Smokeless Tobacco Use in Iran: A Systematic Review

Document Type : Review Article(s)


1 Department of Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran

2 Student Research Committee, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran

4 Department of Health Education and Promotion, School of Health AND Research Center of Health and Environment, Guilan University of Medical Sciences, Rasht, Iran

5 Student Research Committee, Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran


Background: Smokeless tobacco (ST) use is one of the most important public health problems in Southeast
Asia. The use of these substances increases the incidence of some cancers and other diseases. The purpose of
this review study was to investigate on ST use in Iran.
Methods: A literature search was conducted on PubMed, Google Scholar, and three national databases
[Scientific Information Database (SID), IranMedex, and IranDoc] based on the standard search strategy.
Findings: Most consumer people lived in Sistan and Baluchestan Province (Zahedan and Chabahar Cities)
and Golestan Province, Iran. ST use rates ranged from 11.0% to 45.7% among college students in Sistan and
Baluchestan (Zahedan and Chabahar) and Golestan. There are various types of ST consumed in Iran that
have been mentioned in various articles, including Pan, Gutka, Nass, Naswar, Biti, and Supari.
Conclusion: Most studies on ST have been conducted in Sistan and Baluchestan and Golestan Provinces and
we need more research for other provinces. Consumption by women is a warning and a threat to women's
health in the future. Further studies will be needed to find out more precisely the prevalence of consumption
in Iran.