Smokeless Tobacco Kills

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The TRUTH about Smokeless Tobacco
(also known as chewing tobacco, snuff or dip)
FACT: Four pinches of smokeless tobacco contain about as much nicotine as a pack of cigarettes.

FACT: Because it contains high levels of nicotine, smokeless tobacco is highly addictive and hard to quit using.

FACT: Tobacco companies add sand, fiberglass, and other abrasives to smokeless tobacco that increase nicotine absorption and destroy tooth enamel.

FACT: Oral cancers are 50 times more likely in users of smokeless tobacco.

FACT: Oral cancer kills 30- 50% of those diagnosed with it within 5 years.

FACT: It is possible to quit - many people have succeeded.

FACT: Nicotine replacement therapy (patch or gum) can reduce the symptoms of nicotine withdrawal, making it easier to quit.

FACT: Sugarless gum, healthy snacks, or tobacco-free dip can help satisfy your oral fixation and help you remain tobacco-free.

FACT: Changing your routine and avoiding your triggers (those places or situations where you most often use smokeless tobacco) can help.

FACT: Not everyone quits for good the first time they try, but each successive attempt gets easier. Don't give up!

FACT: It is possible to quit.

FACT: There are places to get more information on support: - tips aimed at college students -information on quitting, including where to find tobacco-free dip - information, including an online support group -information from the NIH - information on health risks and tips on quitting from the American Cancer Society

Spit It Out and Keep It Out

Myths About Smokeless Tobacco

Which of the following is true?

  1. Smokeless tobacco is a safe alternative to smoking.
  2. Smokeless tobacco is not as habit forming as cigarettes.
  3. Smokeless tobacco is not a problem except among cowboys and farmers.

If you answered true to #1 - wrong!

If you answered true to #2 - wrong again!

If you answered true to #3 - you strike out!

It has taken a long time for the public to finally realize that smoking is a major health hazard. It's becoming less and less acceptable or chic for people to smoke. Recently, however, another tobacco-related public health menace has begun to surface - smokeless tobacco, that is chewing or sniffing tobacco. This is not just a problem in rural America, but is being used throughout the U.S, mostly by teenagers. Sixteen percent of all males between 12 and 17 used smokeless tobacco in 1985, and the number is increasing rapidly. The tobacco industry has succeeded in duping the youth of this country into thinking that by using smokeless tobacco instead of cigarettes, they are exercising a "safe alternative." Make no mistake about it, it is the young people of this country to whom this industry has directed its efforts - for example in some state surveys, more than 50% of those who use smokeless tobacco developed the habit before they were 13 years old.


Lets Talk About Chemicals

Let's talk about chemicals--smoking, chewing or sniffing tobacco all cause physical feelings; this is not a mental high. Nicotine and related chemicals are found in all forms of tobacco, and how you take it is not important. We're talking chemical stimulation of the brain, blood vessels, heart and other organs. That's why getting rid of the habit is so hard; it is not just mind

over body--not just willpower. It's a physical dependency that makes the whole body crave more of the chemical. These chemicals are in all tobacco. When smoked, these substances are absorbed through the lungs, into the blood, and they are distributed to all body parts. When chewed or dipped, the chemicals are absorbed through the mouth and the stomach. It takes a little longer for this absorption, but the final concentration in the blood is just as high as with smoking. And guess what, the concentrations of the cancer causing chemicals in smokeless tobacco are much higher than in cigarette tobacco.

Now you may say to yourself that if you don't smoke these chemicals, you avoid cancer-you re wrong again! You're only swapping lung cancer for mouth cancer! You see, the body tissues, whether its lungs or membranes in the mouth, don't like tobacco byproducts; they cause them to develop cancer.

Effects of Smokeless Tobacco

The effects of smokeless tobacco include:

  • Increased heart rate caused by nicotine in the blood stream releasing hormones (such as adrenaline).
  • Increased blood pressure caused by nicotine in the blood stream. Can cause irregular heart beats as well.
  • Constricted blood vessels: nicotine constricts the blood vessels, slowing down the circulation of oxygen-rich blood to the organs.
  • Cancer of the mouth (including the lip, tongue, and cheek): mouth cancer is 1 of the 10 most common cancers in the world. The risk of mouth cancer is four times greater for the smokeless tobacco user. It is particularly high where the tobacco is placed.
  • Cancer of the throat: the risk of oral cancer is up to 50 times greater for the person who chews tobacco. The longer smokeless tobacco is used, the greater the risk.
  • Discoloration of teeth: the products in smokeless tobacco permanently stain teeth.
  • Halitosis: Bad breath caused by chewing tobacco is socially unacceptable and offensive.
  • Gum recession: The direct and repeated contact of tobacco with the gum tissue causes the gums to recede from the teeth. This eventually can lead to the loss of teeth.
  • Tooth decay: Smokeless tobacco contains high quantities of sugar. This sugar mixed with the plaque on your teeth forms acids that eat away at the tooth's enamel, causing cavities.

Lets Talk Money

You may not think about the cost of sickness when you're young, but the problems will be obvious when you start paying taxes and wondering where your hard earned money goes. Every year in the U.S., 320,000 people die from diseases that are directly related to tobacco use. Lung cancer alone kills 136,000 citizens yearly, and most of those got the disease from smoking. Can you imagine how much money it takes to care for the 30,000 new mouth cancer patients every year. The overall numbers are staggering.

