gutka

Gutka is a commercially produced form of smokeless tobacco. Manufacturers add sweet or savory flavors, making it more appealing to women and young people in some locations.{{cite web |title=The truth about smokeless tobacco use {{!}} Know the truth {{!}} TFI |url=http://www.emro.who.int/tfi/know-the-truth/smokeless-tobacco-use.html |website=www.emro.who.int |publisher=World Health Organization, Eastern Mediterranean Regional Office |access-date=7 December 2019 |archive-date=7 December 2019 |archive-url=https://web.archive.org/web/20191207223518/http://www.emro.who.int/tfi/know-the-truth/smokeless-tobacco-use.html |url-status=live }} The combinations of gutka ingredients vary according to local preferences. Spices may include mustard, turmeric, anise seeds, cardamom, saffron and cloves.

In addition to areca nut, nicotine, slaked lime, paraffin and catechu, it can be laced with thousands of chemicals.{{cite web |last1=Banerji |first1=Annie |title=India "gutka" chewing tobacco habit a tough nut to crack |url=https://www.reuters.com/article/us-india-tobacco-idUSBRE88508420120906 |website=Reuters |publisher=Thomson Reuters |access-date=7 December 2019 |language=en |date=6 September 2012 |archive-date=6 December 2019 |archive-url=https://web.archive.org/web/20191206191631/https://www.reuters.com/article/us-india-tobacco-idUSBRE88508420120906 |url-status=live }} It is a powdery, granular, light brownish to white substance. Within moments of chewing mixing with saliva, the gutkha begins to dissolve and turn deep red in colour. It may impart upon its user a "buzz" somewhat more intense than that of tobacco chewing, snuffing and smoking.{{Citation needed|date=March 2011}}

Gutka turns saliva bright red, and when it is chewed long and often enough it will stain a user's teeth bright red too. Saliva is generally spat onto a wall or at the ground, causing a red stain that is quite resistant to the elements. Some building owners have taken to combating this by painting murals of gods on their walls, with the idea that gutkha chewers would not spit on a god.{{cite web |last1=Kolhatkar |first1=Sandip |date=12 April 2013 |title=Do not spit here, for god's sake! |url=https://www.mid-day.com/articles/do-not-spit-here--for-gods-sake/208490 |access-date=7 December 2019 |website=mid-day |language=en |archive-date=8 December 2019 |archive-url=https://web.archive.org/web/20191208040751/https://www.mid-day.com/articles/do-not-spit-here--for-gods-sake/208490 |url-status=live }}{{cite news |last1=Bearak |first1=Max |title=Officials in India are really sick and tired of their country's tobacco habit |url=https://www.washingtonpost.com/news/worldviews/wp/2016/04/18/officials-in-india-are-really-sick-and-tired-of-their-countrys-tobacco-habit/ |access-date=7 December 2019 |newspaper=The Washington Post |language=en |archive-date=8 December 2019 |archive-url=https://web.archive.org/web/20191208040750/https://www.washingtonpost.com/news/worldviews/wp/2016/04/18/officials-in-india-are-really-sick-and-tired-of-their-countrys-tobacco-habit/ |url-status=live }}{{cite news |last=Bhattasali |first=Amitabha |date=23 November 2011 |title=Scheme to save Calcutta's Howrah Bridge from spit |url=https://www.bbc.co.uk/news/world-asia-india-15837262 |access-date=16 August 2013 |work=BBC News |archive-date=24 July 2012 |archive-url=https://web.archive.org/web/20120724110742/http://www.bbc.co.uk/news/world-asia-india-15837262 |url-status=live }}

Areca nut "quid chewing has claimed to produce a sense of well being, euphoria, warm sensations of the body, sweating, salivation, palpitation and heightened alertness, tolerance to hunger, and increased capacity and stamina to work."{{cite journal |last1=Shah |first1=Gunjan |last2=Chaturvedi |first2=Pankaj |last3=Vaishampayan |first3=Sagar |date=2012 |title=Arecanut as an emerging etiology of oral cancers in India |journal=Indian Journal of Medical and Paediatric Oncology |publisher=Indian Society of Medical and Paediatric Oncology : Official Journal of Indian Society of Medical & Paediatric Oncology |volume=33 |issue=2 |pages=71–79 |doi=10.4103/0971-5851.99726 |pmc=3439794 |pmid=22988348 |doi-access=free}}

