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A period effect such as procedure fatigue, with an increasingly relaxed stance towards the rigid measurement protocol, could have affected our results

First, a PubMed search was conducted for the following terms: presence of smokeless tobacco in Taiwan, prevalence in India, prevalence in Pakistan, presence of smokeless in Asia, occurrence of paan and gutkha in Tanzania, epidemiological prevalence and presence of smokeless tobacco in Indonesia and Malaysia, prevalence and presence of paan and gutkha in Cambodia, and prevalence of paan and gutkha in migrated peoples. Scopus was searched for terms including: oral cancer due to paan and gutkha , genotoxic effect of paan , paan and gutkha chewers, betel quid compounds, risk factor of oral cancer, prevalence of oral cancer, paan associated with oral cancer, smokeless products lead to oral cancer, and gutkha usage. Google Scholar was searched for keywords such as carcinogenic effect of betel, mechanism of oral cancer due to paan and gutkha , ban of paan and gutkha , and OSMF mechanism and etiopathogenesis. The data included in this article were filtered to ensure that they were specifically related to human beings and some laboratory animals

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In the U.S., most snuff tobacco is sold as moist snuff