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When concerning physical fitness, some adverse effects of smoking include less endurance, poorer performance, and increased rates of injury and complications, as stated by Cleveland Clinic

Although nicotine was not detected in the Pan Masala samples, data from the National Tobacco Testing Labs (NTTL, India) (The Hindu, April 8, 2015) reveals that it is a leading cause of oral submucous fibrosis that often progresses to oral cancer 10,24

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McGuinn LA, Coull BA, Kloog I, Just AC, Tamayo-Ortiz M, Osorio-Yez C, Baccarelli AA, Wright RJ, Tllez-Rojo MM, Wright RO (2020) Fine particulate matter exposure and lipid levels among children in Mexico City