14—Smokeless Tobacco Use in the Western Pacific Region (PDF, 922 KB)
- Description of the Region
- Prevalence of Smokeless Tobacco Use
- Types of Smokeless Tobacco Products and Patterns of Use
- Toxicity and Nicotine Profiles
- Health Problems Associated With Product Use
- Marketing and Production Practices of Industry
- Current Policy and Interventions
- Summary and Conclusions
- References
- Chapter 15—Global Smokeless Tobacco Use: Future Research Needs and Policy (PDF, 402 KB)
- Recommendations
- Report Highlights
- Gaps and Research Needs
- Building Capacity
- Intervention and Policy Needs
- References
- Appendix A—Description of Representative Products From Four Broad Categories of Smokeless Tobacco Products Used Globally (PDF, 241 KB)
- Appendix B—Global Smokeless Tobacco Product Factsheets (PDF, 3.8 MB)
Last Updated
July 14, 2022