Chewing tobacco: Not a safe alternative to cigarettes

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Chewing tobacco: Not a safe alternative to cigarettes

You can call chewing tobacco by whatever name you want — smokeless tobacco, spit tobacco, chew, snuff, pinch or dip — but don't call it harmless. Whether you use chewing tobacco or other types of smokeless tobacco because you like it or because you think smokeless is safer than cigarettes, be forewarned — chewing tobacco can cause serious health problems.

Chewing tobacco and other forms of smokeless tobacco

Chewing tobacco is a common type of smokeless tobacco. Smokeless tobacco products consist of tobacco or a tobacco blend that's chewed, sucked on or sniffed, rather than smoked.

There are many types of smokeless tobacco products around the world. In the United States, the main types of smokeless tobacco are:

  • Chewing tobacco. This consists of loose tobacco leaves that are sweetened and packaged in pouches. You put a wad of the tobacco between your cheek and gum and hold it there, sometimes for hours at a time. It's also called chew and chaw. Usually you spit out the tobacco juices, but if you're more addicted, you tend to swallow some of the juices.
  • Plug. This is chewing tobacco that has been pressed into a brick shape, often with the help of syrup, such as molasses, which also sweetens the tobacco. You cut off or bite off a piece of the plug and hold it between your cheek and gum. You spit out the tobacco juices.
  • Twist. This is flavored chewing tobacco that has been braided and twisted into rope-like strands. You hold it between your cheek and gum and spit out the tobacco juices.
  • Snuff. This is finely ground or shredded tobacco leaves. It's available in dry or moist forms and is packaged in tins or tea bag-like pouches. A pinch of snuff is placed between the lower lip and gum or cheek and gum. Dry forms of snuff can be sniffed into the nose. Using snuff is also called dipping. You normally spit out the tobacco juices, but as with chewing tobacco, if you're more addicted you tend to swallow the juices instead.
  • Snus. Snus (pronounced snoos) is a newer smokeless, spitless tobacco product that originated in Sweden. It comes in a pouch that you stick between your upper lip and gum. You leave it there for about a half-hour without having to spit, then discard it.
  • Dissolvable tobacco products. These are pieces of compressed powdered tobacco, similar to small hard candies. They dissolve in your mouth, requiring no spitting of tobacco juices. They're sometimes called tobacco lozenges, but they're not the same as the nicotine lozenges used to help you quit smoking.

Health risks of chewing tobacco and other forms of smokeless tobacco

While the available evidence shows that smokeless tobacco may be less dangerous than cigarettes are, long-term use of chewing tobacco and other smokeless tobacco products can cause serious health problems. That's because they can contain about 30 cancer-causing substances. Like cigarettes, smokeless tobacco also contains nicotine, which can cause you to become addicted. Here's a look at some of the health problems related to smokeless tobacco:

Addiction
Because smokeless tobacco contains nicotine, you can get addicted, just as you can with cigarettes and other tobacco products. Your body may actually absorb more nicotine from chewing tobacco or snuff than it does from a cigarette. Just as with smoking, withdrawal from smokeless tobacco causes signs and symptoms such as intense cravings, increased appetite, irritability and depressed mood. Also, over time, you develop a tolerance for the nicotine in chewing tobacco and other smokeless tobacco products, and you need more to feel the desired effects. This may lead you to dangerous habits — using brands with more nicotine, using more often, leaving chew in your mouth overnight and swallowing tobacco juices.

Cancer
Your risk of certain types of cancer increases if you use chewing tobacco or other types of smokeless tobacco. This includes esophageal cancer and various types of oral cancer, including cancers of your mouth, throat, cheek, gums, lips and tongue. Surgery to remove cancer from any of these areas can leave your jaw, chin, neck or face disfigured, and the cancer may be life-threatening. You also face increased risks related to pancreatic cancer and kidney cancer.

Cavities
Chewing tobacco and other forms of smokeless tobacco cause tooth decay. That's because chewing tobacco contains high amounts of sugar, which contributes to cavities. Chewing tobacco also contains coarse particles that can irritate your gums and scratch away at the enamel on your teeth, making your teeth more vulnerable to cavities.

Gum disease
The sugar and irritants in chewing tobacco and other forms of smokeless tobacco can cause your gums to pull away from your teeth in the area of your mouth where you place the chew. Over time you can develop gum disease (gingivitis), which can lead to periodontitis and tooth loss. And like cigarettes, chewing tobacco and other smokeless products can stain your teeth and cause bad breath.

Heart disease
Smokeless tobacco increases your heart rate and blood pressure. Some evidence suggests that long-term use of smokeless tobacco increases your risk of dying of certain types of heart disease and stroke.

Precancerous mouth lesions
Smokeless tobacco increases your risk of developing small white patches called leukoplakia (loo-ko-PLAY-kee-uh) inside your mouth where the chew is most often placed. These mouth lesions are precancerous — meaning that the lesions could one day become cancer. If you stop using smokeless tobacco products, the lesions usually go away within a few months.

Quitting chewing tobacco and other forms of smokeless tobacco

If you use chewing tobacco or other forms of smokeless tobacco, quit. Now that you know the dangers associated with it, you have extra motivation to stop using smokeless tobacco. And if you're trying to stop using cigarettes, don't switch to smokeless tobacco instead. While smokeless tobacco may be safer than cigarettes, smokeless tobacco hasn't been shown to help you stop smoking. In fact, you may end up using both cigarettes and smokeless tobacco.

To stop using any tobacco product, start by talking to your doctor. Or talk to counselor by calling 1-800-QUIT-NOW (800-784-8669). Your doctor or counselor can guide you in creating a quit plan and choosing nicotine replacement products or medications to help ensure success.

Last Updated: 2009-10-30
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