Gutka is highly addictive, represents a major health risk, has no safe level use and is not a safe substitute for smoking.{{cite web |year=2017 |title=Recommendation on smokeless tobacco products |url=http://apps.who.int/iris/bitstream/10665/42658/1/9241590556.pdf |publisher=World Health Organization |pages=1–9 |access-date=2 June 2024 |archive-date=8 August 2017 |archive-url=https://web.archive.org/web/20170808233908/http://apps.who.int/iris/bitstream/10665/42658/1/9241590556.pdf |url-status=live }}{{cite web |date=13 November 2015 |title=Health Risks of Smokeless Tobacco |url=https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer/smokeless-tobacco.html |publisher=American Cancer Society |access-date=2 June 2024 |archive-date=6 July 2024 |archive-url=https://web.archive.org/web/20240706204005/https://www.cancer.org/cancer/risk-prevention/tobacco/health-risks-of-tobacco/smokeless-tobacco.html |url-status=live }}{{cite web |date=25 October 2010 |title=Smokeless Tobacco and Cancer |url=https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/smokeless-fact-sheet |publisher=United States Department of Health and Human Services |agency=National Cancer Institute at the National Institutes of Health |access-date=2 June 2024 |archive-date=31 May 2024 |archive-url=https://web.archive.org/web/20240531183504/https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/smokeless-fact-sheet |url-status=live }}{{PD-notice}}{{cite book |author=Royal College of Physicians of London. Tobacco Advisory Group |url=https://books.google.com/books?id=fpUgCBGb5SwC&pg=PA5 |title=Protecting Smokers, Saving Lives: The Case for a Tobacco and Nicotine Regulatory Authority |publisher=Royal College of Physicians |year=2002 |isbn=978-1-86016-177-3 |pages=5– |access-date=2 June 2024 |archive-date=31 May 2024 |archive-url=https://web.archive.org/web/20240531183455/https://books.google.com/books?id=fpUgCBGb5SwC&pg=PA5 |url-status=live }} Globally smokeless tobacco products like gutka contribute to 650 000 deaths each year with a significant proportion of them in Southeast Asia.{{cite journal |last1=Sinha |first1=Dhirendra N |last2=Suliankatchi |first2=Rizwan A |last3=Gupta |first3=Prakash C |last4=Thamarangsi |first4=Thaksaphon |last5=Agarwal |first5=Naveen |last6=Parascandola |first6=Mark |last7=Mehrotra |first7=Ravi |year=2016 |title=Global burden of all-cause and cause-specific mortality due to smokeless tobacco use: systematic review and meta-analysis |journal=Tobacco Control |volume=27 |issue=1 |pages=tobaccocontrol–2016–053302 |doi=10.1136/tobaccocontrol-2016-053302 |issn=0964-4563 |pmid=27903956 |s2cid=10968200}}{{Cite journal |last1=Chugh |first1=Aastha |last2=Arora |first2=Monika |last3=Jain |first3=Neha |last4=Vidyasagaran |first4=Aishwarya |last5=Readshaw |first5=Anne |last6=Sheikh |first6=Aziz |last7=Eckhardt |first7=Jappe |last8=Siddiqi |first8=Kamran |last9=Chopra |first9=Mansi |last10=Mishu |first10=Masuma Pervin |last11=Kanaan |first11=Mona |last12=Rahman |first12=Muhammad Aziz |last13=Mehrotra |first13=Ravi |last14=Huque |first14=Rumana |last15=Forberger |first15=Sarah |date=June 2023 |title=The global impact of tobacco control policies on smokeless tobacco use: a systematic review |url=https://linkinghub.elsevier.com/retrieve/pii/S2214109X2300205X |journal=The Lancet Global Health |language=en |volume=11 |issue=6 |pages=e953–e968 |doi=10.1016/S2214-109X(23)00205-X |pmid=37202029 |access-date=2 June 2024 |archive-date=3 June 2024 |archive-url=https://web.archive.org/web/20240603043722/https://linkinghub.elsevier.com/retrieve/pii/S2214109X2300205X |url-status=live |hdl=20.500.11820/e0442377-9f02-4360-8d09-292d86110e45 |hdl-access=free }}

