New Delhi: Almost 250 million adults consume smokeless tobacco in India and 10 other countries in WHO's South-East Asia Region, accounting for 90 per cent global smokeless tobacco users, according to WHO.
The world health body said the figure is in addition to 250 million smokers in the region.
Given the high number of users and serious health consequences of tobacco use, nations in the region have set a target for 30 per cent reduction in prevalence of current tobacco use by persons over 15 years age.
The WHO said oral cancer is the most common cancer caused by smokeless tobacco and the SE-Asia Region carries the highest burden of oral cancer with over 95,000 oral cancer cases each year.
International Agency for Research on Cancer (IARC) said over half of all oral cancers in Asia are caused by tobacco.
Oral cancer affects the poor, who have a greater exposure to smokeless tobacco.
Studies in Bangladesh, India, Indonesia, Sri Lanka and Thailand have shown that both smoking and use of smokeless tobacco are more prevalent among the less educated and illiterate population.
Smokeless tobacco is associated with a 2–4 times increase in risk for cardiovascular diseases. Asian studies indicate that mortality risk for women who consume smokeless tobacco is higher than that for men.
Use of smokeless tobacco in pregnancy is linked to stillbirths and has 2–3 times higher risk of low birth weight babies.
"Use of smokeless tobacco is rampant in South East Asia.
Lack of public awareness and incomplete knowledge about the harmful effects of smokeless tobacco are powerful obstacles in creating effective tobacco control policies," WHO Regional Director (South-East Asia) Samlee Plianbangchang said.
The WHO said a study of health care costs attributable to tobacco in India estimated that in 2004, the direct medical costs of treating smokeless tobacco-related diseases amounted to USD 285 million.
The indirect morbidity costs of smokeless tobacco use which includes the cost of caregivers and value of work loss due to illness amounted to USD 104 million. Thus the total cost of diseases caused by smokeless tobacco use was USD 389 million (about Rs 1,790 crore) in 2004, the world body said.
While many people are aware that tobacco is dangerous, the majority of users are not aware about the lethal connection between chewing tobacco and fatal diseases like cancers or that product like betel quid or mishri or gutka are dangerous.
About misinformation of chewing tobacco, WHO said many use it to cleanse teeth, as a breath freshener, for toothache, to relieve gastric disturbances, to ease abdominal pain to relieve stress and even as an antidote for morning sickness.
This lack of awareness likely contributes to the low number of quit attempts for smokeless tobacco users in the Region, it said, adding that the percentages of users who made a quit attempt in the past year was very low in Bangladesh 29 per cent, India 35 per cent and Thailand 22 per cent.
The Framework Convention on Tobacco Control (FCTC) has been ratified by all countries in WHO's South-East Asia Region except Indonesia.
Some commendable legislative actions for tobacco control include the government's decision to increase pictorial warning sizes to cover 85 per cent of the front and back of the cigarette packets in Thailand and 45 per cent in Sri Lanka.
It said revenue earned through increase taxes and pricing policies for tobacco products have been effectively used in many countries to help reduce tobacco consumption.