For the first time in the GBD study, we estimated exposure to and burden attributable to smokeless tobacco, defined as current use of any smokeless tobacco product. RR estimates were derived from prospective cohort studies and case-control studies and vary depending on the type of product used. Based on available evidence, for chewing tobacco RRs were significantly higher than one for oral cancer and oesophageal cancer, while for snus or snuff we did not find sufficient evidence of a RR greater than one for any health outcome. Additional details on the estimation methods and RRs are presented in appendix 1 (p 11, p 181).
