The prevalence of use of smokeless tobacco varies widely across countries and regions, with particularly high rates of consumption in some areas of South-East Asia. For example, in Bangladesh and India, levels of use of smokeless tobacco surpass cigarette smoking.1 In Sweden, use of smokeless tobacco is also common, and in 2010 was about 10 times higher than the rest of Europe.2
In contrast, use of these products in Australia is very low; results from the 2019 National Drug Strategy Household Survey showed that only a small portion of Australian smokers aged 14 years or older reported using chewing tobacco (2.2%), snus (1.1%), or snuff (1.4%) in the past 12 months.3 However, prevalence of use among some minority groups is much higher. A 2014 survey of South Asian residents in Sydney found rates of having ever used smokeless tobacco products, using it more than 100 times, and current use at 72.1%, 65.9% and 17.1%, respectively.4 Chewing tobacco is also used in some Indigenous communities, particularly in Central Australia. Aboriginal Australians may chew commercially available tobaccos mixed with ash from certain trees, or native tobaccos (pituri).5 Tobacco chewing among the Australian Indigenous population is discussed in greater detail in Chapter 8, Section 5.3.
Relevant news and research
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1. National Cancer Institute and Centers for Disease Control and Prevention, Smokeless tobacco and public health: a global perspective. NIH publication no. 14-7983. Bethesda, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Institutes of Health, National Cancer Institute; 2014. Available from: http://nccd.cdc.gov/gtssdata/Ancillary/Publications.aspx
2. Leon ME, Lugo A, Boffetta P, Gilmore A, Ross H, et al. Smokeless tobacco use in Sweden and other 17 European countries. European Journal of Public Health, 2016. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27048433
3. Australian Institute of Health and Welfare, National Drug Strategy Household Survey (NDSHS) 2019 key findings and data tables. Canberra: AIHW, 2020. Available from: https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy-household-survey-2019/contents/table-of-contents
4. Hossain MS, Kypri K, Rahman B, and Milton AH. Smokeless tobacco consumption in the South Asian population of Sydney, Australia: prevalence, correlates and availability. Drug Alcohol Rev, 2014; 33(1):86-92. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24256138
5. Ivers R, Indigenous Australians and tobacco: a literature review. Menzies School of Health Research and the Cooperative Research Centre for Aboriginal and Tropical Health Darwin, Australia; 2001. Available from: https://www.lowitja.org.au/sites/default/files/docs/Indigenous_Australians_and_Tobacco.pdf .