Impact of Smokeless Tobacco Product Usage on Systemic Health

The deleterious impacts of smokeless tobacco (ST) are not restricted to the oral cavity and can jeopardize multiple organ systems increasing morbidity and mortality risks. ST products contain carcinogens, nitrosamines, heavy metals, and nicotine, which contribute to oxidative stress, systemic inflammation, and endothelial dysfunction. ST use has been associated with increased risks of cardiovascular diseases, including hypertension, myocardial infarction, and stroke. Additionally, it is linked to metabolic syndrome (MS) and type-2 diabetes due to nicotine-induced insulin resistance and inflammation. In the reproductive system, ST use disrupts menstrual cycles, increases risks of stillbirth, and affects male fertility by reducing sperm quality. Respiratory and gastrointestinal health are also compromised, with ST users showing decreased lung function, higher incidences of oesophageal and gastric inflammation, and greater prevalence of Helicobacter pylori infection. Furthermore, ST is implicated in kidney and liver toxicity, with studies indicating ST-related renal dysfunction and hepatic damage. Several cohort studies have reported an increased risk of pancreatic cancer among ST-chewers than non-chewers. Moreover, the International Agency for Research on Cancer (IARC) has classified ST as carcinogenic to humans indicating sufficient evidence linking its use to various cancers, including those of the oral cavity, oesophagus, and pancreas. Given these wide-ranging systemic effects, public health initiatives must emphasize the dangers of ST and promote cessation programmes to mitigate its impact on overall health. The purpose of this chapter is to provide an overview of the effects of ST on systemic health.