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A summary of research by Bofetta, Petal regarding cancer risk from smokeless tobacco use states "Although epidemiological data from the USA and Asia show a raised risk of oral cancer in those who use smokeless tobacco (overall relative risk 26 [95% CI 13-52]), these are not confirmed in northern European studies (10 [07-13])

Importantly, these associations remained statistically significant even after adjusting for a wide range of potential confounders, including sociodemographic factors, family psychiatric history, other prenatal substance use, and postnatal smoke exposure

Frequently Asked Questions Should you inhale cigar smoke

The strategy of the Goal 3,4 focuses on six factors, including reduction of tobacco smoking, which poses one of the most significant burdens to public health