Using gutka can cause a number of adverse health effects such as head and neck cancer, oral cancer, oral submucous fibrosis, oesophagus cancer, and pancreatic cancer, cardiovascular disease, and asthma.{{cite journal |last1=Niaz |first1=Kamal |last2=Maqbool |first2=Faheem |last3=Khan |first3=Fazlullah |last4=Bahadar |first4=Haji |last5=Ismail Hassan |first5=Fatima |last6=Abdollahi |first6=Mohammad |year=2017 |title=Smokeless tobacco (paan and gutkha) consumption, prevalence, and contribution to oral cancer |journal=Epidemiology and Health |volume=39 |pages=e2017009 |doi=10.4178/epih.e2017009 |issn=2092-7193 |pmc=5543298 |pmid=28292008}}{{CC-notice|cc=by4|url=https://www.e-epih.org/journal/view.php?doi=10.4178/epih.e2017009|author(s)=Kamal Niaz, Faheem Maqbool, Fazlullah Khan, Haji Bahadar, Fatima Ismail Hassan, Mohammad Abdollahi}} It also raises the risk of fatal coronary artery disease, fatal stroke and non-fatal ischaemic heart disease When a person chews gutka, the mixture directly enters the system through the oral cavity, which absorbs 28 cancer-causing chemicals.

Gutka can cause adverse reproductive effects including stillbirth, premature birth, low birth weight. Nicotine in gutka that are used during pregnancy can affect how a baby's brain develops before birth.

Gutka use causes the production of various reactive free radicals that induce oxidative stress, particularly in oral tissues.{{cite journal |vauthors=Prajapati RK, Joshi J, Karthikeyan S, Inder MP |title=Comparative evaluation of salivary, serum and urinary 8-OHdG in gutka-associated oral submucous fibrosis |journal=J Oral Maxillofac Pathol |volume=28 |issue=1 |pages=37–41 |date=2024 |pmid=38800434 |pmc=11126255 |doi=10.4103/jomfp.jomfp_442_23 |doi-access=free |url=}} Gutka exposure can lead to the oxidation of guanine bases in DNA to form 8-hydroxy-2’-deoxyguanosine (8-OHdG or its tautomer 8-oxo-dG) as a major byproduct. Exposure to Gutka tends to be highest in saliva and urine as evaluated by measuring 8-OHdG in DNA.

Creative advertising by tobacco companies and lack of accessible information for the public leads to many gutka users being unaware of the dangers it can bring. Often users believe that gutka can act as a digestion aid, kill germs, and generally give a sense of well-being.{{cite journal |last1=Niaz |first1=Kamal |last2=Maqbool |first2=Faheem |last3=Khan |first3=Fazlullah |last4=Bahadar |first4=Haji |last5=Ismail Hassan |first5=Fatima |last6=Abdollahi |first6=Mohammad |title=Smokeless tobacco (paan and gutkha) consumption, prevalence, and contribution to oral cancer |journal=Epidemiology and Health |volume=39 |pages=e2017009 |publisher=US National Library of Medicine, National Institutes of Health |doi=10.4178/epih.e2017009 |pmid=28292008 |pmc=5543298 |date=9 March 2017}} In fact 34.4% of smokers have switched to smokeless tobacco use as way to quit but there is no scientific evidence that using gutka can help a person quit smoking.{{Cite web |last=ERS |date=2019-05-29 |title=ERS Position Paper on Tobacco Harm Reduction |url=https://www.ersnet.org/news-and-features/news/ers-position-paper-on-tobacco-harm-reduction-2/ |access-date=2024-05-30 |website=ERS - European Respiratory Society |language=en-GB |archive-date=30 May 2024 |archive-url=https://web.archive.org/web/20240530093952/https://www.ersnet.org/news-and-features/news/ers-position-paper-on-tobacco-harm-reduction-2/ |url-status=live }} As of 2015 it was the fourth most common addictive product worldwide.{{cite journal |last1=Wu |first1=Fen |last2=Parvez |first2=Faruque |last3=Islam |first3=Tariqul |last4=Ahmed |first4=Alauddin |last5=Rakibuz-Zaman |first5=Muhammad |last6=Hasan |first6=Rabiul |last7=Argos |first7=Maria |last8=Levy |first8=Diane |last9=Sarwar |first9=Golam |last10=Ahsan |first10=Habibul |author10-link=Habibul Ahsan |last11=Chen |first11=Yu |date=25 June 2015 |title=Betel quid use and mortality in Bangladesh: a cohort study |journal=Bulletin of the World Health Organization |publisher=World Health Organization |volume=93 |issue=10 |pages=684–692 |doi=10.2471/blt.14.149484 |pmc=4645429 |pmid=26600610}}{{cite journal |last1=Javed |first1=Fawad |last2=Chotai |first2=Milisha |last3=Mehmood |first3=Abid |last4=Almas |first4=Khalid |date=1 June 2010 |title=Oral mucosal disorders associated with habitual gutka usage: a review |journal=Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology |publisher=Oral Surgery, Oral edicine, Oral Pathology, Oral Radiology, and Endodontology |volume=109 |issue=6 |pages=857–864 |doi=10.1016/j.tripleo.2009.12.038 |pmid=20382045}}

