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. 2023 Jan;26(1):46-55.
doi: 10.1017/S1368980022001331. Epub 2022 May 27.

Smokeless tobacco use and public health nutrition: a global systematic review

Shikha Saxena  1 , Prashant Kumar Singh  1 , Lucky Singh  2 , Shekhar Kashyap  3 , Shalini Singh  1
Affiliations

Smokeless tobacco use and public health nutrition: a global systematic review

Shikha Saxena et al. Public Health Nutr. 2023 Jan.

Abstract

Objective: Tobacco consumption among low- and middle-income countries where food insecurity remains a challenge poses several concerns. This review examines the available global evidence linking smokeless tobacco (SLT) use with public health nutrition and its implications.

Design: Systematic review of articles extracted from PubMed and Scopus from January 2000 to December 2020.

Setting: Included studies that demonstrated the relationship between SLT and nutrition-related factors, that is, BMI, malnutrition, anaemia, poor birth outcomes and metabolic disorders. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines have been followed to conduct the systematic evidence review.

Participants: A total of thirty-four studies were finally used in the systematic review, which included cross-sectional (thirty-one) and cohort (three).

Results: SLT use has a huge impact on body weight, alteration in taste, poor oral health, and consumption of fruits and vegetables leading to malnutrition. Maternal use of SLT not only leads to anaemia but also hampers birth outcomes. Increased risk of metabolic syndrome and gallstone disease among SLT users are also well documented in the studies.

Conclusion: The review highlights the linkages between SLT usage and poor nutritional outcomes. Tobacco control efforts should be convergent with public health nutrition to achieve overall health benefits. Attention is also required to explore suitable mechanisms for SLT cessation combined with enhancing food and nutrition security at the community level in sync with investments in public health nutrition intervention.

Keywords: BMI; Food insecurity; Metabolic disorders; Nutrition; Smokeless tobacco.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
The PRISMA flowchart for selection of epidemiological studies. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analysis; SLT, smokeless tobacco
Fig. 2
Fig. 2
Diagrammatic representation of the association between smokeless tobacco use and public health nutrition; SLT, smokeless tobacco
See this image and copyright information in PMC

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