Smokeless Tobacco (Dip, Chew, Snuff)

What's the Problem?

Smokeless tobacco is a significant health risk and is not a safe substitute for smoking cigarettes. Smokeless tobacco contains 28 cancer-causing agents (carcinogens). Smokeless tobacco use can lead to nicotine addiction and dependence. Adolescents who use smokeless tobacco are more likely to become cigarette smokers.

The two main types of smokeless tobacco in the United States are chewing tobacco and snuff. Chewing tobacco comes in the form of loose leaf, plug, or twist. Snuff is finely ground tobacco that can be dry, moist, or in sachets (tea bag-like pouches). Although some forms of snuff can be used by sniffing or inhaling into the nose, most smokeless tobacco users place the product in their cheek or between their gum and cheek. Users then suck on the tobacco and spit out the tobacco juices, which is why smokeless tobacco is often referred to as spit or spitting tobacco.

It is a known cause of human cancer, as it increases the risk of developing cancer of the oral cavity.

Who's at Risk?

• Smokelesstobacco use in the United States is higher among young white males;American Indians/Alaska Natives; people living in southern and northcentral states; and people who are employed in blue collar occupations,service/laborer jobs, or who are unemployed.
• Nationally,an estimated 3% of adults are current smokeless tobacco users. Smokelesstobacco use is much higher among men (6%) than women (<1%).
• In theUnited States, 9% of American Indian/Alaska Natives, 4% of whites, 2% ofAfrican Americans, 1% of Hispanics, and <1% of Asian-American adultsare current smokeless tobacco users.
• Anestimated 8% of high school students are current smokeless tobacco users.Smokeless tobacco is more common among males (13.6%) than femalehigh school students (2.2%). Estimates by race/ethnicity are10.2% for white, 5.1% for Hispanic, and 1.7% for African-American highschool students.
• Anestimated 3% of middle school students are current smokeless tobaccousers. Smokeless tobacco is more common among male (4%) than female (2%)middle school students. Estimates by race/ethnicity are 3% forwhite, 1% for Asian, 2% for African-American, and 4% for Hispanic middleschool students.

Can It Be Prevented?

Yes. Hopefully by clarifying that smokeless tobacco is not safe, we can help people make an informed decision about its use. School-based programs are an opportunity to discourage youth on the use of smokeless tobacco. The film industry can also influence the public by not glamorizing any form of tobacco use. More community-wide efforts aimed at prevention and cessation of smokeless tobacco use among young people are needed. In addition, opportunities for intervention occur in all clinical settings and require knowledgeable and committed health-care professionals. Training programs for health care providers should include components to help make smokeless tobacco counseling a higher priority.

Case Example

Jimmy is a good looking kid and friends with just about everyone. Recently some of his friends have started using smokeless tobacco. He used to think it was something the old folks used to do with spit coming out of their mouths. He'll never admit it, but the sight of the spitting used to make him want to puke. The stuff smelled awful and looked grotesque.

However, the stuff his friends use doesn't seem to be like that. What they use smells like apple and cherry with just a little bit of the awful stuff mixed in. They just put it in their mouths and suck. They don't even have to spit. Some of the older kids have been using these products for a few years now.

Recently he noticed some of those kids had white areas in their mouths. He asked them what it was and they told him that the doctor had said it was "leukoplakia, what ever that was". He also noticed that his friend's gums were going back, like old folks.

In addition to being good looking and friendly, Jimmy was also smart. He went online to find out more about leukoplakia. He learned that it can be caused by cigarette smoking or chewing tobacco and it can lead to cancer. He also found that smokeless tobacco made the gums go back which explained the "old folks' gums" on his friends.

He decided not to take the smokeless tobacco when offered. He told his friends about what he had learned and asked the school newspaper to publish an article about the health hazards of smokeless tobacco. He petitioned the student counsel to ban ALL smokeless tobacco on campus. This was so successful that using chewing tobacco became an "un-cool" behavior everywhere on campus.

To learn more about smokeless tobacco, visit: Smokeless Products.