Report of gutkha (smokeless tobacco) use in children aged 10-12 years.

To cite: Mallikarjuna R, Gangwal RR, Shanthraj SL, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2012008319 DESCRIPTION Tobacco is a risk factor for six of the eight leading causes of deaths in the world and kills up to one-half of its users. Tobacco use can result in a number of oral diseases. Oral cancer, periodontitis 4 compromised wound healing, a reduction in the ability to smell and taste, smoker’s palate and melanosis, coated tongue, staining of teeth and restorations, implant failure and leukoplakia 6 are all seen in tobacco users. Smokeless tobacco is a risk factor for periodontal conditions 8 and oral cancer. India is the second largest consumer of tobacco products and the third largest producer of tobacco in the world. The estimated number of tobacco users in India was 274.9 million. Of these, 163.7 million use only smokeless tobacco, 68.9 million are smokers and 42.3 million use both forms of tobacco. The prevalence of smokeless tobacco use has increased from 24% in 1995 to 33% in 2009. Smokeless tobacco use is seen in 13.4% of boys who are high school students and 2.3% ofwomen. 12 Smokeless tobacco contains arecanut which may be raw, baked or boiled, lime obtained from limestone or seashells and may also include aniseed, catechu, cardamom, cinnamon, coconut, cloves, sugar and tobacco. We present two case reports on use of smokeless tobacco in children.