Chewing Tobacco
Understanding Non-Smoked Tobacco
Smokeless tobacco includes products made from tobacco leaves that people do not burn. Instead, people chew, suck, or sniff these products by placing them in the mouth or nose without lighting them. The body absorbs nicotine from smokeless tobacco through the mouth, gums, or nose lining, making these products highly addictive.
Common examples are chewing tobacco, snuff, snus, and dissolvable tobacco forms. People use smokeless tobacco in different ways, so its use is not limited to any one method or group.
Types of Chewing Tobacco
Chewing tobacco comes in several forms:
- Loose Leaf: Shredded tobacco packed loosely.
- Twist: Braided strands of tobacco, sometimes called rope.
- Plug: Tobacco compressed into a block or brick.
People place chewing tobacco between their cheek and gums, then spit out or swallow the saliva that builds up. Flavors are sometimes added to make it more appealing. Chewing tobacco is also called “chew,” “spitting tobacco,” or “spit tobacco.”
Table: Forms of Chewing Tobacco
| Form | Description |
|---|---|
| Loose Leaf | Shredded, packaged loosely |
| Twist | Braided, rope-like strands |
| Plug | Compressed into blocks/bricks |
About Ground Tobacco (Snuff)
Snuff is tobacco that manufacturers finely grind or shred. It comes in moist or dry forms and is usually packaged in tins or small pouches. Users take a pinch and place it between the gum and cheek or lip, a practice called “dipping.” Some people use dry snuff by snorting it through the nose.
Manufacturers sometimes add flavors to snuff to make the taste milder or more appealing. The mouth or nose tissues absorb nicotine from snuff quickly. Many people in the United States choose moist snuff if they do not want to smoke.
Information on Pasteurized Snus
Snus is a special kind of moist snuff that began in Sweden and Norway. Companies sell it as loose powder or in small, tea-bag-like pouches. They heat the tobacco in snus to remove certain bacteria, which might lower some of the harmful chemicals.
Research suggests that snus may have a lower risk of causing mouth cancer, heart disease, lung cancer, and stroke compared to regular cigarettes. However, using snus still exposes users to nicotine and many chemicals that are not safe for health.
Dissolvable Tobacco Explained
Dissolvable tobacco is a newer smokeless product. Manufacturers powder the tobacco and press it into forms like tablets, sticks, or strips. These can be sweetened or flavored, and some look like candy. Users let the product dissolve in their mouth or chew it until it dissolves, absorbing nicotine directly.
Dissolvable tobacco is not the same as nicotine gum or lozenges used to quit smoking. It is made from real tobacco and carries the same risks as other smokeless tobacco forms.
Risks and Dangers Linked to Smokeless Tobacco
Smokeless tobacco products contain nicotine and many harmful chemicals. Using these products is not a safe alternative to smoking cigarettes.
Key Health Risks
- Addiction: Smokeless tobacco delivers as much or more nicotine than cigarettes. Nicotine causes strong cravings and withdrawal symptoms, making quitting difficult.
- Cancer: Chewing tobacco, snuff, and other products raise the risk for oral cancer, throat cancer, and pancreatic cancer. White patches in the mouth, called leukoplakia, may also form and can become cancerous.
- Heart and Vascular Disease: Some smokeless tobacco types raise blood pressure and heart rate. Long-term use increases the chance of heart disease and stroke.
- Dental and Gum Disease: The sugars and chemicals can cause tooth decay, gum disease, receving gums, stained teeth, bone loss, and even tooth loss. Bad breath and mouth sores are also common.
- Pregnancy Problems: Using smokeless tobacco while pregnant raises the risk for low birth weight, premature birth, stillbirth, and problems with the baby’s heartbeat.
- Nicotine Poisoning: Some dissolvable products look like candy, making them attractive to children. If a child swallows them, these can cause serious nicotine poisoning with symptoms such as vomiting, trouble breathing, shaking, weakness, seizures, coma, or even death.
List of Health Effects
- Oral cancer, mouth cancer, throat cancer, esophageal cancer, pancreatic cancer
- Leukoplakia (precancerous white patches)
- Gum disease, dental disease, tooth decay
- Heart disease, stroke, cardiovascular disease
- Premature birth, stillbirth, low birth weight in infants
- Nicotine addiction and withdrawal symptoms
Steps and Support for Quitting Smokeless Tobacco
Quitting smokeless tobacco improves health and lowers future risks. Tobacco manufacturers sometimes claim that these products can help smokers quit cigarettes, but research does not support smokeless tobacco as a safe quitting tool. The most effective ways to stop involve support and professional help.
Ways to Quit
- Supportive Counseling: Health professionals, phone or text quit lines, smartphone apps, and support groups offer guidance and help people build skills to stay tobacco-free.
- Nicotine rReplacement Therapy (NRT): NRT gives small amounts of nicotine in safer forms such as patches, gum, or lozenges. These products reduce cravings while a person quits tobacco.
- Medicines for Quitting: Certain prescription medications can help manage withdrawal symptoms. These include non-nicotine oral treatments that work by reducing cravings and easing the urge to use tobacco. They may act as nicotine receptor modulators or antidepressants, depending on the type prescribed.
- Behavioral Therapies: Counseling methods such as cognitive behavioral therapy often work best when combined with medication.
People who want to quit can reach out to the National Cancer Institute’s quit line or a state’s tobacco quit service. International support is also available through the World Health Organization’s list of tobacco cessation hotlines.
Support Tools Table
| Method | Description |
|---|---|
| Counseling | Personal, group, or phone/text-based support |
| Nicotine Replacement | Patches, gum, lozenges—reduce withdrawal and cravings |
| Prescription Pills | Non-nicotine oral treatments that reduce tobacco cravings (e.g., nicotine receptor modulators or antidepressants) |
| Digital Tools | Mobile apps, websites, self-help guides |
People who use smokeless tobacco benefit most when they get support and use proven treatments to stop. Quitting smokeless tobacco, like quitting smoking, can improve heart and dental health, lower risk for cancer, and reduce birth problems during pregnancy.
