Table 1:

Summery of the studies included in this study

N	Article titles	Reference Number	Target group and sample size	Part of the results
1	Why do Bangladeshi people use smokeless tobacco products?	55	1812 nonsmoking adults	Family members’ influence was the main factor for initiation. The participants believed that people continued using SLT because of addiction (52%) and as a part of their lifestyle (23%). The majority of participants (77%) did not mention any benefit, but SLT users considered it to be a remedy for toothache (P < .05). Almost all participants mentioned that SLT was harmful and causes heart disease, cancer, and tuberculosis.
2	Factors Influencing the Initiation of Smokeless Tobacco Consumption Among Low Socioeconomic Community in Bangladesh: A Qualitative Investigation	43	33 man and women	Tradition of hospitality, curiosity, offer from an elderly person, and avoiding nausea during pregnancy and at time of quitting smoking were key factors for the initiation of SLT consumption. The results also revealed most people were aware about the danger of SLT consumption but, in practice, consumed frequently.
3	Between Traditions and Health: Beliefs and Perceptions of Health Effects of Smokeless Tobacco Among Selected Users in Nigeria.	7	36 consumers	The findings revealed that the majority of SLT users believed that the practice had the following health benefits, among others: clearing of eyes and nose, aiding in sleep and rest, protecting against colds and nose bleeds and curing headaches. The users believed that SLT helped them ‘feel high’ or bold when afraid. The SLT users also believed that it protected them from evil spirit(s) and dangerous reptiles. The users believed that SLT had no negative health consequences, and SLT was generally preferred to smoking cigarettes
4	Patterns of Use and Perceptions of Harm of Smokeless Tobacco in Navi Mumbai, India and Dhaka, Bangladesh	20	2083 users and non-users	Among users in Bangladesh, the most commonly reported reason for using their usual product was the belief that it was “less harmful” than other types. Perceptions of harm also differed with respect to a respondent’s usual product. Bangladeshi respondents reported more negative attitudes toward smokeless tobacco compared to Indian respondents
5	Psychological predictors of male smokeless tobacco use initiation and cessation: a 16-year longitudinal study	13	219 (age 20 outcome) and 192 (age 28 outcome) adolescents	Peer influence, rebelliousness, and thrill-seeking appear to predict smokeless tobacco initiation strongly among male youth in the United States.
6	A comparative study of perceptions on tobacco in vulnerable populations between India and France	10	163 adults with disabilities	In both samples, the most relevant reasons of tobacco use were daily life circumstances, which were also a major barrier to quitting. None of the participants reported that quitting difficulties could be due to dependence or nicotine addiction. The data also suggested that whilst some participants wanted to stop, they also anticipated quitting would be extremely challenging. In addition, there were a number of cross-cultural differences between Indian and French disadvantaged people: level of information concerning the health risk related to tobacco use and level of demand for support to quit from health professionals were most often cited. Recommendations are made for a specific approach among disadvantaged people. The paper concludes that in order to facilitate cessation, tobacco control interventions need to focus on coping strategies to deal with feelings of distress, withdrawal symptoms, and the circumstances of everyday life experienced by disadvantaged tobacco users
7	Awareness, perceptions and use of snus among young adults from the upper Midwest region of the USA	15	2607 young adults (ages 20–28)	More young adults in the sample than the overall US adult population believed that snus is less harmful than cigarettes. Perceptions of snus are associated with snus use.
8	A systematic review of contextual factors relating to smokeless tobacco use among South Asian users in England	44.	14 studies	Reasons for chewing included the use of these products in times of stress, boredom or simply to relax. Traditional health messages and prior held beliefs may lead them to chew these products because of misconceptions about their health benefits, since very few people were aware of the health risks. Many expressed a desire to quit, however found it difficult to go without ST.
9	A national qualitative study of tobacco use among career firefighters and department health personnel	46	332career firefighters	Firefighters suggested several reasons for the decline in smoking in the fire service including changes in the fire service culture, concerns about the impact of smoking on their ability to perform their job, regulations aimed at reducing smoking in departments, and the costs of smoking. In contrast, they felt that the greater use of SLT was primarily due to increasing restrictions on smoking.
10	Current use of smokeless tobacco among adolescents in the Republic of Congo	8	3034 users and non-users	Having parents or friends smokers was positively associated with using smokeless tobacco
11	Smokeless tobacco uses in Nepal.	60	4072 respondents	SLT users have multiple habits of tobacco chewing, smoking and drinking. Despite SLT products being manufactured in the unorganized sector, they are also largely imported from India. People have easy access to various SLT products. There is a general lack of information on the health hazards of SLT use to the population.