According to University of York researchers, more than a quarter of a million people die each year from using smokeless tobacco.
Millions more have their lives shortened by ill health due to the effects of chewing tobacco-based products, the study reveals.
Researchers say it is the first time the global impact of smokeless tobacco consumption on adults has been assessed.
The team, which included collaboration from the University of Edinburgh and Imperial College, London, says governments and public health bodies need to consider incorporating the regulation of smokeless tobacco into policy frameworks.
Dr Kamran Siddiqi, senior lecturer in epidemiology and public health at the Department of Health Sciences/Hull York Medical School, said: “It is possible that these figures are underestimated and future studies may reveal that the impact is even bigger. We need a global effort to try and address and control smokeless tobacco.”