In 2022, as per global estimates, around 253 million people in India were tobacco users, making it the second-highest country in the world for tobacco use. According to the World Health Organisation (WHO), from 2017 to 2018, the economic cost of tobacco use for people aged 35 and older was estimated to be Rs 1,77,341 crore (USD 27.5 billion), a very high cost leading to several diseases like cancer, lung damage, kidney damage, heart problems and stroke. The most common forms of tobacco use in India are smokeless tobacco, such as khaini , gutkha , betel quid with tobacco, and zarda , and smoking tobacco, such as bidi , cigarette, and hookah. The Health Ministry has been campaigning against tobacco use prohibiting smoking in various public places as part of the National Tobacco Control Programme
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There it has an acute effect, with nicotine levels peaking within 10 seconds or less to elicit primarily pleasurable effects
