New Delhi: It comes in small pouches, is easy to slip into the pocket, is cheap — and is also a killer. Chewing tobacco, or gutkha, can cause oral cancer, and India has the largest recorded incidence of the disease. The government is now planning to crack down on its use.

The health ministry is planning measures to curb the use of the most widespread form of tobacco in India and will soon call a meeting of state ministers to discuss the issue, an official said yesterday.

The health ministry's Additional Secretary Keshav Desiraju said policies will be formulated to inform people about the harmful effects of tobacco.

"Most of our work so far has focused on smoking. The users of smokeless tobacco are usually from the weakest sections of society, and a different approach is needed to reach them," he said. "Smokeless tobacco is being increasingly used in university campuses and urban areas," he said.

India has the world's highest incidence of mouth cancer in the world, according to a study by the British Journal of Cancer.

"The risk of oral cancer is up to 50 times greater for the person who chews tobacco. It also increases the risk of throat and pharynx cancer," the European Commission has said.

According to Global Adult Tobacco Survey, 206 million people chew tobacco in India and of these 42.3 per cent are also cigarette users.

According to Public Health Foundation of India president K. Srinath Reddy, the use of smokeless tobacco is increasing among youth and women.

"There is a social stigma related to use of cigarettes by women and youth, so they find it convenient to use smokeless tobacco. It also comes in small pouches, which can be easily hidden. As it is cheap, it is popular among the poor," Reddy said.

Studies have shown that 12.5 per cent of all teenagers use tobacco in some form or another. It has been found responsible for 50 per cent of all cancers in men and 25 per cent of all cancers in women, besides being responsible for 90 per cent of all oral cancers.