The cost of smoking to the economy ranges from $30 to 95 billion, with a middle estimate of $65 billion. This amounts to $2.17 in lost productivity and the treatment of smoking-related diseases for each pack of cigarettes sold.

You might say that health insurance pays for much of this--well that insurance costs employers and employees alike. And for those who are not insured by private carriers, programs such as Medicare and Medicaid pick up the bill. Smoking's adverse health consequences cost nation's taxpayers $65 billion each year in increased medical bills, premature death and time lost from work. You see, there is no such thing as free health care--we all end up paying for the problems caused by tobacco use.

Let's be even more practical, when you are a teenager, you may not think of chewing tobacco as a disgusting habit, but in a few years, after you are addicted, you'll find it is not so socially acceptable. You may even find that your career opportunities are limited because of it.


There are many different types of cancers. The types that we will be discussing are caused by the use of smokeless tobacco.

Smokeless tobacco is the cause of many cancer deaths in the United States.

Squamous cell carcinoma is the most common type of oral cancer and accounts for about 90 to 95 percent of all malignant tumors of the mouth.

There are other types of lesions but these are uncommon. They account for only a small amount of the incidence and mortality from oral cancer.

Scientists don't know everything about what causes oral cancer. They also do not know why some people have a tendency to contract it and others are more resistant.

They have identified many factors that contribute to its development. Poor oral hygiene, chronic irritation caused by jagged teeth, projecting fillings and ill-fitting dentures are contributing factors.

Leukoplakia is a pre-cancerous mouth condition that can become malignant. It consists of a painless, white patch of cells that form on the lip, tongue, or mouth lining.

Leukoplakia is that white patch you feel as a rough spot between your cheek and gum when you move your tongue over where you place your chew or dip.

Does leukoplakia always turn into cancer? The scientific community says no. No one can say for sure whether or not a leukoplaktic lesion will turn malignant, but it is known that smokeless tobacco use causes leukoplakia.

It is also known that no one can predict another's genetics. No one can say how long an individual can irritate their oral membranes into a leukoplaktic condition before it turns cancerous.

There are reported cases of smokeless tobacco users well into their 80's. These guys have developed no malignancies.

Then, you have the kid who has been chewing for six months, feels something not quite right, shows it to mom and dad, and winds up in the hospital with less than 5 years to live.

It must be very sad to be told that you only have a few months of painful, disfigured years to live when you are only 18 or so.

The American Cancer Society has estimated that there were over 29,600 reported cases of oral cancer in 1994.

It has been reported that twice as many men as women will get oral cancer. Men over the age of 40 will be the hardest hit.

There were over 8,000 deaths in 1994 that were related to oral cancer. What does all of this tell us? Smokeless tobacco...kills!

Tips To Quit

Many smokeless tobacco users say it is even harder to quit smokeless tobacco than cigarettes. Chewing tobacco and snuff contain nicotine and are addictive. A recent study showed that nicotine in the blood stream was actually twice as great for smokeless' tobacco as for cigarettes. Trying to quit can be difficult, but not impossible. Here are some tips to spit it out and keep it out!

  1. Think of reasons why you want to quit. You may want to quit because:
  • The people around you find it offensive.
  • You don't like having bad breath after chewing and dipping.
  • You don't want stained teeth.
  • You don't want to risk getting cancer.
  • You don't like being addicted to nicotine.
  • You want to start leading a healthier life.
  1. Pick a quit date and throw out all your chewing tobacco and snuff.
  2. Ask your friends, family, teachers, and coaches to help you kick the habit by giving you support and encouragement. Tell friends not to offer you smokeless tobacco. You may want to ask a friend to quit with you.
  3. Ask your doctor about a nicotine chewing gum tobacco cessation program.
  4. Find alternatives to smokeless tobacco.
  5. A few good examples are sugarless gum, pumpkin or sunflower seeds, apple slices, or raisins.
  6. Find activities to keep your mind off of smokeless tobacco.
  7. You could ride a bike, talk or write a letter to a friend, work on a hobby, or listen to music. Exercise can help relieve tension caused by quitting.
  8. Remember that everyone is different, so develop a personalized plan that works best for you. Set realistic goals and achieve them.
  9. Reward yourself. You could save the money that would have been spent on smokeless tobacco products and buy something nice for yourself.



Otolaryngology-head and neck surgery is a specialty concerned with medical treatment and surgery of the ear, nose, throat and related structures of the head and neck. The specialty encompasses cosmetic facial reconstruction, surgery of benign and malignant tumors of the head and neck, management of patients with loss of hearing and balance, endoscopic examination of air and food passages and treatment of allergic, sinus, laryngeal, thyroid and esophageal disorders.

To qualify for the American Board of Otolaryngology certification examination, a physician must complete five or more years of post-M.D. (or D.O.) specialty training.

1988. This leaflet is published as a public service. The material may be freely used so long as attribution is given to the American Academy of Otolaryngology-Head and Neck Surgery, Inc., Alexandria, VA

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