Smokeless Is Not Harmless: The Truth About Smokeless Tobacco

Glamorized by major league baseball players for decades, and most recently by NASCAR drivers, the use of smokeless tobacco is increasing among young men and teen-age boys, many of whom have been misled to believe that smokeless tobacco is harmless. Nothing could be further from the truth.

All forms of tobacco contain nicotine and are addictive. Available as a leaf, plug or snuff, smokeless tobacco is usually placed between the cheek and the gum and sucked or chewed to release nicotine. There it is absorbed through the oral mucous membranes into the bloodstream and to the brain where the psychoactive effects (the buzz) occur.

Who uses smokeless tobacco?

About 6 million people in the United States currently use smokeless tobacco, compared to about 47 million Americans who smoke cigarettes. Ninety-two percent of users are young men and teen-age boys. Specifically, 4.2 percent of middle school boys and 11.6 percent of high school boys currently use smokeless tobacco. While cigarette use is much higher—9.6 percent for middle school boys and 28.7 percent for high school boys, the rate of smokeless tobacco use by teens is worrisome because the median age for first use of smokeless tobacco is 12, two years younger than the median age for cigarette use.

Medical risks

There are about 28,000 new cases of oral cancer diagnosed each year, and nearly all of the cases are associated with the use of smokeless tobacco. One-third of those diagnosed with oral cancer will die.

Between half and three-quarters of daily smokeless tobacco users have noncancerous and precancerous lesions called leukoplakia in their mouth or throat. These lesions can be seen in users after only a short period of use. The American Academy of Otolaryngology has identified the early warning signs of oral cancer. They are:

• a sore in your mouth that bleeds easily and doesn't heal
• a lump or thickening anywhere in the mouth or neck
• any soreness or swelling in your mouth that doesn't go away
• a red or white patch in your mouth that doesn't go away
• difficulty chewing, swallowing or moving your tongue or jaw

Not sexy

Aside from the medical risks, men frequently report that their wives and girlfriends are “grossed out” by the smell, taste and poor dental hygiene associated with smokeless tobacco use. Accordingly, many men are motivated to seek help not because of the medical risks, but rather because of the disgust and consequent lack of physical affection from their wives or girlfriends. Bad breath, spitting and drooling, and permanent staining of tooth enamel are all caused by smokeless tobacco.

Quitting isn’t easy—but it’s worth it

Quitting smokeless tobacco is as difficult as quitting cigarettes, and the success rate is about the same—approximately 10 percent or 12 percent over the long haul. Because smokeless tobacco users show warning signs such as lesions in their mouth, they are sometimes easier to motivate than cigarette smokers.

The good news is that people who quit using tobacco products, regardless of age, live longer and healthier than people who continue their use. For example, those who quit before age 50 cut the risk of dying in the next 15 years by 50 percent compared with those who don’t quit.

Sources: Rodu, B., Smokeless tobacco and oral cancer: A review of the risks and determinants. (2004) Critical Review Oral Biological Med . 15(5):252-63; Ebbert J.O, Carr A.B, Dale L.C., Smokeless tobacco: An emerging addiction. (2004 ) Med Clin North Am . 88(6):1593-605.

By Drew Edwards, EdD, MS
© 2005 Achieve Solutions