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Holden Comprehensive Cancer Center Cancer Information Service Health Topics A-Z Health Topics by Category
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Cancer Prevention: What You Need To Know
Smokeless Tobacco
Peer Review Status: Internally Reviewed by Cancer
Center Staff
Creation Date: 1996
Last Revision Date: February 2007
What Is Known About This Topic?
The last twenty-five years have seen marked changes in patterns of tobacco use in the United States. There has been a decline in cigarette smoking among adults. But there has been an increase in smokeless tobacco use, especially among young men.
What is smokeless tobacco?
Smokeless tobacco is unburned tobacco that is placed into the mouth. There are two basic types:
Chewing Tobacco: coarsely divided tobacco leaf mixed with sugar and molasses, usually packaged in a pouch. It is used in a plug or twist. A "quid" or "chaw" of the tobacco is chewed or sucked. Popular brands include Red Man and Chattanooga Chew. Snuff: moist, finely divided tobacco. It is usually flavored with mint, menthol, wintergreen, etc. It is sold in small, round cans. It is "dipped" by placing a pinch between the cheek and gum. Common brands include Skoal, Copenhagen and Hawken. Dry Snuff: is finely ground and snuffed through the nostrils. This is rarely used in the United States.
How many people use it and who are the users?
It is estimated that approximately 6 percent of all males and less than 1 percent of all females are users of smokeless tobacco. Overall, there are between 10 and 12 million users in the United States. The predominant users (21 percent) are white males aged 18-24 years. About 90 percent of smokeless tobacco use begins at or before the age of 18.
Smokeless tobacco is most commonly used in rural regions. But use in urban areas is growing. In Iowa, it has been found that about 9 percent of 12-18 year old males use smokeless tobacco regularly.
What are the risks and consequences of use?
Addiction: Nicotine is an addictive compound leading to dependence in most regular users. It affects the cardiovascular system, increasing heart beat and blood pressure. It causes blood vessels to clamp down. Smokeless tobacco contains higher quantities of nicotine than most cigarettes and is more addictive. An average size dip held in the mouth for 30 minutes has the same amount of nicotine as four cigarettes. Smokeless tobacco users usually start on a flavored brand with lower nicotine levels (like Skoal Bandits). They then work up to higher nicotine level brands (like Copenhagen) as dependence increases.
Quitting may be difficult and lower quit rates have been found for smokeless tobacco than for smoking. Changes in the mouth: Bad breath and a decreasing sense of taste and smell are common results of tobacco use. Changes often occur in the regions of the mouth where tobacco is placed. These changes include the staining of teeth, recession of gums. Over 50 percent of users develop thickened white patches called leukoplakia in the lining of the mouth. These patches can develop into cancer. Heart disease: The nicotine and sodium in smokeless tobacco may lead to high blood pressure (especially in males aged 18-25). The use of smokeless tobacco increases the risk of heart and blood vessel disease. Reproductive effects: Smokeless tobacco use can adversely affect sperm concentration, mobility, structure and formation. Cancer: Oral cancer claims the life of one American every hour. An estimated 34,360 cases of oral cancer will be reported in 2007. 7,550 of these will die in 2007. Users of smokeless tobacco have a four times greater risk of oral cancer than non-users. After 50 years of use, this risk can be 50 times greater. Cancer can affect any part of the mouth. Signs of cancer of the mouth are:
- A sore which can bleed easily and does not heal,
- A lump or thickening or
- A lingering whitish or reddish patch.
Overall, the five year survival rate for oral cancer patients is about 53 percent.
What Can I Do to Prevent the Problem?
The use of smokeless tobacco among adolescents and young adults is growing. Educating young people to the dangers of smokeless tobacco could save their lives. The nicotine in tobacco is highly addictive. It will be just as difficult for smokeless tobacco users to quit their habit as it is for cigarette smokers. Refer to the Smoking section of the booklet for suggestions on how to quit the smokeless tobacco habit.
Where Can I Get More Information?
University of Iowa Resources
- Cancer Information Service (1-800-237-1225)
Other Resources:
If you would like more information about smokeless tobacco and cancer or to obtain phone numbers to the above organizations, please contact the Cancer Information Service at 1-800-237-1225 or e-mail: cancer-information@uiowa.edu.
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