http://www.nhs.uk/Livewell/SouthAsianhealth/Pages/Smokingandpaan.aspx

Paan, bidi and shisha

Tobacco that you don’t smoke (including paan, betel quid and chewing tobacco) is not a ‘safe’ way to use tobacco. It causes cancer and can be as addictive as smoking. Find out the risks and how you can quit.

Chewing tobacco

Betel quid, paan or gutkha is a mixture of ingredients including betel nut (also called areca nut), herbs, spices and often tobacco, wrapped in a betel leaf. Chewing smokeless tobacco, such as paan or gutkha, is popular with many people from south Asian communities, but all forms of tobacco can harm your health. Research has shown that using smokeless tobacco raises the risk of mouth cancer and oesophageal (food pipe) cancer.

Studies have also found that betel itself can raise the risk of cancer, so chewing betel quid without tobacco is still harmful.

Cigarettes, bidi and shisha

Smoking rates are higher among Bangladeshi men (40%) and Pakistani men (29%) than in the general population (21%). Indian men and south Asian women are less likely to smoke.

Smoking increases your risk of cancer, heart disease and respiratory (breathing) disease. This is true whether you smoke bidi (thin cigarettes of tobacco wrapped in brown tendu leaf), cigarettes or shisha (also known as a water pipe or hookah).

A World Health Organization study has suggested that during one session on a hookah (around 20 to 80 minutes) a person can inhale the same amount of smoke as a cigarette smoker consuming 100 or more cigarettes. Hookah smoke also contains nicotine, cancer-causing chemicals and toxic gases such as carbon monoxide.

Quitting

People who use NHS support are up to four times more likely to quit smoking than those who try to stop alone. All areas have a free local NHS Stop Smoking Service that provides medication and support to help you quit. Many services also offer support to help you stop using smokeless tobacco, such as paan. Find out more about using NHS Stop Smoking support.

Nine out of 10 people using a stop-smoking service would recommend it to another person who wants to stop smoking. It is proven to offer you your best chance of stopping. To find your local service, call the smoking helpline on 0300 123 1014, go to the Smokefree website, or ask your doctor or nurse to refer you to your local service.

You can also call the NHS Asian Tobacco Helpline, available in five languages, from 1pm to 9pm on Tuesdays:

• Urdu: 0800 169 0881
• Punjabi: 0800 169 0882
• Hindi: 0800 169 0883
• Gujarati: 0800 169 0884
• Bengali: 0800 169 0885

Or you can visit NHS Smokefree: south Asian information.