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It is a mixture of crushed areca (betel) nut, tobacco, slaked lime, catechu (a plant extract), flavourings, and sweeteners and is typically placed between the cheek and gum and gently chewed or sucked for extended periods and spat.[2] Observation of the data on tobacco use practices (Table 2), collected before starting the interviews, revealed that participants who reported lower daily SLT use also reported a greater number of attempts to quit

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Tobacco smoking has been observed to affect the peripheral immune system on several levels, including a decrease in the activity of natural killer cells, increase in white blood cell counts, and a higher susceptibility to infection [29]

You know whos going to win, says Mukesh, a newsagent and tobacconist in Southwark in south London