Smokeless Tobacco Q&A

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Effects of Smokeless Tobacco

What harmful chemicals are found in smokeless tobacco?
Chewing tobacco and snuff contain 28 carcinogens (cancer-causing agents).  The most harmful carcinogens in smokeless tobacco are the tobacco-specific nitrosamines (TSNAs).  They are formed during the growing, curing, fermenting, and aging of tobacco.  TSNAs have been detected in some smokeless tobacco products at levels many times higher than levels of other types of nitrosamines that are allowed in foods, such as bacon and beer.

Other cancer-causing substances in smokeless tobacco include N-nitrosamino acids, volatile N-nitrosamines, benzo(a)pyrene, volatile aldehydes, formaldehyde, acetaldehyde, crotonaldehyde, hydrazine, arsenic, nickel, cadmium, benzopyrene, and polonium-210.

All tobacco, including smokeless tobacco, contains nicotine, which is additive.  The amount of nicotine absorbed from smokeless tobacco is 3 to 4 times the amount delivered by a cigarette.  Nicotine is absorbed more slowly from smokeless tobacco than from cigarettes, but more nicotine per dose is absorbed from smokeless tobacco than from cigarettes.  Also, the nicotine stays in the bloodstream for a longer time.

What cancers are caused by or associated with smokeless tobacco use?
Smokeless tobacco users increase their risk for cancer of the oral cavity.  Oral cancer can include cancer of the lip, tongue, cheeks, gums, and the floor and roof of the mouth.

People who use oral snuff for a long time have a much greater risk for cancer of the cheek and gum than people who do not use smokeless tobacco.

The possible increased risk for other types of cancer from smokeless tobacco is being studied.

What are some of the other ways smokeless tobacco can harm users' health?
Some of the other effects of smokeless tobacco use include addiction to nicotine, oral leukoplakia(white mouth lesions that can become cancerous), gum disease, and gum recession (when the gum pulls away from the teeth.) Possible increased risks for heart disease, diabetes, and reproductive problems are being studied. 

How much does using smokeless tobacco increase my probability of cancer?
Mouth cancer is 1 of the 10 most common cancers in the world.  The risk of mouth cancer is four times greater for the smokeless tobacco user.  It is particularly high where the tobacco is placed.

Is smokeless tobacco a good substitute for cigarettes?
In 1986, the Surgeon General concluded that the use of smokeless tobacco "is not a safe substitute for smoking cigarettes.  It can cause cancer and a number of noncancerous conditions, can lead to nicotine addiction and dependence."  Since 1991, the National Cancer Institute, a part of the National Institutes of Health, has officially recommended that the public avoid and discontinue the use of all tobacco products, including smokeless tobacco.  NCI also recognizes that nitrosamines, found in tobacco products, are not safe at any level.  The accumulated scientific evidence does not support changing this position.

What about using smokeless tobacco to quit cigarettes?
Because all tobacco use causes disease and addiction, NCI recommends that tobacco use be avoided and discontinued.  Several nontobacco methods have been shown to be effective for quitting cigarettes.  These methods include pharmacotherapies such as nicotine replacement therapy and bupropion, individual and group counseling, and telephone quit lines.

Who uses smokeless tobacco?
In the United States, the 2000 National Household Survey on Drug Abuse, which was conducted by the Substance Abuse and Mental Health Services Administration, reported the following statistics:

  • An estimated 7.6 million Americans age 12 and older  had used smokeless tobacco in the past month.
  • Smokeless tobacco use was the most common among young adults aged 18 to 25.
  • Men were 10 times more likely than women to report using smokeless tobacco 96.5 percent of men age 12 and older compared to 0.5 percent of women).