Gutka is a preparation of crushed areca nuts, tobacco, catechu and other ingredients. It’s a known carcinogen and is extremely dangerous. While the major public health burden in the Western countries are due to smoking, in India, the main problem is smokeless tobacco. It’s believed that among the tobacco users, 75% consume gutka or some other form of smokeless tobacco while the rest are cigarette and beedi smokers. Its main ingredient the betel nut is a confirmed carcinogen, causes oral health problem, precancerous lesions and is also associated with heart ailments. Despite being banned in several states the product continues to available and is responsible for India having the highest oral cancer rates in the world.