Practice of Offering a Small Pouch of Tobacco for Free With a Big Pouch of Pan Masala: A Strategic Move to Circumvent Gutkha Regulations

Document Type : Letter to Editor

Authors

1 Department of Public Health Dentistry, King George’s Medical University, Lucknow, India

2 Community Health Centre, Lucknow, India

Keywords


Dear Editor,

 

Gutkha—a mixture of crushed areca nut, tobacco, catechu, paraffin wax, slaked lime, and flavoring agents—is a well-known smokeless tobacco product associated with a high risk of oral submucous fibrosis and oral cancer.1-4 Recognizing its carcinogenic potential, the Government of India banned the manufacture, sale, and distribution of Gutkha in 2012 under the Food Safety and Standards (Prohibition and Restrictions on Sales) Regulation, 2011 issued by the Food Safety and Standards Authority of India (FSSAI).5 

  1. Gupta PC, Ray CS. Smokeless tobacco and health in India and South Asia. Respirology. 2003;8(4):419-431.
  2. Niaz K, Maqbool F, Khan F, Bahadar H, Ismail Hassan F, Abdollahi M. Smokeless tobacco (paan and gutkha) consumption, prevalence, and contribution to oral cancer. Epidemiol Health. 2017;39:e2017009. doi:4178/epih.e2017009
  3. Ministry of Health and Family Welfare & National Institute of Health and Family Welfare. Evidence assessment: Harmful effects of consumption of gutkha, tobacco, pan masala and similar articles manufactured in India. Government of India. https://ntcp.mohfw.gov.in/assets/document/surveys-reports-publications/NIHFW-report-Evidence-assessment-Harmful-effects-of-consumption-of-gutkha-tobacco-pan-masala-and-similar-articles-manufactured-in-India.pdf. Accessed December 3, 2025. Published 2011.
  4. Sahitha R. Effects of Smokeless Tobacco, Betel Quid and Areca Nut on Oral Mucosa. IOSR Journal of Dental and Medical Sciences. 2014;13(2):8-11.
  5. Ministry of Health and Family Welfare, Government of India. Food Safety and Standards (Prohibition and Restrictions on Sales) Regulations, 2011. New Delhi: FSSAI; 2011.
  6. Das Aparmita, Sharma A, Kanungo HD. Banned but thriving: How loopholes keep gutkha alive in India. India Today. https://www.indiatoday.in/health/story/banned-but-thriving-how-loopholes-keep-gutkha-alive-in-india-2673954-2025-02-03. Accessed October 12, 2025. Published February 3, 2025.
  7. Arakeri G, Us VR, Patil S, Brennan PA. Unsuccessful ban on gutkha and need for tobacco control in India. Lancet. 2023;401(10383):1154. doi:1016/S0140-6736(23)00406-3
  8. Ministry of Health and Family Welfare. Report on Tobacco Control in India 2022. New Delhi: MoHFW; 2024. https://ntcp.mohfw.gov.in/assets/document/surveys-reports-publications/Report%20on%20Tobacco%20Control%20in%20India%202022_22%20April%202024.pdf. Accessed December 3, 2025.
  9. National Health Mission. COTPA 2003 and Rules made thereunder. NHM. Accessed December 3, 2025.
  • Received Date: 13 October 2025
  • Revised Date: 07 December 2025
  • Accepted Date: 17 December 2025
  • First Published Date: 17 December 2025
  • Published Date: 01 December 2025