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Keywords: Electrocardiogram, gutkha, heart rate variability, smokeless tobacco, young adult INTRODUCTION Oral use of smokeless tobacco (ST) has existed for thousands of years and has gained popularity in various areas of the world.[1,2] ST is used in dipping and chewing form

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Further compounding the issue, some tobacco control organisations refuse to consider the innovations coming from the tobacco industry as viable alternatives that governments can use to supplement existing smoking cessation and prevention measures

Another alternative is utilizing powered air-purifying respirators (PAPRs), which offer a continuous flow of filtered air through a battery-operated blower system