- Chewing Tobacco (Smokeless Tobacco, Snuff) Center
- How Smoking Affects Your Looks & Life Slideshow
- Tips to Quit Smoking Slideshow
- Take the Quiz on Smoking
- Patient Comments: Smokeless Tobacco - Experience
- Patient Comments: Smokeless Tobacco - Cancer Risk
- Patient Comments: Smokeless Tobacco - Treatments
- Find a local Doctor in your town
- Chewing tobacco facts
- What is chewing tobacco?
- What are the health risks of chewing tobacco?
- Cancer risk and chewing tobacco
- Other health risks of chewing tobacco
- Is chewing tobacco safer than cigarette smoking?
- What is being done to reduce the use of chewing tobacco?
- What treatments are available to help people quit using chewing tobacco?
Chewing tobacco facts
- Smokeless, snuff, or chewing tobacco contains nicotine as well as many known carcinogens (cancer-causing substances).
- More nicotine is absorbed by chewing tobacco use that by smoking a cigarette.
- Chewing tobacco use is a risk factor for the development of oral cancers and precancers.
- Other health risks of chewing tobacco include gum disease, tooth decay and tooth loss, and possible links to other cancers and cardiovascular disease.
- Products that are designed to help smokers quit can also be used to help quit chewing tobacco use.
What is chewing tobacco?
Chewing tobacco is sometimes known as chewing tobacco or spitting tobacco. It is available in two forms, snuff and chewing tobacco. Both types of chewing tobacco are held in the mouth inside the cheek or between the cheek and gum. Snuff and chewing tobacco are commonly available in tins or pouches; popular brand names include Skoal and Copenhagen. Snus (pronounced like "snoose") is a finely ground form of snuff that originated in Norway and Sweden that comes in small tins. The amount of snuff placed in the mouth is referred to as a pinch, dip, lipper, or quid. A portion of chewing tobacco is referred to as a plug, wad, or chew.
Chewing tobacco is known to contain at least 28 cancer-causing chemicals, medically known as carcinogens. The main carcinogens in chewing tobacco are the tobacco-specific nitrosamines (TSNAs). Some of the other cancer-causing agents found in chewing tobacco are formaldehyde, acetaldehyde, arsenic, benzopyrene, nickel, and cadmium. Many people mistakenly believed that snus is a safe form of chewing tobacco because it is steam-heated rather than fermented when produced in Norway or Sweden, causing it to have fewer nitrosamines. However, snus still contains a number of cancer-causing chemicals. Snus made in America is not necessarily processed in the same way as in Norway or Sweden.
Nicotine is also found in snuff and chewing tobacco, like all tobacco products. Although nicotine is absorbed more slowly from chewing tobacco than from cigarettes, 3 to 4 times more nicotine is absorbed from chewing tobacco than from a cigarette, and the nicotine from chewing tobacco remains longer in the bloodstream. Nicotine is the substance responsible for tobacco addiction.
Chewing tobacco is not the same thing as chewing cigarettes. Chewing cigarettes (also termed e-cigarettes) are designed to provide nicotine in vapor to the user without burning tobacco. However, the smokeless cigarettes still provide addictive nicotine to the user and secondhand nicotine to others.
Quick Guide25 Effects of Smoking on Your Looks and Life
What are the health risks of chewing tobacco?
A number of significant health risks are associated with the use of chewing tobacco.
Cancer risk and chewing tobacco
Users of snuff and chewing tobacco are at an increased risk for certain types of cancer, most notably cancer of the oral cavity including cancers of the:
- tongue, and
- floor and roof of the mouth.
Some studies have suggested a link between the use of chewing tobacco and the development of:
Other health risks of chewing tobacco
Those who use chewing tobacco have an increased risk of:
- developing gum diseases and gum recession (pulling away of the gum tissue from the teeth);
- leukoplakia (whitish patches inside the mouth that can become cancerous);
- abrasion (wearing down) of teeth;
- staining of teeth;
- tooth decay; and
- tooth loss.
