Gutka

Gutka, ghutka, guṭkha is a type of betel quid and chewing tobacco preparation made of crushed areca nut (also called betel nut), tobacco, catechu, paraffin wax, slaked lime (calcium hydroxide) and sweet or savory flavourings, in India, Pakistan, other Asian countries, and North America.^[1]

Using gutka is highly addictive and can cause various harmful effects such as head and neck cancer,^[2][3] oral and oropharyngeal cancers,^[4] coronary heart disease, as well as negative reproductive effects including stillbirth, premature birth and low birth weight.^[5][6]

Gutka is manufactured in the sub-continent and exported to a few other countries, often marketed under the guise of a "safer" product than cigarettes and tobacco.^[7] Reported to have both stimulant and relaxation effects, it is sold throughout South Asia and some Pacific regions in small, individual-sized foil packets/sachets and tins^[8] that cost between 2 and 10 rupees each.^[9] It is widely consumed in India, Pakistan and the Madhesh region of Nepal. Gutka is consumed by placing a pinch of it between the gum and cheek and gently sucking and chewing, similar to chewing tobacco.^[8] Due to containing cancer-causing substances, it is subjected in India to the same restrictions and warnings as cigarettes.^{[1][10][11][12]} Highly addictive and a known carcinogen, gutkha is the subject of much controversy in India. Many states have sought to curb its immense popularity by taxing sales of gutkha heavily or by banning it.^[13]