Smokeless Tobacco

Many people think that smokeless tobacco is a safer alternative to cigarettes. But, smokeless tobacco carries serious risks of its own.

Smokeless tobacco is also known as dip, chew, chaw, and plug. It comes in three forms:

• Snuff. Snuff is finely-chopped tobacco that looks a little like damp tea leaves. It's usually sold in small containers called tins. Users pick up a small "pinch," place it between the cheek and gum, and let it sit there.
• Chewing tobacco. Chewing tobacco is sold as shreds, twists, or blocks of tobacco leaves. It may be placed between the cheek and gum, chewed, or sucked.
• Betel nut or "quid." Betel nut is popular in some parts of India and Asia. It's actually made from the nut of the areca palm tree, combined with flavoring and sometimes other ingredients, including tobacco. Betel nut may be sucked or chewed like gum.

Most users of smokeless tobacco spit out the strong-tasting juices, although "spit-free" forms are available.

Smokeless tobacco is addictive, just like smoking. It's the same substance, nicotine, that causes the addiction in both cases. And, just like with cigarettes, using snuff or chew can become a habit that's as hard to kick as the physical addiction. Once someone has been using these products for a while, going without them can lead to withdrawal symptoms including irritability, depression, and strong cravings for tobacco.

Most people know that cigarettes can cause lung cancer. Since smokeless tobacco isn't inhaled, users often think that it's safe. Unfortunately, it has many of the same risks as cigarettes and several of its own. They include mouth and throat cancer, cavities and gum disease, heart problems, and other unpleasant side effects.

Cancer can develop in the lips, cheeks, gums, tongue, or throat. Curing it may require removal of parts of the jaw and mouth, including the tongue. People who have had mouth cancer may be terribly disfigured and unable to speak normally. Throat cancer can destroy a person's larynx (voice box) so that they can not speak at all without a special machine. Throat cancer can leave a person with a permanent tracheotomy, a hole in the neck through which the person breathes.

Even if a user escapes cancer, he/she is at risk for tooth decay and gum disease. Chewing tobacco and snuff are irritating to gums and can scratch teeth, letting in the bacteria that cause decay. They may also contain sugar, which leads to cavities. These same irritants can cause the gums to separate from the teeth, eventually leading to tooth loss.

Smokeless tobacco raises heart rate and blood pressure, and appears to raise the risk of heart attack. Also, users have higher cholesterol levels than non-users.

Along with very serious health risks, chewing tobacco or using snuff can have other unattractive effects. For example:

• Bad breath. Not everyone appreciates the odor of tobacco. And, the gum disease it causes can also contribute to bad breath.
• Spitting. Most users spit out the tobacco juices and tobacco-loaded saliva. That means having a cup handy at all times, or spitting on the ground. Neither one is particularly attractive!
• Stained teeth. Tobacco can cause yellow or brownish stains.
• Mouth sores. Tobacco can cause ugly white or red sores and bumps on the gums and inside the cheeks. It's possible for these sores to turn into cancer. Even if they don't, they're unpleasant to look at.

If you're a user of smokeless tobacco, one of the best things you can do for yourself is quit. Once you've decided you're done with tobacco, here are some things that can help you kick the habit:

• Set a date to quit. Don't say you'll do it "soon," or next week. Pick a specific day to quit. Mark it on your calendar.
• Tell people. Enlist the help of friends and family. Warn them that you might be irritable for a while, while you're going through withdrawal. Ask them to help you avoid tobacco.
• Think about your "triggers." Most people have certain times or places when they're more likely to use tobacco. Be aware of those times and think about what you can do instead of reaching for some dip.
• Consider getting help. Nicotine replacements, like patches, lozenges, and gum, can help ease the symptoms or withdrawal. A prescription medicine called bupropion (brand name Wellbutrin or Zyban) actually eases cravings in some people, making it easier to quit. Talk to your doctor about other options.

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