Addiction Nicotine Use The Dangers of Smokeless Tobacco By Terry Martin Terry Martin Facebook Twitter Terry Martin quit smoking after 26 years and is now an advocate for those seeking freedom from nicotine addiction. Learn about our editorial process Updated on July 04, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Armeen Poor, MD Medically reviewed by Armeen Poor, MD Armeen Poor, MD, is a board-certified pulmonologist and intensivist. He specializes in pulmonary health, critical care, and sleep medicine. Learn about our Medical Review Board Print Aaron Black / Getty Images Table of Contents View All Table of Contents Smokeless Tobacco Products Harmful Chemicals Smokeless Tobacco vs. Cigarettes Health Risks Smokeless Tobacco as a Quit Aid Nicotine Replacement Therapies Cessation Resources Smokeless tobacco, also known as chew, snuff, spit tobacco, plug, chewing tobacco, chaw, dip, and other names, describes tobacco products that are not smoked. Instead, it's usually placed in the mouth between the cheek or lower lip and the gums, where it mixes with saliva and releases juices that contain nicotine. The nicotine is then absorbed through the tissues in the mouth. Smokeless Tobacco Products Smokeless tobacco is sold in cans and pouches as leaves, plugs, or bricks. It can be dry or moist, and spit or swallowed. Contrary to what many people believe, these products carry health hazards for consumers. Chewing Tobacco Chewing tobacco is available as loose, braided, or compressed leaves that are sometimes flavored. A user puts a bit between the cheek and gum, and spits out the saliva that collects. Snuff Snuff is tobacco that's been ground, sometimes flavored, and packaged. A user puts some behind the lip or between the cheek and gum, and then spits out the saliva. It's available in moist and dry forms. When dry, it can be snorted. Dissolvables Dissolvable tobacco products are made of powdered tobacco compressed into tablets, strips, sticks, and other shapes, some of which look and taste like candy. Harmful Chemicals Smokeless tobacco contains 28 carcinogens, including very high levels of tobacco-specific nitrosamines (TSNAs). TSNAs are some of the most potent carcinogens in chewing tobacco, snuff, and tobacco smoke. Other cancer-causing substances in smokeless tobacco include: Formaldehyde Arsenic Cadmium Radioactive polonium-210 Smokeless Tobacco Products Cause Cancer According to a study published in 2018, people who use dip or chewing tobacco could increase their risk of oral cancer by up to 27 times over those who do not. This includes cancers of the lip, tongue, cheek, roof, larynx, and floor of the mouth. Smokeless tobacco users also face an increased risk of pancreatic cancer. Smokeless Tobacco vs. Cigarettes Cigarette smoking is part addiction to nicotine and part habit; when used according to package directions, the nicotine in smokeless tobacco is easily absorbed through the lining of the mouth in quantities sufficient to cause addiction. In fact, it actually contains more nicotine than commercially manufactured cigarettes. Blood levels of nicotine are about the same for smokeless tobacco users and cigarette smokers. Although smokeless tobacco risks are significant, it is less deadly than cigarette smoking. With approximately 7,000 chemical compounds in cigarette smoke, hundreds of which are poisonous and dozens that are carcinogenic, smoking is by far the most hazardous form of tobacco use on the planet today. An Overview of Quitting Smoking Health Risks Smokeless tobacco creates an unhealthy environment in the mouth that leads to a variety of nasty problems. In addition to brown-stained teeth and bad breath, users also face: Permanent gum recession and bone loss where the tobacco restsLeukoplakia, a condition characterized by benign or precancerous lesions on the tongue or inside of the cheeksTooth decay from the sugar used to enhance the flavor of smokeless tobacco The risks aren't limited to the mouth. Research published in 2018 found that people who use smokeless tobacco have a greater risk of cardiovascular disease and stroke compared to non-users. Smokeless Tobacco as a Quit Aid All tobacco products carry risks that include addiction and potentially deadly health issues, so they aren't good choices as quit aids. Using harm reduction as a fix for smoking also can be disempowering. Although you might think of the switch as a proactive move to improve your health, you're also telling yourself—usually