There are many different types of smokeless tobacco including dip, snuff, snus, and chewing tobacco. Recreational lozenges, strips, sticks, nicotine pouches, and small pouches of tobacco are also considered smokeless tobacco.
Some smokeless tobacco products might expose you to lower levels of harmful chemicals than tobacco smoke. But that doesn’t mean they are a safe alternative to smoking.
Depending on the product, smokeless tobacco is either inhaled or put into the mouth. It isn’t burned like cigarettes or cigars. But it is made from tobacco leaves, and it has many of the same harmful chemicals as cigarettes and cigars.
These come as loose leaves, plugs, or twists of dried tobacco that may be flavored. They are chewed or placed between the cheek and the gums or teeth. The nicotine is absorbed through the mouth tissues. The user then spits out (or swallows) the tobacco ‘juices.’
Snuff is finely ground tobacco packaged in cans or pouches. It’s sold as dry or moist and may have flavorings added.
Dissolvable forms of smokeless tobacco come in different shapes and sizes, such as tobacco pouches, recreational lozenges, orbs, pellets, thin strips (like melt-away breath strips), and toothpick-sized sticks. Some of these also have sweeteners or flavoring and look a lot like candy. All have tobacco and nicotine. Depending on the type, they are held in the mouth, chewed, or sucked until they dissolve. The juices are swallowed.
Nicotine pouches are small packets that contain nicotine powder. They are placed between the teeth and gums, where the nicotine dissolves and is released into the bloodstream. These pouches come in several strengths and a variety of flavors, including fruit, mint, coffee, and tobacco flavor.
The nicotine can be made from tobacco or in a lab, so some of these pouches are marketed as tobacco-free. But lab-made nicotine causes the same health problems as other tobacco products. And some nicotine pouches have been found to contain chemicals that can cause health problems, including cancer.
Nicotine pouches are approved for marketing to people who are at least 21 years of age and already use tobacco products. They are not recommended for younger people or people who don’t already use tobacco.
These products are not approved by the FDA for use as tobacco cessation aids.
Heated tobacco products (sometimes called “heat-not-burn” products) most often use an electronic heating element. This element heats specially designed sticks, plugs, or capsules containing tobacco. The heat releases nicotine (and other chemicals) that can then be inhaled into the lungs, but the tobacco doesn’t get hot enough to burn. These devices are not the same as e-cigarettes.
Using any kind of smokeless tobacco can expose you to health risks.
Smokeless tobacco has nicotine and other chemicals that can cause health problems. Some smokeless tobacco products might expose you to lower levels of harmful chemicals than cigarette smoke. But this doesn’t mean they are safe.
No form of smokeless tobacco is a safe substitute for cigarettes.
Still, tobacco companies often market these products as an alternative to smoking in places where smoking isn’t allowed.
When you use smokeless tobacco, you get about the same amount of nicotine as you do when you smoke cigarettes. You are also exposed to more than 25 chemicals that are known to cause cancer.
The most harmful cancer-causing chemicals in smokeless tobacco are tobacco-specific nitrosamines (TSNAs). TSNA levels vary by product, but the higher the level the greater the cancer risk.
Cancers linked to the use of smokeless tobacco include:
Newer types of smokeless tobacco haven’t been studied as well as chewing tobacco and snuff, so the risk of cancer with these products isn’t as clear. But they often still have harmful chemicals that might increase your risk of cancer. The amount of these chemicals varies by product.
Leukoplakia is a gray-white patch in the mouth that can become cancer. It is often found in the mouths of people who use smokeless tobacco placed between the teeth and gums.
These patches can’t be scraped off. They’re sometimes called sores, but they are usually painless. The longer you use oral tobacco, the more likely you are to have leukoplakia. Stopping tobacco might help clear up the spot, but treatment may be needed if there are signs of early cancer.
Tobacco stains teeth and causes bad breath. It can also irritate or destroy gum tissue. Some regular smokeless tobacco users have receding or swollen gums, tooth decay and cavities, scratching and wearing down (abrasion) of teeth, and bone loss around the teeth. When gums recede (shrink), the surface of the tooth root may be exposed. All of these can cause teeth to loosen and fall out.
Other harmful health effects of smokeless tobacco include:
All smokeless tobacco has nicotine, which can lead to addiction. In teens, using nicotine can harm the parts of the brain that control attention, learning, mood, and impulse control. It can also worsen feelings of depression and anxiety and may increase the risk for future addiction to other drugs.
Manufacturers might say that spit or smokeless tobacco can help people quit smoking. But no smokeless tobacco product has been proven to help people quit smoking.
The U.S. Food and Drug Administration (FDA) has approved several standard treatments, including nicotine replacement therapy (NRT) and certain medicines. These treatments are proven to help people quit smoking.
But smokeless tobacco products have not been tested enough to see if they can help a person stop smoking. Research to date has not shown that they help a person quit.
Even if using smokeless tobacco helps some people give up smoking, it can still cause cancer and other health problems. So it isn’t a safe alternative. Because it still has nicotine, it’s also addictive and hard to quit.
Inhalants, MedlinePlus, Available at: https://medlineplus.gov/inhalants.html
Women have unique health issues. And some of the health issues that affect both men and women can affect women differently.
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