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Gutkha consists of sun-dried, roasted, finely chopped tobacco, areca nut, slaked lime and catechu mixed together with several other ingredients such as flavourings and sweeteners

In very small amounts, some of these metals support life, but when inhaled in large amounts, they can become toxic

These findings indicate that skin inflammation might contribute to the intestinal disorders through immunologic regulations and microbial community changes

Only 5% were smokers, Zahir Amoura, head of the study and professor of internal medicine, told the news agency AFP

The severity of these effects vary, but they lead to discomfort and interfere with daily activities, ultimately reducing overall quality of life