File:Panmasala Gutkha stains on wall due to spitting.jpg]]

Use of gutka and other forms of tobacco are culturally ingrained and use can begin at a young age. Smokeless tobacco use is most common in India where oral cancer accounts for 30 to 40% of cancer cases.{{cite journal |last1=ALI |first1=SYED MUMTAZ |last2=QURESHI |first2=REHAN |last3=JAMAL |first3=SYED |s2cid=35257267 |journal=Pakistan Oral and Dental Journal }} Its use has been reported in Thailand, Sri Lanka, Bangladesh, Pakistan, Malaysia, Cambodia, China, Indonesia and New Guinea. Immigrants to the United Kingdom, parts of Africa, Australia, North America have brought their habits with them.

Gutka is readily available in these locations, especially in neighborhood Asian markets in highly populated areas.{{cite journal |last1=Niaz |first1=Kamal |last2=Maqbool |first2=Faheem |last3=Khan |first3=Fazlullah |last4=Bahadar |first4=Haji |last5=Ismail Hassan |first5=Fatima |last6=Abdollahi |first6=Mohammad |title=Smokeless tobacco (paan and gutkha) consumption, prevalence, and contribution to oral cancer |journal=Epidemiology and Health |volume=39 |pages=e2017009 |publisher=US National Library of Medicine, National Institute of Health |doi=10.4178/epih.e2017009 |pmid=28292008 |pmc=5543298 |date=9 March 2017}} Immigrants to the United States where spitting in public is not as socially acceptable, learn to be discreet.{{cite journal |last1=Banerjee |first1=Smita C. |last2=Ostroff |first2=Jamie S. |last3=Bari |first3=Sehrish |last4=D’Agostino |first4=Thomas A. |last5=Khera |first5=Mitali |last6=Acharya |first6=Sudha |last7=Gany |first7=Francesca |title=Gutka and Tambaku Paan Use Among South Asian Immigrants: A Focus Group Study |journal=Journal of Immigrant and Minority Health |date=12 April 2013 |volume=16 |issue=3 |pages=531–539 |doi=10.1007/s10903-013-9826-4 |pmid=23579964 |pmc=4097304 }} Those in the lower socioeconomic populations are especially at risk. It is here that access to education and treatment is limited.{{cite journal |last1=Coelho |first1=Ken Russell |title=Challenges of the Oral Cancer Burden in India |journal=Journal of Cancer Epidemiology |volume=2012 |pages=701932 |language=en |doi=10.1155/2012/701932 |pmid=23093961 |pmc=3471448 |date=2012|doi-access=free }} Easy access and extremely low cost lead to early addiction and the prevalence of gutka use.{{Cite journal |last1=Dsouza |first1=Vivek |last2=Kembhavi |first2=Pratiksha Mohan |last3=S |first3=Praveen Rao |last4=P |first4=Kumaran |last5=Hebbar |first5=Pragati B. |date=2023-03-27 |title=How does Indian news media report smokeless tobacco control? A content analysis of the gutka ban enforcement |journal=PLOS Global Public Health |language=en |volume=3 |issue=3 |pages=e0001724 |doi=10.1371/journal.pgph.0001724 |issn=2767-3375 |pmc=10042338 |pmid=36972290 |doi-access=free }}{{cite journal |last1=Balappanavar |first1=Aswini |last2=Mohanty |first2=Vikrant Ranjan |last3=Hussain |first3=Abrar |title=Compliance with Tobacco Promotion and Sale Laws in School Neighbourhoods in India |volume=18 |issue=2 |journal=Asian Pacific Journal of Cancer Prevention |publisher=US National Library of Medicine, National Institutes of Health |pages=563–570 |doi=10.22034/APJCP.2017.18.2.563 |pmid=28345846 |pmc=5454759 |date=1 February 2017}}{{cite news |last1=A.H.R. |title=The nut cracks: Half of all Indian states have banned gutka since April. More may follow |url=https://www.economist.com/banyan/2012/10/09/the-nut-cracks |newspaper=The Economist |access-date=7 December 2019 |archive-date=7 December 2019 |archive-url=https://web.archive.org/web/20191207222236/https://www.economist.com/banyan/2012/10/09/the-nut-cracks |url-status=live }} Precancerous lesions have been observed in young children and symptoms of cancer often appear by high school or college age.

