Smokeless Tobacco and Cancer: Questions and Answers

Overview

  • Snuff is a finely ground or shredded tobacco that is either sniffed through the nose or placed between the cheek and gum. Chewing tobacco is used by putting a wad of tobacco inside the cheek.
  • Chewing tobacco and snuff contain 28 cancer-causing agents.
  • Smokeless tobacco users have an increased risk of developing cancer of the oral cavity.
  • Several national organizations offer information about the health risks of smokeless tobacco and how to quit.

  1. What is smokeless tobacco?
  2. 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.

  3. What harmful chemicals are found in smokeless tobacco?
  4. What cancers are caused by or associated with smokeless tobacco use?
  5. What are some of the other ways smokeless tobacco can harm users' health?
  6. Some of the other effects of smokeless tobacco use include addiction to nicotine, oral leukoplakia, gum disease, and gum recession. Possible increased risks for heart disease, diabetes, and reproductive problems are being studied.

  7. Is smokeless tobacco a good substitute for cigarettes?
  8. In 1986, the Surgeon General concluded that the use of smokeless tobacco “is not a safe substitute for smoking cigarettes. It can cause cancer and a number of noncancerous conditions and can lead to nicotine addiction and dependence.” Since 1991, NCI has officially recommended that the public avoid and discontinue the use of all tobacco products, including smokeless tobacco. NCI also recognizes that nitrosamines, found in tobacco products, are not safe at any level. The accumulated scientific evidence does not support changing this position.

  9. What about using smokeless tobacco to quit cigarettes?
  10. Because all tobacco use causes disease and addiction, NCI recommends that tobacco use be avoided and discontinued. Several non-tobacco methods have been shown to be effective for quitting cigarettes. These methods include pharmacotherapies such as nicotine replacement therapy and bupropion SR, individual and group counseling, and telephone quitlines.

  11. Who uses smokeless tobacco?
  12. 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:

    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.

  13. Where can people find help to quit using smokeless tobacco?
  14. 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
    Telephone: 301–402–7364
    E-mail: nohic@nidcr.nih.gov
    Web site: http://www.nohic.nidcr.nih.gov/

    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
    Telephone: 1–800–232–1311 
    E-mail: tobaccoinfo@cdc.gov
    Web site: http://www.cdc.gov/tobacco/how2quit.htm
     

    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
    Address: Suite 352
    410 North Michigan Avenue 
    Chicago, IL 60611
    Telephone: 312–836–9900
    Web Site: http://www.nstep.org
     

    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
    Telephone: 1–800–227–2345
    Web site: http://www.cancer.org

    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
    E-mail: email@familydoctor.org
    Web site: http://familydoctor.org
     

    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.

  15. What other resources are available?
  16. A person's dentist or doctor can be a good source of information about the health risks of smokeless tobacco and about quitting. Friends, family members, teachers, and coaches can help a person quit smokeless tobacco use by giving them support and encouragement.



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