Smokeless Tobacco and Cancer: Questions and Answers
- What is smokeless tobacco? There are two types of smokeless tobacco—snuff and chewing tobacco. Snuff, a finely ground or shredded tobacco, is packaged as dry, moist, or in sachets. Typically, the user places a pinch or dip between the cheek and gum. Chewing tobacco is available in loose leaf, plug, or twist forms, with the user putting a wad of tobacco inside the cheek. Smokeless tobacco is sometimes called “spit” or “spitting” tobacco because people spit out the tobacco juices and saliva that build up in the mouth.
- What harmful chemicals are found in smokeless tobacco?
Chewing tobacco and snuff contain 28 carcinogens. The most harmful carcinogens in smokeless tobacco are the tobacco-specific nitrosamines. They are formed during the growing, curing, fermenting, and aging of tobacco. TSNAs have been detected in some smokeless tobacco products at levels many times higher than levels of other types of nitrosamines that are allowed in foods, such as bacon and beer.
Other cancer-causing substances in smokeless tobacco include N-nitrosamino acids, volatile N-nitrosamines, benzopyrene, volatile aldehydes, formaldehyde, acetaldehyde, crotonaldehyde, hydrazine, arsenic, nickel, cadmium, benzopyrene, and polonium–210.
All tobacco, including smokeless tobacco, contains nicotine, which is addictive. The amount of nicotine absorbed from smokeless tobacco is 3 to 4 times the amount delivered by a cigarette. Nicotine is absorbed more slowly from smokeless tobacco than from cigarettes, but more nicotine per dose is absorbed from smokeless tobacco than from cigarettes. Also, the nicotine stays in the bloodstream for a longer time.
Smokeless tobacco users increase their risk for cancer of the oral cavity. Oral cancer can include cancer of the lip, tongue, cheeks, gums, and the floor and roof of the mouth.
People who use oral snuff for a long time have a much greater risk for cancer of the cheek and gum than people who do not use smokeless tobacco.
The possible increased risk for other types of cancer from smokeless tobacco is being studied.
In the United States, the 2000 National Household Survey on Drug Abuse, which was conducted by the Substance Abuse and Mental Health Services Administration, reported the following statistics:
An estimated 7.6 million Americans age 12 and older had used smokeless tobacco in the past month.
Smokeless tobacco use was most common among young adults ages 18 to 25.
Men were 10 times more likely than women to report using smokeless tobacco.
People in many other countries and regions, including India, parts of Africa, and some Central Asian countries, have a long history of using smokeless tobacco products.
Several national organizations provide information about the health risks of smokeless tobacco and how to quit:
The National Institute of Dental and Craniofacial Research's National Oral Health Information Clearinghouse offers educational booklets that discuss spit tobacco use in a colorful and graphic format. These booklets are designed specifically for young men who have decided to quit or are thinking about it.
|Organization:||National Oral Health Information Clearinghouse
National Institute of Dental and Craniofacial Research
|Address:||One NOHIC Way
Bethesda, MD 20892–3500
The Centers for Disease Control and Prevention's Office on Smoking and Health distributes a brochure for teens who are trying to quit cigarettes or smokeless tobacco. The Office also maintains a database of smoking and health-related materials.
|Organization:||The Office on Smoking and Health
Centers for Disease Control and Prevention
|Address:|| Mail Stop K–50
4770 Buford Highway, NE.
Atlanta, GA 30341–3724
The mission of the National Spit Tobacco Education Program is to prevent people, especially young people, from starting to use tobacco, and to help users to quit. NSTEP offers information and materials on spit tobacco use, prevention, and cessation.
|Organization:||National Spit Tobacco Education Program
Oral Health America
410 North Michigan Avenue
Chicago, IL 60611
The American Cancer Society publishes a series of pamphlets with helpful tips and techniques for smokeless tobacco users who want to quit.
|Organization:||American Cancer Society|
|Address:|| 1599 Clifton Road, NE.
Atlanta, GA 30329
The American Academy of Family Physicians has a fact sheet with information on how to quit using smokeless tobacco. The fact sheet is available at http://familydoctor.org/handouts/177.html on the Internet.
|Organization:||American Academy of Family Physicians|
|Address:|| 11400 Tomahawk Creek Parkway
Leawood, KS 66211–2672
A number of other organizations provide information about where to find help to stop using smokeless tobacco. State and local health agencies often have information about community tobacco cessation programs. The local or county government section in the phone book has phone numbers for health agencies. Information to help smokers who want to quit is also available through community hospitals, the yellow pages, public libraries, health maintenance organizations, health fairs, and community helplines.