"Nearly 85 per cent of the total burden attributable to smokeless tobacco (SLT) use was in South-East Asia, with India alone accounting for 74 per cent of the global burden, followed by Bangladesh (five per cent)," said the study that assessed the impact of smokeless tobacco on adults.
The study collected smokeless tobacco consumption figures for 115 countries and estimated burden of disease for 113 of these countries.
Kamran Siddiqi, senior lecturer in epidemiology and public health at the Department of Health Sciences/Hull York Medical School, said: "It is possible that these figures are underestimated and future studies may reveal that the impact is even bigger. We need a global effort to try and address and control smokeless tobacco."
Siddiqi said that South-East Asia was a hotspot and in particular India which accounts for 74 per cent of the global disease burden.
"We have got no international policy on how to regulate the production, composition, sale, labeling, packaging and marketing of smokeless tobacco products. The international framework to control tobacco doesn't seem to work to control smokeless tobacco. It doesn't get the same regulation as cigarettes."
The study also found that SLT consumption was higher among males than females.
SLT consists of a number of products containing tobacco, which are consumed-without burning-through the mouth or nose.
The results are published in BMC Medicine.
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