All of the above have been linked to chewing tobacco use.
Some studies have shown a link between an increased risk of cardiovascular disease (including heart attacks and stroke) in users of snuff and chewing tobacco, although these risks are not as great as those observed in smokers. Further research is needed to determine whether or not chewing tobacco use presents a significant risk of heart disease and stroke.
Is chewing tobacco safer than cigarette smoking?
Chewing tobacco has been widely marketed as a way for cigarette smokers to use tobacco in smoke-free areas, so it is safer for other people because they are not exposed to secondhand smoke. However, in 1986, a statement from the U.S. Surgeon General concluded that users of chewing tobacco should know that chewing tobacco "is not a safe substitute for smoking cigarettes." Chewing tobacco contains nicotine, which is highly addictive, as well as a number of known cancer-causing chemicals. Any form of tobacco use poses an increased risk of developing cancer, and no level is considered safe.
While the risks of getting cancer from chewing tobacco are lower than those associated with smoking cigarettes, the health risks of chewing tobacco are very real and potentially fatal. Chewing tobacco use also has not been shown to be helpful for smokers who want to quit smoking.
What is being done to reduce the use of chewing tobacco?
Parents are encouraged by health care givers, school authorities, and public health officials to include the topic of chewing tobacco use when they discuss the hazards of any tobacco use with their children, especially teen aged children. It is better never to start than try to stop the addictive tobacco (nicotine) habit in any form.
Legislation has been enacted to help reduce the number of people who use tobacco products and reduce adverse health risks associated with tobacco use. The Family Smoking Prevention and Tobacco Control Act of 2009 gives the Food and Drug Administration (FDA) the power to regulate tobacco products in the U.S., which will allow for increased regulation of marketing and advertising of tobacco products, including chewing tobacco.
In 2015, San Francisco became the first US city to ban the use of smokeless tobacco at sporting events, including AT&T Park, home of the city's Major League Baseball team, the Giants.
What treatments are available to help people quit using chewing tobacco?
Chewing tobacco is an addiction that can be overcome. As with cigarette smoking, various support systems, programs, and even prescription medications are available to help people quit using chewing tobacco. Examples of products available used to wean a person from nicotine addiction from chewing tobacco include:
Smoking Cessation Resources
American Cancer Society. Smokeless Tobacco.
American Cancer Society. Smokeless tobacco and how to quit.
Boffeta P, Hecht S, Gray N, Gupta P, Straif K. Smokeless tobacco and Cancer. Lancet Oncol 2008 Jul;9(7):667-75.
eMedicine.com. Smokeless tobacco lesions.
Gupta R, Gurm H, Bartholomew JR. Smokeless tobacco and cardiovascular risk. Arch Intern Med 2004 Sept;164(17):1845-9.
U.S. National Cancer Institute (NCI). Smokeless tobacco and cancer, questions and answers.
Smokeless Tobacco - Experience
At what age did you first start chewing tobacco? Please share your experience, including why you started.Post View 13 Comments
Smokeless Tobacco - Cancer Risk
Do you or someone you know have cancer due to chewing tobacco? If so, please share your experience so that it may help others.Post View 1 Comment
Smokeless Tobacco - Treatments
What treatments have you tried to quit using chewing tobacco, and were they effective?Post View 2 Comments
Top Smokeless Tobacco Related Articles
Bad BreathBad breath can result from poor oral hygiene habits and may be a sign of other health problems. Bad breath, also called halitosis, can be made worse by the types of food eaten and other unhealthy lifestyle habits.
Bladder CancerTreatment for bladder cancer depends on the stage of the disease, the grade of the tumor, and the type of bladder cancer. Options for treatment include surgery, radiation therapy, chemotherapy, and biological therapy.
