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Paan (pan) and paan (pan) masala should be considered tobacco products
  1. Arnab Mukherjea1,2,
  2. Mary V Modayil3,
  3. Elisa K Tong1
  1. 1Division of General Internal Medicine, Department of Medicine, University of California, Davis, Sacramento, CA, USA
  2. 2Department of Health Sciences, California State University, East Bay, Hayward, CA, USA
  3. 3Institute for Population Health Improvement, University of California, Davis, Sacramento, CA, USA
  1. Correspondence to Dr Arnab Mukherjea, Division of General Internal Medicine, Department of Medicine, University of California, Davis, 4150V Street, Suite 2400 PSSB, Sacramento, CA 95817, USA; arnab.mukherjea{at}


Two products indigenous to the Indian subcontinent and popular among South Asians globally - paan and paan masala - are inconsistently categorised as tobacco by researchers, clinicians, program planners and policymakers. This article calls for a universally standard classification of these smokeless carcinogenic products as tobacco products and thus, subject to the same public health and clinical protections applied to other forms of tobacco. This recommendation is guided by scientific evidence strongly indicating the common presence of tobacco in paan and paan masala. Inclusion of these two products in population-level surveillance, clinical screening, as well as public health program planning and policy interventions may have considerable impact on preventing and reducing tobacco-related disparities among South Asians around the world.

  • Disparities
  • Global health
  • Non-cigarette tobacco products
  • Priority/special populations
  • Surveillance and monitoring

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