Smokeless tobacco (ST) use presents a diverse global epidemiological landscape, with its prevalence varying considerably across geographic regions, age groups, and gender demographics, intricately influenced by cultural practices, socioeconomic factors. Its distribution is shaped by a complex interplay of historical traditions and differing public health policies and national regulatory frameworks. The World Health Organization South-East Asia Region, encompassing countries like India and Bangladesh, accounts for strikingly more than 80% of all global ST users. While most notably prevalent in South Asia—where it is deeply embedded in daily life for an estimated 200 million users in India alone—its use is also significant in parts of Southeast Asia, Africa, and specific Western countries. Its use is substantially less common in Western countries, though it remains a public health concern in the United States, especially among young males and in rural areas. Scandinavia, particularly Sweden, stands out in Europe, where snus use is culturally ingrained. Gender disparities are prevalent, with men generally having higher rates; however, some regions like Bangladesh, Indonesia, and Thailand exhibit higher female prevalence. Globally, ST use is also more prevalent in lower-income and rural communities, especially among younger demographics increasingly adopting the practice.