Smokeless Tobacco

Smokeless tobacco is tobacco consumed orally and not burned. A variety of types of smokeless tobacco are used throughout the world. For example, in the U.S., the principal types of smokeless tobacco are cut tobacco leaves (chewing tobacco) and ground tobacco (snuff). However, in Sweden, finely ground moist tobacco (snus) is used, and in India, smokeless tobacco contains tobacco leaf mixed with other ingredients, such as areca nut and lime.

It is thought that the adverse health consequences vary by the type of smokeless tobacco, which is strongly associated with geography.

According to the Centers for Disease Control and Prevention, National Cancer Institute, American Lung Association, and American Cancer Society, the dangers of smokeless tobacco include:

• Increased risk of disease and death. Long-term risk of smokeless tobacco has been examined in recent American Cancer Society prevention studies. The findings show that smokeless tobacco use is associated with death from heart disease, stroke, cirrhosis, all cancers, lung cancer specifically, and diseases of the respiratory, digestive and genitourinary systems.
• Long-term use and dependence. In a 2014 Centers for Disease Control and Prevention survey, about 3 percent of the U.S. population over 18 years of age reported use of smokeless tobacco, making it the largest source of human exposure to carcinogenic, tobacco-specific nitrosamines. Recent studies show that exposure to the potent carcinogenic compound, nicotine-derived nitrosamine ketone is similar in both smokeless tobacco and cigarettes.

While the risks differ between smokeless tobacco use and cigarette smoking, both involve serious health consequences. In the Nicotine Research Program at Mayo Clinic, researchers are actively pursuing interventions to help people quit using smokeless tobacco.