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Paan, bidi and shisha

Tobacco that you do not 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 and cancer risk

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 increases your risk of cancerheart disease and respiratory problems.

This is true whether you smoke cigarettes, bidi (thin cigarettes of tobacco wrapped in brown tendu leaf) or shisha (also known as a waterpipe or hookah).

Like cigarette smoke, waterpipe smoke contains significant levels of cancer-causing chemicals and toxic gases such as carbon monoxide.

Quit smoking and tobacco

The most effective way to quit smoking and tobacco use is with expert help from a stop smoking adviser.

Your free local NHS Stop Smoking service can provide medication and expert support to help you quit.

Many services also offer support to help you stop using smokeless tobacco, such as paan.

You can find out more about quitting smoking on the Better Health website, or call the Smokefree National Helpline for free on 0300 123 1044 (England only).

The helpline is open 9am to 8pm Monday to Friday, and 11am to 4pm on Saturday and Sunday.

More on quitting smoking

The NHS Quit Smoking app offers daily support to quit:

Page last reviewed: 31 October 2022
Next review due: 31 October 2025