Primer: Smokeless Tobacco

Many people think using smokeless tobacco is safer than smoking. Just because there's no smoke, doesn't mean it's safe, the American Cancer Society (ACS) says.

A person who uses eight to 10 dips or chews a day receives the same amount of nicotine as a heavy smoker who smokes 30 to 40 cigarettes a day.

Spit tobacco is placed inside the mouth, which gives the user a continuous high from the nicotine. It's made with a mixture of tobacco, nicotine, sweeteners, abrasives, salts and chemicals. It contains more than 3,000 chemicals, including 28 known carcinogens.

The most harmful carcinogens in smokeless tobacco are substances called tobacco-specific nitrosamines (TSNAs), the National Cancer Institute (NCI) says. TSNAs are formed during the growing, curing, fermenting and aging of tobacco. The amount of these substances in smokeless tobacco can be much higher than the amounts of other types of nitrosamines that are allowed in foods, such as bacon and beer.

Other chemicals

These are some of the other harmful chemicals in smokeless tobacco:

• Polonium 210 (a rare, naturally occurring element; some polonium 210 comes from radioactive fallout)

• Lead 210 (a radioactive isotope of lead)

• Cadmium (used in rechargeable nickel-cadmium batteries)

• Cyanide

• Arsenic

• Polycyclic aromatic hydrocarbons (PAHs)

• Benzene

• Lead

Spit tobacco is sold in three forms:

1. Chew: a leafy form of tobacco sold in pouches. Users keep the chew between the cheek and gums for several hours at a time.

2. Plug: chew tobacco that has been pressed into a brick.

3. Snuff: a powdered, moist form of tobacco sold in tins. Users put the snuff between the lower lip or cheek and the gum; people also sniff it. Using snuff also is called "dipping."

Health effects

Smokeless tobacco, like cigarettes and other forms of tobacco, is addictive. The nicotine in tobacco is what causes the addiction. A person using smokeless tobacco gets three to four times the amount of nicotine as that in a cigarette, the NCI says. The nicotine in smokeless tobacco is absorbed more slowly than in smoking, but it remains in the body longer.

Like cigarettes, smokeless tobacco affects the cardiovascular system and can cause heart disease, stroke, high blood pressure and cancer of the lip, tongue, cheek, throat, stomach, esophagus and bladder, the ACS says.

Other effects include cracking and bleeding lips and gums, precancerous mouth sores called oral leukoplakia, tooth abrasion, gum recession, gum and tooth disease, loss of teeth and bone in the jaw and chronic bad breath.

Each year, nearly 8,000 Americans die of mouth cancer, according to the Centers for Disease Control and Prevention (CDC), and only about half the people with diagnosed mouth or throat cancer survive more than five years.

Who chews

As many as 13.6 percent of high school boys and 2.2 percent of high school girls use smokeless tobacco, according to the CDC. Young adults ages 18 to 25 are the biggest users of smokeless tobacco.

How to quit

Quitting smokeless tobacco is difficult but it can be done. To break the habit:

• Ask your doctor if you should use nicotine gum or a patch and where you can get support in your effort to quit.

• Try using substitutes, such as tobacco-free mint-leaf snuff, sugarless gum, hard candy, beef jerky, sunflower seeds, shredded coconut, raisins or dried fruit.

• Make a list of all the reasons you want to quit; keep it with you and look at it often.

• Get involved in healthier activities, such as lifting weights, shooting baskets or going for a swim.