Smokeless Tobacco

Tobacco that is not burned (combusted)
Traditional smokeless products
*Chew (“spitting tobacco,” placed between cheek and gums)
*Snuff (dry snuff sniffed through nose; moist snuff, or “dip,” placed between cheek and gums)
Snus (finely ground tobacco placed in small packets)
New generation of products
Dissolvables (lozenges, orbs, sticks, strips)

E-cigarette (not called “smokeless tobacco,” but is similarly not combusted and has been ruled a “tobacco product” subject to FDA regulation)

Addictive
Not a safe alternative to cigarette smoking
Most smokeless tobacco products contain carcinogens (at least 28 identified, and nitrosamine levels are higher in smokeless tobacco than in cigarettes)
Most smokeless tobacco products cause oral, esophageal, and pancreatic cancer
Use of these products causes precancerous lesions of the mouth (leukoplakia), as well as gum recession, gum disease, and tooth decay

Use also associated with greater risk of fatal heart attacks and stroke

An individual, non-smoking smokeless tobacco user experiences lower overall disease and mortality risks than a smoker, but … the health effects depend on the properties of the specific product (they vary considerably) and how the product is used
In 2010, almost 60 percent of young adults who used smokeless tobacco in the past month also smoked cigarettes during the same period
Many smokers who begin using smokeless tobacco products neither successfully quit tobacco use nor transition to exclusive use of smokeless tobacco
Many users remain stuck in a pattern of dual use of smoked and non-smoked tobacco products, instead of turning to FDA-approved nicotine replacement therapy (NRT) options

This behavior effectively increases the user’s health risks.