on a subconscious level—that you're not strong enough to quit using tobacco altogether. This justification can become a pacifier, causing you to put quitting tobacco on the back burner indefinitely. Quit Aids Can Help You Stop Smoking Nicotine Replacement Therapies Nicotine replacement therapies (NRTs), which contain nicotine but none of the other hazardous chemicals in tobacco products, are a better choice as a nicotine-based quit aid. Smokers who switch to smokeless tobacco are still addicted to nicotine and link tobacco to their daily activities. Because of this, the risk of a smoking relapse is substantial. NRTs are not without risk, however. Because the nicotine patch, gum, nasal spray, inhaler, nicotine lozenges, and other forms contain nicotine, they all carry the danger of addiction themselves. That doesn't mean you shouldn't use NRTs, but you must follow package directions carefully and wean yourself off of the product in the time recommended. How You Can Survive Nicotine Withdrawal Cessation Resources Whether you want to quit cigarettes or smokeless forms of tobacco, the first step is to learn what to expect and how to minimize the discomforts associated with nicotine withdrawal. Then, explore all the treatment options in addition to NRTs. These include: Chantix (varenicline tartrate), a non-nicotine prescription medicine Hypnotherapy Natural therapies such as acupuncture Coping strategies such as the five Ds Psychotherapy An Overview of Quitting Smoking The work it takes to claim your freedom pales in comparison to the benefits you'll enjoy, such as improved health and the confidence boost of having overcome your nicotine addiction. 1-(800)-784-8669 Want help beating your nicotine addiction? Quitlines provide free coaching over the phone. Call 1-800-QUIT-NOW to speak confidentially with a highly trained quit coach. Frequently Asked Questions Is nicotine bad for you? Nicotine is just as addictive as heroin and cocaine. It carries health risks such as cancer, degenerative disk disease, heart disease, and more. Learn More: What to Know About Nicotine Use How long does smokeless tobacco stay in your system? Whether from smoking or using smokeless tobacco, cotinine—the substance your body produces when you consume nicotine—stays in your urine, blood, and saliva for up to four days, and in your hair for up to 90. Some insurance companies will classify you as a smoker if you use smokeless tobacco. Is dipping worse than smoking? Both routes of exposure increase your risk for health problems. In fact, people who use dip or chewing tobacco increase their risk of oral cancer by up to 27 times over nonusers. This includes cancers of the lip, tongue, cheek, roof, larynx, and floor of the mouth. Smokeless tobacco users also face an increased risk of pancreatic cancer. 9 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Hatsukami DK, Stepanov I, Severson H, et al. Evidence supporting product standards for carcinogens in smokeless tobacco products. Cancer Prev Res (Phila). 2015;8(1):20–26. doi:10.1158/1940-6207.CAPR-14-0250 Janbaz KH, Qadir MI, Basser HT, Bokhari TH, Ahmad B. Risk for oral cancer from smokeless tobacco. Contemp Oncol (Pozn). 2014;18(3):160–164. doi:10.5114/wo.2014.40524 Ebbert JO, Elrashidi MY, Stead LF. Interventions for smokeless tobacco use cessation. Cochrane Database Syst Rev. 2015;(10):CD004306. doi:10.1002/14651858.CD004306.pub5 American Cancer Society. Why People Start Smoking and Why It’s Hard to Stop. American Cancer Society. Health Risks of Smokeless Tobacco. Malhotra R, Kapoor A, Grover V, Kaushal S. Nicotine and periodontal tissues. J Indian Soc Periodontol. 2010;14(1):72–79. doi:10.4103/0972-124X.65442 Rostron BL, Chang JT, Anic GM, Tanwar M, Chang CM, Corey CG. Smokeless tobacco use and circulatory disease risk: a systematic review and meta-analysis. Open Heart. 2018;5(2):e000846. doi:10.1136/openhrt-2018-000846 Messer K, Vijayaraghavan M, White MM, et al. Cigarette smoking cessation attempts among current US smokers who also use smokeless tobacco. Addict Behav. 2015;51:113–119. doi:10.1016/j.addbeh.2015.06.045 Wadgave U, Nagesh L. Nicotine Replacement Therapy: An Overview. Int J Health Sci (Qassim). 2016;10(3):425–435. By Terry Martin Terry Martin quit smoking after 26 years and is now an advocate for those seeking freedom from nicotine addiction. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Get Treatment for Addiction Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.