title: Paan (pan) and paan (pan) masala should be considered tobacco products.
abstract: 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.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of California, Davis, Sacramento, CA, USA Department of Health Sciences, California State University, East Bay, Hayward, CA, USA.
authors.forename: Arnab
authors.initials: A
authors.lastname: Mukherjea
authors.affiliation: Institute for Population Health Improvement, University of California, Davis, Sacramento, CA, USA.
authors.forename: Mary V
authors.initials: MV
authors.lastname: Modayil
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of California, Davis, Sacramento, CA, USA.
authors.forename: Elisa K
authors.initials: EK
authors.lastname: Tong
mesh_terms: D001114:Areca; D002273:Carcinogens; D006801:Humans; D007194:India; D010947:Plants, Toxic; D012907:Smoking; D019460:Tobacco Industry; D014029:Tobacco Use Disorder; D014030:Tobacco, Smokeless
chemical_list: D002273:Carcinogens
keywords: Disparities; Global health; Non-cigarette tobacco products; Priority/special populations; Surveillance and monitoring