Gul: When ‘fresh breath’ turns fatal

Every morning in Modhubag, Zayeda Begum begins her day with a ritual as familiar to her as her first cup of tea. She dips her finger into a small plastic container, scoops out a dark, powdery substance, and rubs it gently along her gums. For years, this practice has been her trusted way of keeping her mouth "fresh" and her teeth "clean."

The substance is called gul, a little-known yet widely used form of smokeless tobacco in Bangladesh. Sold in unassuming plastic containers and often passed off as a kind of tooth powder, gul is an open secret in rural kitchens and urban backstreets alike. Its affordability and long-standing traditional use have made it especially popular among older women, who treat it as casually as one would toothpaste or mouth freshener.

"If I don't use it, I don't feel good anymore," Zayeda confessed, her fingers stained from years of habit. "When I apply it, there's this slight numbness in my gums… and even in my head. It feels calming, almost soothing."

In the national conversation about tobacco, cigarettes and jarda often steal the spotlight, but gul quietly persists in the shadows. At roadside tea stalls, where conversations linger over steaming cups, tiny gul containers sell for as little as ten taka. Easy to buy, discreet to use, and deeply ingrained in social habits, gul thrives in a space few ever question—despite being just as dangerous, if not more so, than the better-known tobacco products.

Hafizur, a tea stall owner at Tejagon, said, "Rickshaw pullers, especially the older ones, are my primary customers of gul." 

"There are some female customers as well, but the number is much lower," he added. "These days, people do not really use gul that much. It is mostly the older ones who buy it. I keep it in my stall for those."  

Often without any cautionary labels, these products are sold openly in shops and used regularly by people unaware of their potential health risks.     

Malpractices in production 

Gul is usually produced from tobacco leaves. In the regions, especially in the northern and western part of the country, where tobacco is cultivated, gul factories are seen. Media reports suggest that the presence of gul factories is relatively higher in the Northern areas including Kushtia, Lalmonirhat, Rangpur and Gaibandha. Gul factories are usually set up in the localities, posing serious risks to public health. 

While gul remains readily available in local markets, its production often takes place in unregulated, exploitative environments. In some factories, women and children are employed illegally, often without protective gear or adequate pay.  

It is absolutely not acceptable to use gul as a tobacco or addictive substance. The main issue is with the gums. Sores form, then turn into ulcers, and those ulcers can become cancerous.

PROFESSOR DR B A K AZAD, FORMER HEAD OF THE DEPARTMENT OF ORTHODONTICS, DHAKA DENTAL COLLEGE

Experts have raised concerns about the severe health risks, including respiratory and gastrointestinal diseases, faced by those involved in the manufacturing process. The use of children in such hazardous labour not only violates national and international labour laws but also undermines their right to a healthy, dignified childhood. 

Despite legal frameworks, weak enforcement and poor monitoring continue to enable these exploitative practices.

Another legal concern is tax evasion. Bangladesh's smokeless tobacco sector is deeply rooted in informal production practices and regulatory gaps. A recent study supported by Campaign for Tobacco-Free Kids revealed that more than half of the jarda and gul factories in the country operate outside the tax net, with only 218 out of 483 producers contributing taxes.

These products are consumed by over 22 million adults and even by children as young as 13. Alarmingly, many of these producers lack basic legal registrations such as trade licences, and the vast majority rely on manual, small-scale production — often conducted inside residential homes.

The research highlighted that this informality, coupled with infrastructural and administrative weaknesses, severely hinders tax compliance. The absence of modern tax systems, a proper tracking mechanism, and sufficient trained manpower leaves room for large-scale evasion.

Risks of cancer and heart diseases

Although gul is often seen as a not-so-harmful product, medical experts say its effects are far from that. Behind its everyday use lies a range of serious health risks that are rarely discussed in public, especially among the demographic that use it.    

A recent study involving over 1,500 people found that current use of gul was more common among those with heart disease compared to others. Using gul was linked to nearly three times higher chances of having heart disease. 

In another study on smokeless tobacco (SLT) users, researchers found that a larger number of heart disease patients had a long history of SLT use compared to those without the condition.

Professor Dr B A K Azad, former Principal and former head of the department of Orthodontics at Dhaka Dental College, said that gul is placed inside the mouth, and with long-term use, it can cause serious damage to the gums. He explained that it often leads to sores that may eventually turn cancerous. 

"That is why it is absolutely not acceptable to use it as a tobacco or addictive substance," he warned.

While tooth decay does occur, he noted, "The main issue is with the gums. Sores form, then turn into ulcers, and those ulcers can become cancerous." He added that the damage to the teeth is usually less severe in comparison.

Dr Azad also shared an example. He said that one of his patients had come in with a dental problem and was found to have ulcers in his gums. "I referred him to a cancer specialist," he said, adding that the patient underwent surgery and stopped using gul afterward.

However, the relief was temporary. "Three years later, he returned with the same problem," Dr Azad recalled. Upon being asked, the patient admitted that he had started using gul again. "We had to operate on him once more," he concluded.