Snuffing Out Smokeless Tobacco Use
Want something to chew on? Don't let it be smokeless tobacco! Smokeless or spit tobacco comes in two forms: chewing tobacco and snuff—both of which can cause ]]>cancer]]> and serious oral health problems.
Chewing tobacco can be found as leaf tobacco, which is packaged in a pouch, or plug tobacco, which is in a brick form. Both are put between the cheek and gum for several hours, and produce a continuous nicotine high in users. Snuff, usually sold in cans, is a powdered form of tobacco that's put between the lower lip and gum. A very small amount will quickly release nicotine into the bloodstream, producing a quick high.
The Bad and the Ugly
More Nicotine Than Cigarettes
Because smokeless tobacco puts more ]]>nicotine]]> into the bloodstream than cigarettes, people who chew on a regular basis often find it harder to ]]>quit]]> than cigarette smoking. In fact, an average sized "dip" that's held in the mouth for 30 minutes releases as much nicotine as smoking two or three cigarettes. When someone uses smokeless tobacco, his or her body adjusts to the amount of tobacco needed to produce that high. Then he or she needs a little more tobacco to achieve the same feeling and ends up addicted. Using smokeless tobacco is not a good way to quit smoking cigarettes. Smokeless tobacco has many of the same toxic chemicals as tobacco in cigarettes.
It may be smokeless, but it isn't harmless! In addition to nicotine, smokeless tobacco contains at least 28 known cancer-causing chemicals. Here are just a few of the substances found in smokeless tobacco:
- Lead (nerve poison)
- Polonium 210 (nuclear waste)
- Cadmium (in car batteries)
- Formaldehyde (used for embalming)
- N-Nitrosamines (cancer-causing)
Physical and Social Concerns
Smokeless tobacco users put themselves at a high risk for many serious and visible health problems such as:
- Cancer. Cancer of the mouth (the lip, tongue, and cheek) and of the ]]>throat]]> (the pharynx, larynx, and esophagus). Surgery to treat cancer of the mouth (oral cancer) is disfiguring and sometimes involves removing parts of the face, cheek, tongue, or lip. Oral cancer can spread quickly to other parts of the body. The average oral cancer patient lives only five years after diagnosis.
- Tooth and gum disease. Smokeless tobacco permanently discolors the teeth. It scratches the teeth and wears away the hard surface or enamel. It causes bad breath, ]]>cavities]]> , gum recession, and tooth loss.
- ]]>Leukoplakia.]]> When smokeless tobacco irritates the mouth, it can cause precancerous changes in the mouth. They are marked by white, leathery patches, which can be different shapes and sizes. Anyone noticing these changes should see their doctor immediately.
- Nicotine dependence. The constant flow of nicotine in the blood causes increased heart rate, blood pressure, and sometimes irregular heart beats. In addition, it causes the blood vessels to constrict, which can lead to decreased athletic performance and reduced endurance levels.
- Social embarrassment. There's nothing socially desirable about bad breath, gunk-filled and discolored teeth, and constant spitting. Smokeless tobacco users risk hurting their social lives with this habit. Even worse, their appearance could be permanently altered with surgery for oral cancer.
Danger Signals for Users
Anyone who uses smokeless tobacco (or has used it in the past), should check regularly for early signs of oral cancer:
- A sore in the mouth that bleeds and doesn't heal
- A lump or red or white patch that doesn't go away
- A lump or thickening anywhere in the mouth or neck
- Difficulty chewing, swallowing, or moving the tongue or the jaw
- Feeling that something is in the throat
Tobacco users should be vigilant about seeing their dentist every few months to have their mouth checked for oral cancer. The earlier the cancer is detected, the greater the chance for curing it.
It may be difficult to quit using smokeless tobacco, but many people succeed at it. If you want to quit, here are some tips that can help:
- Think of all the reasons you want to quit. You may want a healthy lifestyle. You don't want cancer, bad breath, or stained teeth. Maybe you're concerned about how the habit may be offensive to others.
- Look for support from others. Join a support group or tobacco cessation class. Ask your friends, family, teachers, and healthcare providers for encouragement and support.
- Pick a quit date. Put it on your calendar, and tell your plans to supportive others. Throw out all your chewing tobacco and snuff.
- Don't give up! If you've failed before, remember that it often takes several tries to give up tobacco.
- Seek advice. Ask your doctor about nicotine chewing gum and cessation programs.
- Find alternatives to smokeless tobacco. Try sugar-free gum or low calorie snacks such as popcorn, vegetables, and fruit.
- Stay busy. Hobbies and other activities can help you keep your mind off chewing. Exercise to relieve tension, listen to music, talk to friends, or do some research on your computer.
- Reward yourself. Give yourself positive reinforcement every day, if necessary. With the money you'll be saving, you could treat yourself to a movie or buy something nice.
- Develop a plan that works for you. Everyone is different, and what works for someone else may not work for you. Experiment and see what does and doesn't work. Above all, set realistic goals and don't give up because of a setback or two.
National Institute on Drug Abuse
Healthy Living Unit (Public Health Canada)
Fiore MC, Jaen CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008.
Last reviewed May 2009 by ]]>Janet H. Greenhut, MD, MPH ]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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