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Among them, 21% adults use only ST, 9% only smoke and 5% smoke as well as use ST.[] The prevalence of ST use in India is 26% with the prevalence being 33% in males and 18% in females and 29% in rural areas compared to 18% in urban areas.[] People who use tobacco are at risk for several cancers.[] Chronic use of ST can result in harmful effects on soft tissues of oral cavity such as cancer.[ , ] The systemic effects of ST are due to its long-term use caused by nicotine dependence.[ , ] Mouth cancer is one of the most common cancers in India due to the use of ST.[] A number of toxicants and carcinogens present in ST are believed to be responsible for these negative health effects (Brunnemann and Hoffmann, 1992
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