Chewing tobacco kills a whole lot of people around the world, but how it kills them is a little more surprising than you’d expect given the process by which the tobacco is absorbed into the body. You’d naturally assume shoving a wad of chemical-soaked leaves into your cheek would turn your mouth into a tumor garden, but according to a massive global study published in The Lancet Global Health, oral cancer is still likely to get you, but not as much as a stroke.Data from the Institute for Health Metrics and Evaluation reveals that chewing tobacco killed an estimated 251,000 people in 2023 alone. There were plenty of lip and mouth cancer culprits in that bunch, but the real, far more frightening threat was stroke, which accounted for more than three times the total health damage and lost healthy years worldwide. Instead of just destroying your gums, chewing tobacco is doing a number on your brain’s blood vessels.The study tracked 204 countries and found that 241 million people are actively dipping or chewing. That’s a population roughly the size of Pakistan cramming moist wads of cardiovascular damage into their mouths and subsequently spitting disgusting brown streams of foul-smelling saliva everywhere. Chewing Tobacco Was Linked to 251,000 Deaths in One Year. Here’s What Stood Out.If you’re imagining folks in the American South being inordinately hit, it’s actually people in South Asia, in countries like India and Bangladesh, that account for a huge majority of users. Never fear, the United States is still in the top 10 for total deaths, because nothing kills an American more than the freedom to freely purchase a highly addictive, stroke- and cancer-causing substance at 7-Eleven. All of this happens as smoking rates have plummeted thanks in large part to decades of public health campaigns. Chewing tobacco got lost in the shuffle, hitting a peak in usage rates in 1990 and staying relatively flat ever since, while total annual deaths have spiked over 133 percent between 1990 and 2023. Chewing tobacco is the addictive silent killer everyone chooses to ignore, possibly because it doesn’t quite have the stigma of smoking, even though it’s still quite deadly, just not exactly in the way you’d assume.The post Chewing Tobacco’s Biggest Health Burden Isn’t What You Might Expect appeared first on VICE.