Snuffing Out Smokeless Tobacco Use

IMAGE Want something to chew on? Do not let it be smokeless tobacco.Smokeless or spit tobacco comes in two forms: chewing tobacco andsnuff—both of which can increase your risk of cancer and serious oral healthproblems. Chewing tobacco can be found as leaf tobacco, whichis packaged in a pouch, or plug tobacco, which is in a brickform. Both are put between the cheek and gum for several hours andproduce a continuous nicotine high. Snuff, usuallysold in cans, is a powdered form of tobacco that is put between thelower lip and gum. A small amount will quickly releasenicotine into the bloodstream, producing a quick high.

The Bad and the Ugly

More Nicotine Than Cigarettes

Because smokeless tobacco puts more nicotine into the bloodstreamthan cigarettes, people who chew on a regular basis often find itharder to quit. When someone usessmokeless tobacco, the body adjusts to the amount of tobacconeeded to produce that high. Over time, moretobacco is needed to achieve the same feeling, which can lead to addiction.

Harmful Chemicals

It may be smokeless, but it is not harmless! In addition tonicotine, smokeless tobacco contains at least 28 knowncancer-causing chemicals. Here are just a few of the substancesfound in smokeless tobacco:
  • Lead
  • Arsenic
  • Cyanide
  • Benzene
  • Cadmium
  • Formaldehyde
  • Polonium 210—A radioactive element found in the tobacco fertilizer
  • Nitrosamines—A known cancer-causing agent

Physical and Social Concerns

Smokeless tobacco users put themselves at a high risk for manyserious health problems, such as:
  • Cancer of the mouth, which includes the lip, tongue, and cheek,and of the throat, which includes the pharynx, larynx, and esophagus—Surgery totreat cancer of the mouth, also called oral cancer, is disfiguring. Itsometimes involves removing parts of the face, cheek, tongue, orlip. Oral cancer can spread quickly to other parts of the body.
  • Tooth and gum disease—Smokeless tobacco permanentlydiscolors the teeth. It scratches the teeth and wears away the hardsurface or enamel. It can cause bad breath, cavities, gum recession,and tooth loss.
  • Leukoplakia—When smokeless tobacco irritates the mouth,it can cause precancerous changes in the mouth. They are marked bywhite, leathery patches, which can be different shapes and sizes.Anyone noticing these changes should see their doctorright away.
  • Nicotine dependence—The constant flow of nicotine inthe blood causes increased heart rate, blood pressure, and sometimesirregular heart beats. In addition, it causes the blood vessels toconstrict, which can lead to decreased athletic performance andreduced endurance levels.
Using smokeless tobacco also has a social consequence. There is nothing socially desirableabout bad breath, discolored teeth, and constantspitting. Smokeless tobacco users risk hurting their social liveswith this habit. Even worse, their appearance could be permanently changed due to treatment for cancer.

Danger Signals for Users

Anyone who uses smokeless tobacco or has used it in the past,should check regularly for early signs of oral cancer, such as:
  • A sore in the mouth that bleeds and does not heal
  • A lump or red or white patch that does not go away
  • A lump or thickening anywhere in the mouth or neck
  • Difficulty chewing, swallowing, or moving the tongue or thejaw
  • Feeling that something is in the throat
Tobacco users should be vigilant about seeing their dentist regularly to have their mouth checked for oral cancer. Theearlier the cancer is detected, the greater the chance for curingit.


The Good

It may be difficult to quit using smokeless tobacco, but manypeople succeed at it. If you want to quit, here are some tips thatcan help:
  1. Think of all the reasons you want to quit.—You maywant a healthy lifestyle. You do not want cancer, bad breath, orstained teeth. Maybe you are concerned about how the habit may beoffensive to others.
  2. Look for support from others.—Join a support group ortobacco cessation class. Ask your friends, family, teachers, andhealthcare providers for encouragement and support.
  3. Pick a quit date.—Put it on your calendar and tellyour plans to others who will support you. Throw out all your chewing tobaccoand snuff.
  4. Do not give up!—If you have failed before, remember thatit often takes several tries to give up tobacco.
  5. Seek advice.—Ask your doctor aboutnicotine chewing gum, cessation programs, and medications that block the effects of nicotine.
  6. Find alternatives to smokeless tobacco.—Try sugar-freegum or low calorie snacks such as popcorn, vegetables, andfruit.
  7. Stay busy.—Hobbies and other activities can help youkeep your mind off chewing. Exercise to relievetension, listen to music, talk to friends, or do some research on yourcomputer.
  8. Reward yourself.—Give yourself positivereinforcement every day, if necessary. With the money you will besaving, you could treat yourself to a movie or buy somethingnice.
  9. Develop a plan that works for you.—Everyone isdifferent. What works for someone else may not work for you.Experiment and see what does and does not work. Above all, setrealistic goals and do not give up because of a setback.


American Cancer Society

Smokefree—US Department of Health and Human Services


Canadian Cancer Society

Health Canada


Fiore MC, Jaen CR, Baker TB, et al. Treating tobacco use and dependence. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services; 2008.

Oral cancer facts. Oral Cancer Foundation website. Available at: Accessed February 23, 2015.

Smokeless tobacco. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: Updated December 2010. Accessed February 23, 2015.

Smokeless tobacco: a guide for quitting. National Institute of Dental and Craniofacial Research website. Available at: Updated August 2012. Accessed February 23, 2015.

Smokeless tobacco and cancer. National Cancer Institute website. Available at: Updated October 25, 2010. Accessed February 23, 2015.

Tobacco use. EBSCO DynaMed website. Available at: Updated November 4, 2014. Accessed February 23, 2015.

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