Prevalence, patterns and sociocultural factors associated with use of tobacco-based dentifrices (Gul) in India

Indian J Cancer. 2020 Jul-Sep;57(3):311-320. doi: 10.4103/ijc.IJC_717_18.


Background: India poses a novel tobacco problem with majority of the tobacco users consuming smokeless form of tobacco (21.4%). Gul is one such Smokeless Tobacco (ST) product that is manufactured commercially as a dentifrice to be applied to the teeth and then to gums many times during the day, making it a cheap and easy tobacco source. Hence, the aim of the present study was to estimate the usage of Gul and its social determinants among adults in the capital city of India, Delhi.

Methods: The cross-sectional study was conducted among 1300 adults across 27 Delhi government dispensaries across 3 districts of Delhi through multistage stratified random sampling. A structured, close-ended, validated questionnaire inquiring about the tobacco practices was used for all the participants and a specially constructed, structured, close-ended, validated proforma was used for Gul users to assess practice and pattern of use.

Results: The overall prevalence of Gul users was found to be 4.9% with a mean usage duration of 6.28 ± 6.75 years. The usage was found to be more among males (67.7%) and unskilled workers (45.2%). 74.9% started using Gul to treat dental pain with 93.47% of them reporting pain relief.

Conclusion: Gul usage is an emerging menace in Delhi. Awareness programs and initiatives are the need of the hour to bring this tobacco product under the tobacco control policy radar and at the same time educate people about the actual contents and ill effects of Gul usage.

Keywords: Illegal tobacco products; non-cigarette tobacco products; packaging and labelling; socioeconomic status; tobacco industry.

MeSH terms

  • Cross-Sectional Studies
  • Dentifrices / therapeutic use*
  • Female
  • Humans
  • India
  • Male
  • Nicotiana / adverse effects*
  • Prevalence
  • Sociological Factors
  • Tobacco, Smokeless / adverse effects*


  • Dentifrices