1. Research, Monitoing and Surveillance of Smokeless tobacco use
Dhirendra Narain Sinha

3. SLT use: Global prevalence of SLT users by gender
Based on available prevalence of SLT use among adults in 140 countries,
Nearly one in 10 males and one in 20 females used SLT in some form.
Source: Sinha et al Nicotine & Tobacco Research,,

4. Prevalence of smoking and SLT use among adults by WHO region

5. Prevalence of smoking and SLT use among adolescents by WHO region

6. 356 million SLT users worldwide
Males 65.8% (234 million)
Females 34.2% (122 million)

7. Proportion of smokeless tobacco users by income group of countries and gender
Source:. Sinha et al. Nicotine & Tobacco Research, 2018

8. Number of SLT Users by WHO Region
South-East Asia Region (SEAR), African Region (AFR), American Region (AMR), Eastern Mediterranean Region (EMR), European Region (EUR) and Western Pacific Region (WPR)
Source: Sinha et al Nicotine & Tobacco Research,,

9. SLT Use by Place of Residence and Income of the Family in LIC and LMICs
SLT use is 1.2–8 times higher in rural areas as compared to urban in countries of SEAR and AFR ;
SLT use was 1.5–17 times higher among poorest section as compared to the richest section in countries of SEAR and AFR .

10. Percentage distribution type of tobacco use and gender among adults aged 15 years and above in select member countries of the South East Asia Region
Source: Sinha et al. Indian Journal of Public Health, Volume 55, Issue 3, July-September, 2011;

11. Prevalence of SLT use by type among adults

12. Trends of SLT use among adults in selected LICs and LMICs
In India SLT use was on increase between but has significantly decreased between 2010 and 2016
SLT use has significantly increased between 2008 and 2016 in Myanmar**
SLT use remained the same between 2004 and 2014 in Sri Lanka
In Bangladesh SLT use remains the same over last 10 years (conflicting reports)

13. Trend of smokeless tobacco among adolescents in countries of South-East Asia Regions
Source: WHO, SEARO

15. Percentage of Parties having SLT use Prevalence data

16. Number and percentage of Parties having data on prevalence, health and economic indicators of smokeless tobacco (SLT) use
Source: Dhirendra N. Sinha et al. Indian J Med Res 148, July 2018;

17. Percentage of Parties having tax incidence data and Health Cost Study

18. Comparison of retail price and tax incidence between smokeless tobacco (SLT) and cigarettes by country income groups. Note: Retail Price (PPP$) shows the retail price in international purchasing power parity dollars for a 20 cigarettes pack of the most sold brand and 20 g pouch of the most sold SLT brand in each country. HIC, high-income countries; UMIC, upper middle-income countries; LMIC, lower middle-income countries; LIC, low-income countries.
Source: Rijo M. John et al. Indian J Med Res 148, July 2018; 46-55

19. Summary
in 140 countries, Nearly one in 10 males and one in 20 females use SLT
356 million SLT users worldwide, 23rd males
Nearly 82% SLT users live in SEAR
Over 90%users live in LICs and LMICs
Nearly 3/4th parties have SLT use one time data both among adults and adolescents, however two point data is lacking in LIC and LMICs
All cause mortality and cause specific mortality is available for 5% of the parties and data on SLT economics is availavle for <20% Parties

20. Conclusion
SLT use is global epidemic wide variation by region. Poorest of Poors are sufferers
Data collection on SLT related issues have increased in the recent past however there is a big gap in information on SLT related issues.
Standard methods and protocols are available, countries should use those and collect periodic comparable data