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But there was no obvious substitute crop, and since t he end of the payment program in 2014, many farmers across the Southern Appalachians have faced both the challenge of replacing lost revenue and, at a deeper level, a kind of identity crisis

Dr Roohi Pirzada, a senior physician and critical care specialist in Mumbai, stated that herbal options are safer than cancerous gutka and pan masala, but cautioned, No pan masala is safe, with or without tobacco

But even as a food, tobacco does contain high amounts of nicotine, which can be poisonous in large doses

However, in many LMICs, smoking rate declines have not been enough to offset population growth