Brighter, Whiter TeethWant brighter, whiter teeth? Brushing up on these photo tips can help keep your teeth white. Discover which smile-whitening ideas will make your teeth shine their brightest and how to avoid future stains.
Cancer CausesThough it's difficult to say why some people develop cancer while others don't, research shows that certain risk factors increase a person's odds of developing cancer. These risk factors include growing older, family history of cancer, diet, alcohol and tobacco use, and exposure to sunlight, ionizing radiation, certain chemicals, and some viruses and bacteria.
Cancer-Fighting FoodsExperts have praised certain foods for their ability to reduce cancer risks. Learn which foods and eating strategies may help reduce your risk of developing cancer.
Cancer QuizTake this quiz to learn the causes of cancer. Get the facts about the causes, symptoms, and treatments for the world's most common cancers.
CavitiesLearn more about cavities including symptoms, treatment, and prevention. See how tooth decay, plaque, and bacteria contribute to the creation of cavities and how regular brushing and flossing can help prevent dental caries.
Dental Health QuizTake the Dental Health Quiz to test your IQ of oral hygiene, cavities, and common tongue and gum diseases. This quiz covers healthy mouths and teeth from brushing to flossing and everything in between check-ups!
Esophageal CancerEsophageal cancer is a disease in which malignant cells form in the esophagus. Risk factors of cancer of the esophagus include smoking, heavy alcohol use, Barrett's esophagus, being male and being over age 60. Severe weight loss, vomiting, hoarseness, coughing up blood, painful swallowing, and pain in the throat or back are symptoms. Treatment depends upon the size, location and staging of the cancer and the health of the patient.
Gum DiseaseGum disease is caused by plaque and may result in tooth loss without proper treatment. Symptoms and signs of gum disease (gingivitis or periodontal disease) include receding gums, bad breath and pocket formation between the teeth and gums. Treatment depends upon the stage of the gum disease, how you responded to earlier treatments, and your overall health.
Larynx CancerSymptoms of cancer of the larynx, the organ at the front of the neck, include hoarseness, a lump in the neck, sore throat, cough, problems breathing, bad breath, earache, and weight loss. Treatment for larynx cancer depends on the stage (the extent) of the disease. Radiation therapy, surgery, and chemotherapy are all forms of treatment for laryngeal cancer.
Oral CancerThe term oral cancer includes cancer of the mouth (oral cavity) and the back of the mouth (oropharynx). Red and white patches inside the mouth, bleeding, loose teeth, pain upon swallowing, a lump in the neck, earache, and a sore on your lip or in your mouth that won't heal are all symptoms of oral cancer. Treatment for oral cancer depends upon the staging of the disease and usually involves surgery, radiation therapy, or chemotherapy.
Pancreatic CancerPancreatic cancer is a malignant tumor of the pancreas. Pancreatic cancer has been called a "silent" disease because early pancreatic cancer usually does not cause symptoms.
Pregnancy Planning (Preparing for Pregnancy)
Pregnancy planning is an important step in preparation for starting or expanding a family. Planning for a pregnancy includes:
- Taking prenatal vitamins
- Eating healthy for you and your baby
- Disease prevention (for both parents and baby) to prevent birth defects and infections
- Avoiding certain medications that may be harmful to your baby
- How much weight gain is healthy
- Exercise safety and pregnancy
- Travel during pregnancy
Quit Smoking SlideshowOne of the best ways to improve your health is to quit smoking. These practical tips to help you quit smoking have been shown to work. Learn tips and techniques to quit smoking and kick the cigarette habit for good.
Take the Smoking QuizYou know it's time you quit smoking. Learn the myths and facts about quitting smoking with the Smoking Quiz. When it comes to smoking, quitters always win!
Smoking & Your WeightLearn how to avoid weight gain while quitting smoking. Explore what causes weight gain after quitting smoking. See lifestyle changes, medication, and weight management counseling tools that help avoid weight gain after smoking cessation.