Smoking is not allowed in many places, and when done by children, is disapproved of. In contrast gutka use, being all but invisible to others, is the method of choice. A New York Times article reported in 2002 that sales of gutka and the tobaccoless version, paan masala, reached $1 billion a year.{{cite web |last1=Waldman |first1=Amy |title=Sweet but Deadly Addiction Is Seizing the Young in India |url=https://www.nytimes.com/2002/08/13/world/sweet-but-deadly-addiction-is-seizing-the-young-in-india.html |website=The New York Times |access-date=8 December 2019 |date=13 August 2002 |archive-date=8 December 2019 |archive-url=https://web.archive.org/web/20191208005154/https://www.nytimes.com/2002/08/13/world/sweet-but-deadly-addiction-is-seizing-the-young-in-india.html |url-status=live }}

Over 25% of India's population use tobacco products including cigarettes and multiple forms of smokeless tobacco. India has the largest number of smokeless tobacco users in the world. The poorest populations are greatly affected due to the detrimental effects of its use and the subsequent costs of medical care. Many Indian states have sought to curb the use and spread of gutka by taxing sales heavily or by banning it.

They have banned the sale, manufacture, distribution and storage of gutka and all its variants. As of May 2013, gutka is banned in 24 states and 3 union territories.{{cite news |url=http://www.dnaindia.com/mumbai/report_cancer-centres-urge-pm-to-ban-gutka-across-india_1767377 |title=Cancer centres urge PM to ban gutka across India |newspaper=DNA India |date=21 November 2012 |access-date=16 August 2013 |archive-date=7 January 2019 |archive-url=https://web.archive.org/web/20190107054602/https://www.dnaindia.com/mumbai/report-cancer-centres-urge-pm-to-ban-gutka-across-india-1767377 |url-status=live }} The federal Food Safety and Regulation (Prohibition) Act 2011 allows harmful products such as gutka to be banned for a year. This can be renewed annually, resulting in a permanent ban. The ban is enforced by the state public health ministry, the state Food and Drug Administration, and the local police.{{cite news|url=https://timesofindia.indiatimes.com/city/mumbai/Govt-to-file-caveat-in-HC-today-on-gutka-paan-masala-ban/articleshow/14858958.cms |archive-url=https://archive.today/20130126085134/http://articles.timesofindia.indiatimes.com/2012-07-13/mumbai/32662776_1_paan-masala-gutka-magnesium-carbonate |url-status=live |archive-date=26 January 2013 |title=Govt to file caveat in HC today on gutka, paan masala ban |date=13 July 2012 |work=The Times of India |access-date=16 August 2013}} Enforcement of the law is generally lax and many shops still sell gutka, although it may not be displayed.{{cite news|url=http://www.firstpost.com/india/why-the-gutka-ban-in-maharashtra-wont-work-376475.html|title=Why the gutka ban in Maharashtra won't work|date=13 July 2012|access-date=13 July 2012|archive-date=14 July 2012|archive-url=https://web.archive.org/web/20120714030058/http://www.firstpost.com/india/why-the-gutka-ban-in-maharashtra-wont-work-376475.html|url-status=live}}{{cite news|url=http://www.thehindu.com/news/cities/Kochi/article3535702.ece|title=Sale of pan masala thriving|date=16 June 2012|location=Chennai, India|work=The Hindu|first=M. P.|last=Praveen|access-date=13 July 2012|archive-date=18 June 2012|archive-url=https://web.archive.org/web/20120618000904/http://www.thehindu.com/news/cities/Kochi/article3535702.ece|url-status=live}}{{cite news|url=https://timesofindia.indiatimes.com/city/patna/What-ban-Gutka-still-sells/articleshow/14222559.cms|archive-url=https://archive.today/20130103144240/http://articles.timesofindia.indiatimes.com/2012-06-18/patna/32298406_1_paan-masala-gutka-tobacco-products|url-status=live|archive-date=3 January 2013|work=The Times of India|title=What ban? Gutka still sells|date=18 June 2012 }}{{cite news|url=https://timesofindia.indiatimes.com/city/patna/Gutka-ban-not-satisfactory-admits-minister/articleshow/18095271.cms |archive-url=https://archive.today/20130411034453/http://articles.timesofindia.indiatimes.com/2013-01-20/patna/36445192_1_tobacco-control-voice-of-tobacco-victims-gutka-ban |url-status=live |archive-date=11 April 2013 |title=Gutka ban not satisfactory, admits minister |date=20 January 2013 |work=The Times of India |access-date=16 August 2013}}{{cite news|url=https://timesofindia.indiatimes.com/city/bhubaneswar/Gutka-continues-to-rustle-undercover-despite-ban/articleshow/18231182.cms |archive-url=https://archive.today/20130411035609/http://articles.timesofindia.indiatimes.com/2013-01-29/bhubaneswar/36614819_1_ban-gutka-gutka-and-paan-masala-tobacco-products |url-status=live |archive-date=11 April 2013 |title=Gutka continues to rustle undercover despite ban |date=29 January 2013 |work=The Times of India |access-date=16 August 2013}} Enforcemnent is stricter in some regions like Mumbai and Delhi, but illegal sale of gutka still occurs.{{cite news |url=http://www.business-standard.com/india/news/indians-want-their-fixgutkhapan-masala-despite-ban/486544/ |title=Indians want their fix of gutkha & pan masala despite ban |work=Business Standard |date=16 September 2012 |access-date=16 August 2013 |archive-date=6 July 2024 |archive-url=https://web.archive.org/web/20240706204007/https://www.business-standard.com/search?q=news |url-status=live }}

