Addiction Nicotine Use Important Facts About 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 05, 2020 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 Harmful Chemicals Addictive Health Consequences Dangerous Alternative to Cigarettes Smokeless Tobacco as a Quit Aid Nicotine Replacement Therapies All Tobacco Products Carry Risks Cessation Resources Smokeless tobacco, also known as chew, snuff, spit tobacco, plug, chewing tobacco, chaw, dip, and other names, describes a variety of tobacco products that are not smoked by the consumer. Instead, this type of tobacco is 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 is sold in cans or pouches, as both leaf tobacco that is moist or as plugs or bricks. It can be dry or moist. Dry smokeless tobacco is called snuff and is usually sold in a can. These products carry a number of health hazards for consumers. Harmful Chemicals Smokeless tobacco is known to contain 28 carcinogens, including very high levels of tobacco-specific nitrosamines (TSNAs). TSNAs are known to be some of the most potent carcinogens present in chewing tobacco, snuff and tobacco smoke. Other cancer-causing substances in smokeless tobacco are known to 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 possibly increase their risk of oral cancer by up to 27 times as compared to those who do not use these products. This includes cancer of the lip, tongue, cheek, roof, and floor of the mouth, as well as cancer of the larynx. Smokeless tobacco users also face an increased risk of pancreatic cancer. Addictive Dip and chewing tobacco contain more nicotine than commercially manufactured cigarettes. The amount of nicotine varies by type of smokeless tobacco and brand. However, in the long run, blood levels of nicotine are about the same for users of smokeless tobacco and cigarette smokers. 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. How to Quit Smoking for Good Health Consequences 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 Research published in 2018 found that people who use smokeless tobacco have a higher risk of cardiovascular disease and stroke compared non-users. Dangerous Alternative to Cigarettes Smokeless tobacco is less deadly than cigarette smoking—there is no disputing that. With approximately 7000 chemical compounds in cigarette smoke, hundreds of which are known to be poisonous, and dozens that are carcinogenic, smoking is by far the most hazardous form of tobacco use on the planet today. That said, smokeless tobacco poses serious risks to the user that do not make this class of tobacco product a safe alternative to smoking. Cigarette smoking is part addiction to nicotine and part habit, born out of many years of associating smoking with every activity we have in our daily lives. Smokers who switch to smokeless tobacco are still addicted to nicotine and still link tobacco to the activities in their lives. Because of this, the risk of a smoking relapse is substantial. Smokeless Tobacco as a Quit Aid All tobacco products carry the risk of disease and addiction, and as such are not good choices as quit aids. Using harm reduction as a fix for smoking can also be disempowering. While a person might think of the switch as a proactive move to improve one's health, they are also telling themselves—usually on a subconscious level—that they are not strong enough to quit using tobacco altogether. And to make matters worse, this justification can become a pacifier, causing the user to put quitting tobacco on the back burner indefinitely. We all have what it takes to beat nicotine addiction successfully. With the right tools at hand to help us change our relationship with nicotine, freedom is within reach of every person who wants it. Quit Aids Can Help You Stop Smoking Nicotine Replacement Therapies Nicotine replacement therapies (NRTs), which contain nicotine but none of the other hazardous chemicals present in tobacco products, are a better choice as a nicotine-based quit aid. NRTs are not without risk. Because these products, which include the nicotine patch, gum, nasal spray, inhaler and nicotine lozenges contain nicotine, they all carry the danger of addiction themselves. That doesn't mean one shouldn't use NRTs, but it does mean that package directions should be followed carefully and that ex-smokers wean themselves off of the products in the time recommended. All Tobacco Products Carry Risks Some forms of tobacco are more hazardous than others, but all tobacco products carry risks to the user that include addiction and potentially deadly health issues. We all deserve freedom from nicotine addiction. Imagine a life that is free of the need to use a drug multiple times a day, day-in and day-out. If you smoke or use any type of tobacco product, you can quit, and you do have what it takes to do it within you right now. How You Can Survive Nicotine Withdrawal Cessation Resources Learn what you can expect when you quit smoking and how to minimize the discomforts associated with nicotine withdrawal. Smokeless tobacco products carry a number of risks and are not a good alternative to smoking. Use the quit smoking resources to help you tap into your own inner strength and resolve to quit smoking. The work it takes to claim your freedom is small indeed when compared to the benefits you'll enjoy, from improved health to the boost of confidence you'll get from overcoming nicotine addiction. How to Quit Smoking for Good Was this page helpful? Thanks for your feedback! So you're ready to finally quit smoking? Our free guide can help you get on the right track. Sign up and get yours today. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 10 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 American Cancer Society. Why People Start Smoking and Why It’s Hard to Stop. 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 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 American Cancer Society. Health Risks of Smokeless Tobacco. National Institute on Drug Abuse. Is nicotine addictive?. 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. Get Treatment for Addiction Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.