Smokeless Tobacco and Coronary Heart Disease

Tobacco does not include smoking only, another form of tobacco which warrants public health attention is smokeless tobacco (SLT). In South Asia, 17% of the population - over 250 million people - use SLT products. While epidemiological studies report consistent association between SLT use and many health effects, there is an ongoing debate regarding the role of SLT for coronary heart disease (CHD). The majority of the studies about this issue were conducted either in Sweden or in USA. SLT products from South Asia differ significantly from European or Western products; therefore, those study results cannot be generalised to South Asian settings. This monograph is focused on a study from Bangladesh, which is one of the developing countries in South-East Asia, where prevalence of SLT use is 27% (equating to 26 million people). Besides exploring the association between SLT use and CHD, this monograph also highlighted on the perceptions of SLT use among non-smoking adults in Bangladesh. Two important methodological issues are also presented here. All the components add significantly for any future research in this issue from South Asian perspective.