Smokeless Tobacco

Medically Reviewed by Brunilda Nazario, MD on May 09, 2008
From the WebMD Archives

Watch any baseball team at game time, and chances are you'll see players using smokeless tobacco. How do you recognize them? Look for a large lump on their cheeks, and watch them continually spit on the ground to rid their mouths of the excess saliva. Sound pleasant? Probably not!

Here are some questions and answers about smokeless tobacco:

Q. What Is Smokeless Tobacco?

A. Chewing tobacco and snuff are the two main types of smokeless tobacco. Chewing tobacco usually comes in leaves or plugs that users put in their cheek pouches and then chew. Snuff is finely ground tobacco that users put between their gums and cheeks.

Many people believe that smokeless tobacco is not dangerous, but that is not true. Smokeless tobacco has many bad side effects and serious health risks, including cancer and even death.

Q Is Smokeless Tobacco Addictive?

A. Yes. Like cigarettes, chewing tobacco and snuff contain nicotine - a highly addictive drug. Because the nicotine is absorbed into the bloodstream from the mouth, it takes longer to reach the brain. Smokeless tobacco users do not feel the effects of the nicotine as fast as cigarette users do. But about the same amount of nicotine enters their bloodstreams.

Nicotine works by making the brain release adrenaline-like compounds(such as norepinephrine). These "excitatory" neurotransmitters get your body revved up. (You have probably heard the term "get your adrenaline pumping.") Many people enjoy this feeling, but not the feeling that comes after it. After the nicotine is gone, and the brain stops releasing the positive neurotransmitters, smokeless tobacco users feel tired, depressed, and down.

Nicotine also causes the brain to release a chemical called dopamine. Other very addictive drugs like cocaine make the brain release dopamine, too. Even though dopamine makes you feel very good, drugs that make the brain release it are highly addictive.

About 35 million tobacco users try to quit every year. Only 1 out of every 15 people who try quitting actually succeeds for more than a month.

Q.What Are the Health Risks of Smokeless Tobacco?

A. The most noticeable side effects are stained teeth and poor dental health. Although these are not usually life threatening, dental problems are painful, expensive, and may hurt your social life. Chewing tobacco and snuff can turn your teeth yellowish-brown and give you bad breath. They can also make your gums bleed and create sores on your gums and inside your mouth that refuse to heal.

The most serious health risk associated with smokeless tobacco is cancer. Smokeless tobacco products contain at least 28 cancer-causing chemicals. Over time, these chemicals increase your risk of cancers in the mouth and throat. If you use smokeless tobacco, talk to your doctor about checking for any precancerous lesions.

While tobacco use is the most preventable cause of death in the United States, more than 400,000 people die prematurely each year because of tobacco use. If you have thought about using smokeless tobacco or any other tobacco product, think again. Any tobacco use is dangerous and unhealthy, especially for teenagers.

Q. How Can I Quit Using Smokeless Tobacco?

A. Just like any other tobacco product, chewing tobacco or snuff can be hard to quit. Only 6% of tobacco users are able to stop for more than a month. Many people try to quit over and over again. Don't despair! There are ways to help you stop. Nicotine replacement, behavioral therapy, and prescription medicines are proven to help tobacco users quit.

Nicotine gum, patches, inhalers, and lozenges are all different kinds of nicotine replacement. They work by giving you nicotine without having to use chewing tobacco or snuff. Even though they contain nicotine, they do not have all the cancer-causing chemicals as chewing tobacco and snuff. They can also help you quit by reducing cravings and discomfort. The nicotine patch has been specifically shown to work. If you are under 18, you need to get your doctor's or parent's permission to use nicotine replacements.

Behavioral therapy consists of visiting a therapist who will help you find the best strategy to quit. He or she will help you come up with ways to get through strong cravings and provide emotional support when you need it.

Some medicines, including bupropion SR (Zyban and Wellbutrin SR) and Varenicline tartrate (Chantix), are formulated to help people quit using tobacco. Patients should tell their doctor about any history of psychiatric illness prior to starting Chantix. Chantix may cause worsening of a current psychiatric illness even if it is currently under control and may cause an old psychiatric illness to reoccur. Your doctor must prescribe these medications.

Q. What Do I Say If Somebody Offers Me Some Chewing Tobacco or Snuff?

A. Saying no to a friend is really hard. But if a friend offers you a "dip," just tell them "No thanks." Even if they seem upset, they probably won't stay upset for long. They may even respect you more. Choosing not to use smokeless tobacco is all about YOU. It's better for your teeth, gums, and breath; helps prevent cancer of your mouth, throat, and esophagus; and is a very wise decision for your overall health.