En Español (Spanish Version)

by Scholten A

Snuffing Out Smokeless Tobacco Use

IMAGE 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 cancer and serious oral health problems.
Chewing tobacco can be found as leaf tobacco, which 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. Snuff, usually 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.

The Bad and the Ugly

More Nicotine Than Cigarettes

Because smokeless tobacco puts more nicotine into the bloodstream than cigarettes, people who chew on a regular basis often find it harder to 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.

Harmful Chemicals

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:
  • Lead
  • Arsenic
  • Cyanide
  • Benzene
  • Cadmium
  • Formaldehyde
  • Polonium 210—A radioactive element found in the tobacco fertilizer
  • Nitrosamines—A known cancer-causing agent

Physical and Social Concerns

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 right away.
  • 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.

Danger Signals for Users

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 jaw
  • 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.

The Good

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 can help:
  1. 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.
  2. 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.
  3. 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 and snuff.
  4. Do not give up!—If you have failed before, remember that it often takes several tries to give up tobacco.
  5. Seek advice.—Ask your doctor about nicotine chewing gum and cessation programs.
  6. Find alternatives to smokeless tobacco.—Try sugar-free gum or low calorie snacks such as popcorn, vegetables, and fruit.
  7. 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 computer.
  8. 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 nice.
  9. 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.

RESOURCES

American Cancer Society http://www.cancer.org

Smokefree.gov http://www.smokefree.gov

CANADIAN RESOURCES

Canadian Cancer Society http://www.cancer.ca

Health Canada http://www.hc-sc.gc.ca

References

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: http://www.oralcancerfoundation.org/facts/. Accessed March 7, 2013.

Smokeless tobacco. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/HealthInformation/Smokeless-Tobacco.cfm. Updated December 2010. Accessed March 7, 2013.

Smokeless tobacco: a guide for quitting. National Institute of Dental and Craniofacial Research website. Available at: http://www.nidcr.nih.gov/OralHealth/Topics/SmokelessTobacco/SmokelessTobaccoAGuideforQuitting.htm. Updated August 2012. Accessed March 7, 2013.

Smokeless tobacco and cancer. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/factsheet/Tobacco/smokeless. Accessed March 7, 2013.

Tobacco use disorder. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 19, 2013. Accessed March 7, 2013.

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