Want something to chew on? Do not let it be smokeless tobacco.
Smokeless or spit tobacco comes in two forms: chewing tobacco and
snuff—both of which can increase your risk of
and serious oral health
can be found as
is packaged in a pouch, or
plug tobacco, which is in a brick
form. Both are put between the cheek and gum for several hours and
produce a continuous nicotine high.
sold in cans, is a powdered form of tobacco that is put between the
lower lip and gum. A very small amount will quickly release
nicotine into the bloodstream, producing a quick high.
Because smokeless tobacco puts more
into the bloodstream
than cigarettes, people who chew on a regular basis often find it
quit. When someone uses smokeless tobacco, the body adjusts to the amount of tobacco needed to produce that high. Over time, more tobacco is needed to achieve the same feeling, which can lead to addiction.
It may be smokeless, but it is not harmless! In addition to
nicotine, smokeless tobacco contains at least 28 known
cancer-causing chemicals. Here are just a few of the substances
found in smokeless tobacco:
- Polonium 210—A radioactive element found in the tobacco fertilizer
- Nitrosamines—A known cancer-causing agent
Smokeless tobacco users put themselves at a high risk for many
serious 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 to treat cancer of the mouth, also called oral cancer, is disfiguring. It sometimes involves removing parts of the face, cheek, tongue, or lip. Oral cancer can spread quickly to other parts of the body.
Tooth and gum disease—Smokeless tobacco permanently
discolors the teeth. It scratches the teeth and wears away the hard
surface 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 by
white, leathery patches, which can be different shapes and sizes.
Anyone noticing these changes should see their doctor
Nicotine dependence—The constant flow of nicotine in
the blood causes increased heart rate, blood pressure, and sometimes
irregular heart beats. In addition, it causes the blood vessels to
constrict, which can lead to decreased athletic performance and
reduced endurance levels.
Using smokeless tobacco also has a social consequence. There is nothing socially desirable
about bad breath, discolored teeth, and constant
spitting. Smokeless tobacco users risk hurting their social lives
with this habit. Even worse, their appearance could be permanently changed due to treatment for cancer.
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 the
- 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. The
earlier the cancer is detected, the greater the chance for curing
It may be difficult to quit using smokeless tobacco, but many
people succeed at it. If you want to quit, here are some tips that
Think of all the reasons you want to quit.—You may
want a healthy lifestyle. You do not want cancer, bad breath, or
stained teeth. Maybe you are concerned about how the habit may be
offensive to others.
Look for support from others.—Join a support group or
tobacco cessation class. Ask your friends, family, teachers, and
healthcare providers for encouragement and support.
Pick a quit date.—Put it on your calendar and tell
your plans to others who will support you. Throw out all your chewing tobacco
Do not give up!—If you have failed before, remember that
it often takes several tries to give up tobacco.
Seek advice.—Ask your doctor about
nicotine chewing gum and cessation programs.
Find alternatives to smokeless tobacco.—Try sugar-free
gum or low calorie snacks such as popcorn, vegetables, and
Stay busy.—Hobbies and other activities can help you
keep your mind off chewing. Exercise to relieve
tension, listen to music, talk to friends, or do some research on your
Reward yourself.—Give yourself positive
reinforcement every day, if necessary. With the money you will be
saving, you could treat yourself to a movie or buy something
Develop a plan that works for you.—Everyone is
different. What works for someone else may not work for you.
Experiment and see what does and does not work. Above all, set
realistic goals and do not give up because of a setback.
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 March 7, 2013.
Smokeless tobacco. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: . Updated December 2010. Accessed March 7, 2013.
Smokeless tobacco: a guide for quitting. National Institute of Dental and Craniofacial Research website. Available at: . Updated August 2012. Accessed March 7, 2013.
Smokeless tobacco and cancer. National Cancer Institute website. Available at: . Accessed March 7, 2013.
Tobacco use disorder. EBSCO DynaMed website. Available at: . Updated February 19, 2013. Accessed March 7, 2013.
Last reviewed March 2013 by Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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