In 2019, the Delhi government extended the ban for one more year on Gutka, Pan Masala, Flavoured/Scented Tobacco, Kharra and similar products containing tobacco. In September 2012, State of Delhi banned Gutka and Pan Masala containing tobacco and/or nicotine. After the notification, Gutka manufacturers separated the components like tobacco from Gutka and Pan Masala. Since the term ‘Gutka and Pan Masala Containing Tobacco’ was used in the notification. The components like tobacco were manufactured and sold in separate pouches after the ban. The notification was revised in March 2015 to make it more strict and banned all smokeless tobacco (SLT) products including twin-pack.{{cite news | url=https://thehealth.today/fact-check-about-ban-on-smokeless-tobacco-products-in-india/ | title=Fact Check About Ban On Smokeless Tobacco Products In India | work=The Health | date=May 10, 2019 | access-date=September 8, 2019 | author=Siddharth | url-status=live | archive-date=25 August 2019 | archive-url=https://web.archive.org/web/20190825183531/https://thehealth.today/fact-check-about-ban-on-smokeless-tobacco-products-in-india/ }} Offenders can be fined or receive prison sentences.{{cite news|author=Masand, Pratibha |url=https://timesofindia.indiatimes.com/city/mumbai/Ban-implementation-may-take-few-weeks/articleshow/14858935.cms |archive-url=https://archive.today/20130126044336/http://articles.timesofindia.indiatimes.com/2012-07-13/mumbai/32663143_1_paan-masala-ban-implementation-fda-commissioner-mahesh-zagade |url-status=live |archive-date=26 January 2013 |title=Ban implementation may take few weeks |date=13 July 2012 |work=The Times of India |access-date=16 August 2013}} The law has provisions of imposing fines up to {{INRConvert|25000}} on the sale of products that are injurious to health.{{cite web |url=http://hillpost.in/2012/07/13/himachal-bans-sale-of-gutka-pan-masala-masheri-khaini/46753/latest-news/ravinder |title=Himachal bans sale of Gutka, Pan Masala, Masheri & Khaini |work=Hill Post |date=13 July 2012 |access-date=16 August 2013 |archive-date=24 November 2012 |archive-url=https://web.archive.org/web/20121124040710/http://hillpost.in/2012/07/13/himachal-bans-sale-of-gutka-pan-masala-masheri-khaini/46753/latest-news/ravinder |url-status=dead }}

