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Smoking cigarettes is the leading cause of preventable death in the United States, causing over 480,000 deaths yearly
Smokeless tobacco is classified as a known human carcinogen by IARC, and various constituents are similarly classified ( Currently, there is no way to relate a particular level of a chemical constituent in STPs to cancer risk
This could be particularly challenging for LMICs with limited resources for surveillance or research, and an area for technical assistance from higher income countries, civil society or WHO
Although further investigation into the reasons for this is required, the strong influence of the HEIC-PA sub-index may be an artefact of Taranakis mixed rural-urban setting
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