Health risks of smokeless tobacco

All tobacco products contain nicotine, the chemical that makes the products addictive. Also, there are as many as 28 different chemicals, which are either present in tobacco or which form during the production process, that have been identified as cancer-causing agents (carcinogens). These substances in smokeless tobacco products have been linked to well-documented risk of disease.

Health problems related to smokeless tobacco include the following.

  • Addiction. Because smokeless tobacco contains nicotine, you can become addicted, just as you can with cigarettes. The levels of nicotine circulating in the bloodstream are about the same for people who smoke cigarettes and those who use chewing tobacco. However, unlike smoked tobacco that is used periodically during the day, smokeless tobacco is often used constantly, exposing users to high levels of nicotine throughout the day, resulting in high levels of dependence. Just as with smoking, withdrawal from smokeless tobacco causes symptoms such as intense cravings, increased appetite, irritability and depressed mood.
  • Cancer. The use of chewing tobacco and other smokeless tobacco products increases the risk of oral cancers — cancer of the mouth, throat, cheek, gums, lips or tongue. There's also an increased risk of cancers of the pancreas and esophagus, the long tube that runs from your throat to your stomach.
  • Precancerous mouth lesions. Smokeless tobacco increases your risk of developing small white patches called leukoplakia (loo-koh-PLAY-key-uh) inside your mouth. These mouth lesions are precancerous — meaning that the lesions could one day become cancerous.
  • Heart disease. Some forms of smokeless tobacco increase your heart rate and blood pressure. Evidence suggests that long-term use of smokeless tobacco increases your risk of dying of heart disease and stroke.
  • Dental disease. The sugar and irritants in smokeless tobacco products can cause cavities, abrasion of teeth, teeth staining, bad breath, gum disease, receding gums, bone loss around roots and tooth loss.
  • Pregnancy risk. Studies have shown that the use of smokeless tobacco, including Swedish snus, may increase the risk of stillbirths, low birth weight and heart rate variability in infants.
  • Poison risk for children. The candy-like appearance or flavors of smokeless tobacco products make them attractive to children. Ingestion of these products can cause nicotine poisoning. Effects of nicotine poisoning in children may include nausea, vomiting, weakness, convulsions, unresponsiveness, impaired breathing and death.

Quitting smokeless tobacco

If you use chewing tobacco or other forms of smokeless tobacco, consider options to help you quit. Because of the health risks of chewing tobacco, smokeless tobacco products are not a good alternative to quit cigarette smoking.

Research about methods to quit smokeless tobacco products is relatively limited, and the effectiveness of strategies for quitting these products is not as well understood as strategies to quit smoking. Nonetheless, guidelines and resources for smoking cessation may be beneficial.

Interventions that have been found most effective in research about quitting chewing tobacco and other smokeless products include the following.

  • Nicotine replacement therapy with nicotine gum or lozenges, a nicotine replacement that is also absorbed through the lining of the mouth, can help reduce cravings for tobacco products, as can nicotine patch therapy.
  • Varenicline (Chantix), a non-nicotine prescription medication, can help reduce nicotine withdrawal symptoms by mimicking how nicotine functions in your body.
  • Behavioral interventions — such as telephone services, self-help materials, counseling or professional advice — can provide you with needed support and help you develop coping skills.

Your doctor can guide you in creating a quit plan and choosing nicotine replacement products or medications to help ensure success. Your doctor also may refer you to local resources or support groups. To reach the National Cancer Institute's telephone quit line, call 877-44U-QUIT (877-448-7848). To find your state's quit line, call 800-QUIT-NOW (800-784-8669).

Sept. 13, 2017 See more In-depth