The Dangers of Smokeless Tobacco

Man pulls chewing tobacco from can

Aaron Black / Getty Images

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 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.


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:

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.

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 rests
  • Leukoplakia, a condition characterized by benign or precancerous lesions on the tongue or inside of the cheeks
  • Tooth 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.

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.

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:

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.


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.

  • 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.
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  4. American Cancer Society. Why People Start Smoking and Why It’s Hard to Stop.

  5. American Cancer Society. Health Risks of Smokeless Tobacco.

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  7. Rostron BL, Chang JT, Anic GM, Tanwar M, Chang CM, Corey CG. Smokeless tobacco use and circulatory disease risk: a systematic review and meta-analysisOpen Heart. 2018;5(2):e000846. doi:10.1136/openhrt-2018-000846

  8. 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

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By Terry Martin
Terry Martin quit smoking after 26 years and is now an advocate for those seeking freedom from nicotine addiction.