They exhibited an increased consumption of betel quid with tobacco
and its associated locally available variants.
In India, khaini or tobacco-lime mixture (12%) is the most commonly used smokeless tobacco product, followed by Gutkha, a mixture of tobacco, lime and areca nut mixture (8%), betel quid with tobacco
(6%) and applying tobacco as dentifrice (5%) (7).
A large majority of these tobacco users prefer smokeless tobacco products like betel quid with tobacco
, gutkha, paan masala, khaini, mishri, gul, over smoking tobacco.
The use of tobacco with lime, betel quid with tobacco
, betel quid without tobacco, and areca nut has been classified as carcinogenic to humans.