In a new study, researchers said that India has highest number of smokeless tobacco deaths.
University of York researchers said it was the first time that global impact of smokeless tobacco consumption on adults has been assessed.
Kamran Siddiqi Hull York Medical School said it was possible that these figures were underestimated and future studies might reveal that the impact was even bigger, and added that they need a global effort to try and address and control smokeless tobacco.
In the study, researchers compiled the figures using data from 113 countries and extracted from the 2010 Global Burden of Disease Study and surveys such as Global Adult Tobacco Survey.
Siddiqi said South-East Asia was a hotspot and in particular India which accounts for 74 percent of the global disease burden.
He added that smokeless tobacco was used by almost a quarter of tobacco users and most of them live in South-East Asia, and added that the international framework to control tobacco did not seem to work to control smokeless tobacco.
Siddiqi further said that there was a need to build on the insights obtained from efforts to reduce cigarette smoking and to investigate strategies to reduce the use of smokeless tobacco.
The study is published in the Journal BMC Medicine.