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Difference in CRP, random glucose, serum cholesterol, TG, HLDL-C, LDL-C, VLDL-C, neutrophil count, monocyte count, ESR, SOD (PBMC) and TBARS (RBC membrane) were found to be statistically significant (p The habit of oral use of smokeless tobacco (SLT), such as “chewing tobacco” or “spit tobacco” is becoming a global threat to human health with every passing day due to its numerous deleterious effects.

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Level of different pro- and anti- apoptotic markers such as p53, p21, Bax, Bcl-2 and pro-inflammatory cytokines such as IL-6, TNF-α, i NOS, Cox-2 were analysed.

Structural changes of RBC were analysed microscopically among the studied groups.

We reported that SLT use aggravated the systemic stress and inflammatory developments; moreover, it grossly perturbed the metabolic harmony as reflected in apoptotic developments and RBC morphology change.

This is perhaps the first exhaustive report on the menace of SLT on Indian population to make a road map for the therapeutic approach of the disease and open further avenues for research in this field. We found that, SLT-user group had higher levels of c-reactive protein (CRP), glucose (random), urea, serum cholesterol, serum triglyceride (TG), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), very low-density lipoprotein-cholesterol (VLDL-C), leukocyte count, neutrophil count, platelet count, erythrocyte sedimentation rate (ESR), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) level compared to the non-user group.

With the course of events and actions, SLT and CS both seem to be equally powerful in altering the cellular and metabolic changes. In this study, we investigated with the objective of analyzing effects of chewing tobacco among the northern sub-population of Kolkata, India.