Research firm Edelweiss estimates the gutka ban will cause the industry {{INR|15-20 billion}} in losses.{{cite news|author=Chandramouli, Rajesh |url=https://timesofindia.indiatimes.com/city/chennai/Gutka-ban-loss-could-be-Rs-1500--Rs-2000-crores/articleshow/16398290.cms |archive-url=https://archive.today/20130103131948/http://articles.timesofindia.indiatimes.com/2012-09-14/chennai/33842950_1_gutka-ban-gutkha-tobacco |url-status=live |archive-date=3 January 2013 |title=Gutka ban loss could be Rs 1500 - Rs 2000 crores |date=14 September 2012 |work=The Times of India |access-date=16 August 2013}}

Like alcohol and tobacco products, there is a ban on advertisement of gutka. Often tobacco companies advertise gutka as pan masala in order to skirt the ban on advertising tobacco products. Surrogate advertisements often use pan masala ads to promote gutka products with similar name and packaging.{{Cite news |date=20 June 2012 |title=Ban surrogate advertisements of tobacco products |url=http://www.deccanherald.com/content/258543/ban-surrogate-advertisements-tobacco-products.html |work=Deccan Herald |access-date=10 July 2012 |archive-date=17 October 2014 |archive-url=https://web.archive.org/web/20141017222628/http://www.deccanherald.com/content/258543/ban-surrogate-advertisements-tobacco-products.html |url-status=live }}

According to the Food Safety and Standards (Prohibition and Restriction on Sales) Regulations, 2011 of the Food Safety and Standards Authority of India, misleading advertisement of such products invites a fine of {{INRConvert|1000000|lk=on}}.{{cite news| url=https://timesofindia.indiatimes.com/city/bhubaneswar/No-relaxation-on-gutka-ban/articleshow/18041675.cms | archive-url=https://archive.today/20130411034610/http://articles.timesofindia.indiatimes.com/2013-01-16/bhubaneswar/36373255_1_gutka-and-paan-masala-sale-and-advertisement-anti-tobacco | url-status=live | archive-date=2013-04-11 | work=The Times of India | title=No relaxation on gutka ban}}

According to StraitsResearch, The India pan masala market is expected to reach {{USD|10,365 million}} by 2026 at the CAGR of 10.4% during the forecast period 2019–2026. The India pan masala market is driven by significant switching of consumers from tobacco products to pan masala, aggressive advertising and convenient packaging, and Maharashtra State's revocation of the ban over pan masala products.{{cite news | url=https://industrynewswire.us/what-are-the-key-challenges-to-india-pan-masala-market-growth/136971/ | work=Industry News Wire | title=Indian Pan Masala Market Share Analysis | access-date=20 February 2020 | archive-date=20 October 2020 | archive-url=https://web.archive.org/web/20201020140525/https://industrynewswire.us/what-are-the-key-challenges-to-india-pan-masala-market-growth/136971/ | url-status=live }}

• Mukesh Harane

{{Reflist|30em}}

• Javed F, Altamash M, Klinge B, Engström PE. (2008). Periodontal conditions and oral symptoms in gutka-chewers with and without type 2 diabetes. Acta Odontol Scand; 66(5):268-73.
• Javed F, Chotai M, Mehmood A, Almas K. Oral mucosal disorders associated with habitual gutka usage. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109:857-64.
• Javed F, Bello Correa FO, Chotai M, Tappuni AR, Almas K. Systemic conditions associated with areca nut usage: A literature review. Scand J Public Health 2010; 38: 838–44.

• [https://www.nytimes.com/2002/08/13/international/asia/13INDI.html?todaysheadlines Sweet but Deadly Addiction is Seizing the Young in India], The New York Times, 13 August 2002
• [http://news.bbc.co.uk/1/hi/health/398630.stm Chewing tobacco cancer warning], BBC News, 26 July 1999
• [http://news.bbc.co.uk/2/hi/health/289976.stm Health: Children Buy Cancerous Sweets], BBC News, 3 March 1999
• [https://web.archive.org/web/20150517015526/http://www.cpaaindia.org/activities/projects.htm#gutkha Anti Gutkha Campaign], Cancer Patients Aid Association
• [http://ruaab.in Ruaab Pan Masala], Gutka, 16 July 2018

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