Cultural Drivers, Modes of Use, and Perceived Harms of Traditional and Non-Traditional Smokeless Tobacco Use in South Africa: A Qualitative Study.
Smokeless tobacco use in South Africa is driven by cultural, spiritual, and medicinal beliefs rather than just recreation. Users experience real health harms, but some believe spiritual practices protect them from danger, which may prevent them from quitting.
Relevance to India: India has high smokeless tobacco use including traditional forms like gutkha and paan; understanding cultural and spiritual drivers of use could inform tobacco control strategies adapted to Indian contexts.
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