Chewing Tobacco (Smokeless Tobacco)

• Smokeless tobacco is sometimes known as chewing tobacco or spitting tobacco. It is held in the mouth between the cheeks and gums instead of being smoked.
• Snuff and chewing tobacco are the main forms of smokeless tobacco. Snus is a form of finely ground snuff that originated in Norway and Sweden.
• Snuff and chewing tobacco are commonly sold in tins or pouches under brand names like Copenhagen or Skoal.
• Like smoking, the use of smokeless tobacco is associated with a number of health risks, including cancer.
• Snuff and chewing tobacco contain at least 28 cancer-causing agents (carcinogens).
• The main carcinogens in smokeless tobacco are called tobacco-specific nitrosamines (TSNAs).
• Chewing tobacco and snuff contain nicotine, which causes addiction.
• Although nicotine is absorbed more slowly from smokeless tobacco than from cigarettes, 3 to 4 times more nicotine is absorbed from smokeless tobacco than from a cigarette.
• The nicotine from smokeless tobacco stays longer in the bloodstream than nicotine from a cigarette.
• Smokeless tobacco is used worldwide in a number of different cultures.
• Smokeless tobacco is not the same thing as e-cigarettes, which are designed to provide nicotine in vapor form without burning tobacco.

Studies have shown that the use of chewing tobacco increases the risk of developing a number of health problems and even potentially fatal conditions; including:

• cancers of the oral cavity (including cancers of the cheek, gums, lips, tongue, and floor and roof of the mouth);
• gingivitis and gum disease;
• tooth decay and loss; and
• leukoplakia (whitish patches inside the mouth that have the potential to become cancerous)

Some reports show an increased risk for cancer of the esophagus, pancreas, and stomach.

Some research studies have shown an association between chewing tobacco use and an increased risk of cardiovascular disease (such as heart attacks and stroke). These risks do not seem to be as great as those of cigarette smokers. Further research is underway to determine whether or not chewing tobacco use presents a significant risk of heart disease and stroke.

Although chewing tobacco has been marketed as a way to use tobacco when smoking is not permitted, chewing tobacco is not a safe substitute for smoking. Any tobacco use carries a significant risk of adverse health effect and raises cancer risk, and there is no safe level of chewing tobacco use. Advertisers have also implied that chewing tobacco use is a way to help quit cigarette smoking, although there is no proof that chewing tobacco can be used to help quit smoking, and this is not recommended.

The Family Smoking Prevention and Tobacco Control Act of 2009 gives the U.S. Food and Drug Administration (FDA) the power to regulate tobacco products in the United States. This will permit control over the marketing and advertising of tobacco products, including chewing tobacco. This law restricts the type and amount of advertising of tobacco products, including exposure of teens and youth to tobacco advertising.

In 2015, San Francisco banned the use of snuff or chewing tobacco at all sports venues, becoming the first US city to undertake this preventive measure. This includes AT&T Park, home to the city's major league baseball team (Giants).

Quitting chewing tobacco addiction is possible. The numerous support systems, programs, and even prescription medications that are available to help people quit smoking are also effective in helping people quit using chewing tobacco.

Nicotine replacement products as well as prescription medications can be useful in helping people overcome nicotine addiction. The American Cancer Society's publication on quitting chewing tobacco (see References below) is an excellent guide for those interested in quitting chewing tobacco use.