Get the facts about chewing tobacco and other forms of smokeless tobacco. They're more harmful and addictive than you might think.

By Mayo Clinic Staff

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 a safe way to use tobacco, be forewarned — chewing tobacco can cause serious health problems.

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:

  • 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. Using snuff is also called dipping. 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.
  • Chewing tobacco. This consists of loose tobacco leaves that are sweetened and packaged in pouches. A wad of the tobacco is placed between the cheek and gum and held there, sometimes for hours at a time. It's also called chew and chaw. Usually, tobacco juices are spit out, but those who are more addicted may swallow some of the juices.
  • Snus. Snus (pronounced snoos) is a newer smokeless, spitless tobacco product that originated in Sweden. It's similar to snuff but is pasteurized during the manufacturing process to kill bacteria that can produce cancer-causing chemicals, and it must be kept refrigerated up to the point of sale. It comes in a pouch that's placed between your upper lip and gum. The snus sold in Sweden seems to have a lower risk of certain cancers, but the snus sold in the U.S. is not manufactured with the same regulations as the Swedish product.
  • Dissolvable tobacco. These are pieces of compressed powdered tobacco, similar to small hard candies. They dissolve in the 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 people quit smoking.
  • Other products. In some parts of the country, smokeless tobacco also comes in the form of plugs and twists. Plugs are tobacco compressed into a brick shape, and twists are braided and twisted tobacco. A piece of a plug or twist is held between the cheek and gum. Tobacco juices are then spit out.

While the available evidence shows that smokeless tobacco may be less dangerous than cigarettes, long-term use of chewing tobacco and other smokeless tobacco products can cause serious health problems. There's no safe level of tobacco use.

That's because chewing tobacco and other smokeless tobacco products 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 as much nicotine from chewing tobacco or snuff as it does from cigarettes. Just as with smoking, withdrawal from smokeless tobacco causes symptoms such as intense cravings, increased appetite, irritability and depressed mood.
  • 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. You also face an increased risk of pancreatic 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, which can be severe enough to destroy the soft tissue and bone that support your teeth (periodontitis) and lead to tooth loss.
  • Heart disease. Some forms of smokeless tobacco increase 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-koh-PLAY-key-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 use chewing tobacco or other forms of smokeless tobacco, quit. And if you're trying to stop using cigarettes, don't switch to smokeless tobacco instead. Smokeless tobacco hasn't been shown to help you stop smoking, and you could end up using both cigarettes and smokeless tobacco.

To stop using any tobacco product, start by talking to your doctor. Or talk to a counselor from your state's quitline by calling 1-800-QUIT-NOW (800-784-8669). The National Cancer Institute also offers help at 877-44U-QUIT (877-448-7848).

Your doctor or counselor can guide you in creating a quit plan and choosing nicotine replacement products or medications to help ensure success.

April 02, 2016