Old-timers, who still remember nostalgically the polished brass cuspidors in Pullman car smoking rooms, need not be told that there is more to tobacco than smoking. But only the occasional sight of the odd ballplayer perfunctorily emitting streams of brownish saliva as a macho ritual reminds the young that tobacco can be chewed as well as smoked.
To the community of Maharashtra, India, however, chewing tobacco is not a distant nostalgic memory but a disturbing reality. In this tobacco-growing town, the habit is prevalent even among pregnant women, with potential harm to the fetus. To determine the extent of this harm, Krishna1 conducted a study on 1,393 hospitalized pregnant women, each delivered of a single infant. Two hundred twenty (15.8%) of these women chewed tobacco. The nicotine content of the 50 to 100 g of tobacco chewed daily by each was estimated to be 4.24%.
Mothers who chewed tobacco