smokeless tobacco products that are used during pregnancy can affect how a baby's brain develops before birth. management due to smokeless tobacco harms, it should be treated. some medications shows some benefits are varenicline, nicotine lozenges. some behavioural interventions may help, however a cochrane review mentioned that there components need to be clearer. history smokeless tobacco was first discussed in the english language in 1683 as a powdered tobacco for breathing into the nose. people have used it for over a thousand years. cigarette manufacturers have penetrated the smokeless tobacco market. public perceptions many people who use smokeless tobacco may think it is safer than smoking, but all tobacco products contain toxicants, and use of smokeless tobacco poses its own significant health risks. in south and south-east asia these products are considered part of the cultural heritage and there is little enthusiasm for regulation. around 80% of users live in these regions.