“We sow tobacco to make extra money” says Askarbek Duisheyev, a farmer in Kyrgyzstan’s impoverished Batken province whose crops are used to produce nasvay chewing tobacco. The substance is cheaper than cigarettes and has become wildly popular in Central Asia, with its production now key to supporting the economies of regions like Batken. It has, however, also been linked with a number of health issues, like lip, throat and stomach cancer, leaving politicians with a difficult choice to make: eradicate a public health threat or turn a blind eye to a harmful economic cornerstone.