“…In this population, nearly all the cancers of the gingiva and buccal mucosa were attributed to the long -term use of snuff and other smokeless tobacco products [128] . However, the relationship between smokeless tobacco use and oral cancer risk is not consistent among different populations, which could be explained by the fact that smokeless tobacco products used in different countries contain different levels of carcinogens [107,129] . In India, for example, smokeless tobacco is often used in combinations with betel leaf, areca nut, and powdered slaked lime, and these additives make the combination more carcinogenic than tobacco alone [130,131] .…”