Peer Review Status: Internally Reviewed by Cancer Center Staff
First Published: 1988
Last Revised: May 2004
What Is It?
Smokeless tobacco is unburnt tobacco which is placed into the mouth. It is estimated there are between 5 and 10 million users in the United States.
The Three Types of Smokeless Tobacco
- Chewing Tobacco: consists of coarsely divided tobacco leaf that is mixed with sugar and molasses and 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: is a moist, more finely divided tobacco. It is usually flavored with mint, wintergreen, etc. and is sold in short round cans. This is "dipped" by placing a pinch between the cheek and gum. Brands include Skoal, Copenhagen, and Hawken.
- Dry Snuff: is finely ground and snuffed through the nostrils. This is rarely used in the United States.
What's In Smokeless Tobacco
Here are a few of the ingredients found in smokeless tobacco.
- * Polonium 210 (nuclear waste)
- Formaldehyde (embalming fluid)
- Cadmium (used in car batteries)
- Lead (nerve poison)
- Nitrosamines (cancer causing substances)
Who Uses It?
Of the estimated 10 million American users, about three million are under the age of 21. The average age of first use is 10.
What Are The Risks?
- Short Term: Smokeless tobacco contains higher quantities of nicotine than most cigarettes. Nicotine is an addictive compound that leads to dependence in most users. It affects the cardiovascular system, increasing the heartbeat, constricting the blood vessels, and can increase blood pressure. It also increases the likelihood that the individual will become a smoker.
- Mid Term: After about two years, changes often occur in the regions of the mouth where tobacco is placed. These changes include staining of teeth, recession of gums, and in over 50% of users, the development of thickened white patches or leukoplakia in the oral lining. Two to four percent of these patches may develop into cancer.
- Long Term: Long term use leads to increased risk of oral cancer. Smokeless tobacco users have a four fold greater risk of oral cancer than non-users. After 50 years of use, this risk can be approximately 50 times greater. Smokeless tobacco is also linked to cancer of the esophagus and pancreas and may contribute to the cause of lung cancer.
Oral Cancer Incidence and Mortality
It is estimated that 28,260 new cases of oral cancer will be reported in the United States in 2004. These cancers occur more frequently in men than women, and are more common in people over the age of 50. In 2004, an estimated 7,230 deaths will occur from oral cancer.
- a sore on the lip, gums, mouth which bleeds easily and doesn't heal
- a lump or thickening
- a reddish or whitish patch that persists
- difficulty in swallowing, chewing, or moving the tongue or jaws are often late changes
Principal methods are radiation therapy and surgery. Chemotherapy is sometimes used before surgery or radiation therapy to shrink large tumors.
Early detection is important! Ask your dentist or family physician how to perform oral self-exams and do them regularly.
SMOKELESS TOBACCO IS NOT A SAFE ALTERNATIVE TO SMOKING.