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Betel leaves are arranged aesthetically on a decorated plate called paandani

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For LMICs, median maximal market share was 60.0% (IQR: 46.075.0) in 2011 and 57.0% (IQR: 43.071.0) in 2020 (Supplementary file Table 1)

A statement that still crops up on its website notes that while vapor from e-cigarettes (which it refers to as Electronic Nicotine Delivery Systems, or ENDS) is not likely to be as bad as the smoke from burning tobacco, there are concerns because these products are not regulated. The society worries that ENDS are designed to deliver nicotine, and nicotine is addictive, and concludes that this strongly suggests that ENDS use will lead to nicotine dependence, which could lead to the use of other tobacco products. Some have reported that the society has change[d] its position on e-cigarettes. It looks like the ACSs position has simply evolved in the face of new evidence