Smokeless Tobacco

What is smokeless tobacco?

Smokeless tobacco and snuff are various forms of leaf tobacco which contain nicotine. Nicotine  is a central nervous system stimulant. Nicotine constricts blood vessels, speeds up the heart and increases blood pressure.

How is it used?

Chewing tobacco is loose leaf tobacco, often coated with a flavoring such as licorice or molasses. A wad is placed in the cheek.

Moist snuff is chopped tobacco which is dipped or placed between the lower lip and teeth or between the cheek and gums.

Dry snuff is fine, almost powdery tobacco and is placed in the nose and sniffed.

What are the health risks of using smokeless tobacco?

Smokeless tobacco is not a safe substitute for smoking cigarettes. Nicotine and other harmful chemicals found in tobacco are NOT removed by spitting; they mix with saliva which, after contact with tissues of the mouth and throat, is absorbed through the oral mucous into the bloodstream. It can cause cancer and a number of non-cancerous oral conditions and can lead to nicotine addiction and dependence. Oral cancer (especially in the cheeks, gums and throat) may be 50 times more likely in people who use smokeless tobacco. Oral cancer is a particularly deadly form of cancer, killing 30% to 50% of its victims within 5 years.

Leukoplakia (leathery white patches inside the mouth) are a result of direct contact with and continued irritation by tobacco juice. Just a few months of dipping or chewing is often enough to cause leukoplakia on the gum or cheek where the tobacco is held. Approximately 5% of diagnosed cases of leukoplakia develop into oral cancer.

Dental problems such as receding gums, tooth decay, loss of teeth, worn spots on the enamel, discolored teeth and bad breath are common among users of smokeless tobacco. They also experience a decreased sense of taste and smell.

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What are warning signs to look for?

If you use smokeless tobacco, you should see a medical provider if you experience any of the following symptoms:

  • A sore in the mouth that bleeds easily and doesn't heal
  • A lump or thickening anywhere in the mouth or neck
  • Any soreness or swelling in your mouth that doesn't go away
  • A red or white patch that doesn't go away
  • Difficulty chewing, swallowing or moving your tongue or jaw

Quitting

There are a variety of techniques for quitting smokeless tobacco. Whether you choose to quit "cold turkey" or go slowly by "nicotine fading," you can decrease any discomfort you may feel as you quit. Follow these tips:

  • Choose a time to quit. Don't pick a time when there's a high level of stress in your life; you could be setting yourself up for failure. For example, don't try to quit during exams.
  • Think about why you started using smokeless tobacco in the first place. Is it a way of coping with stress? Is it a habit in certain situations? Do you use it when you're bored? Do certain times of the day trigger an urge to use?
  • When the urge to use strikes you, interrupt it. Develop strategies for dealing with triggers, urges and social pressure. Substitute other things for tobacco, such as sugarless gum, snacks or deep breathing if you chew to relieve stress. You can modify your behavior by using techniques such as relaxation, exercise, cognitive awareness and stress management.
  • Ask friends for support. They can help you get beyond triggers and celebrate your successes along the way.
  • The physical desire for nicotine is not something you can "unlearn" but you have several options for handling withdrawal. You can quit all at once and tough out the days when your body really wants the nicotine. Or you can steadily decrease your intake until you quit.
  • It is normal for some people to have relapses. Instead of feeling that you've failed, remind yourself that you've quit before and you can quit again. Learn from past experiences; the second or third time may be easier because you've done it before.

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How do I help a friend quit?

Click here for ways to help a friend.

Resources

www.QuitNowRI.com, 1-800-QUIT-NOW (1-800-784-8669)  
The Smokers' Helpline provides referrals to local programs, phone counseling and will mail out self-help materials and quit smoking information packets. It is free and confidential.

University Health Services 401.863-3953
Confidential medical care, including prescriptions for Zyban. Pamphlets on quitting smoking available throughout the building. Located at 13 Brown Street on the corner of Brown and Charlesfield Streets.

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Links you can use

These sites are more likely to refer to cigarettes, but you can apply the same principles to quitting smokeless tobacco.

Trytostop.org
An online, interactive quit site developed by the Massachusetts Department of Public Health. The Quit Wizard will help you assess your risk factors, set a quit date and keep you smoke free. Other features include success stories, expert advice and a bulletin board. There are many language options including Spanish, Korean, Chinese, Hatian-Creole, Russian and Portuguese.

Web MD’s Smoking Cessation Center 
This site allows you to set goals, design your own personalized quit plan, find out about nicotine replacement therapy and read up on quitting options. There is a smoking cessation support group and articles on the latest news, like facts about nicotine water.

Quitnet 
Run by Boston University, Quitnet offers quitting guides, personalized quit plans and forums with expert counselors.

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Disclaimer: Health Education is part of Health Services at Brown University. Health Education maintains this site as a resource for Brown students. This site is not intended to replace consultation with your medical providers. No site can replace real conversation. Health Education offers no endorsement of and assumes no liability for the currency, accuracy, or availability of the information on the sites we link to or the care provided by the resources listed. Health Services staff are available to treat and give medical advice to Brown University students only. If you are not a Brown student, but are in need of medical assistance please call your own health care provider or in case of an emergency, dial 911. Please contact us if you have comments, questions or suggestions.