Chapter Five
Why Quit? 3
Smokeless Tobacco
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What about snuff and chewing tobacco? They are often thought to be good substitutes for cigarette and pipe smoking. But medical facts reveal they are just as bad.

In the U.S., there are four primary types of smokeless tobacco. The first three are chewing or dip tobaccos: loose leaf (scrap tobacco), plug, and twist or roll. The fourth is oral snuff.

Dip is made up of dark, moist tobacco leaves which the user places between the cheek and gums. Snuff is dry, powdered tobacco plant material which users inhale through the nose.

Loose leaf has 52% of the U.S. smokeless tobacco market, plug is 7.2%, Twist or roll is only 1.1%. Oral snuff is being increasing used and accounts for 39.0% (USDA report, 1990).

To date, 28 carcinogens have been identified in smokeless tobacco. Of these, the major cancercausing factor is Nnitrosamines, only found in tobacco. This chemical is formed from Nicotiana alkaloids during tobacco processing. 
Smokeless tobacco produces cancers of the lip, tongue, floor of the mouth, gingiva, buccal mucosa, hard palate, and oropharynx (upper throat). Any one of these is a miserable way to die.

Wake Forest University Medical Center conducted a study of 150 patients who had oral cavity cancer. Of these, 116 used only smokeless tobacco and had never smoked cigarettes or pipes; so their cancers could not be blamed on smoking (L. V. Ackerman, "Verrucous carcinoma of the oral cavity," Surgery, 23:670678, 1948).
In chewing tobacco, the highest risk area was where the quid (the plug) was held, but all areas bathed by saliva containing the carcinogenic agents that leach from the tobacco were also in high risk. It did not matter what form of chewing tobacco was used.

The researchers noted that the cancer tended to develop slowly and be little noticed until the lesion was so advanced that there was little hope of a cure. For chewers, the best that the physicians knew to do was to cut out parts of the mouth or throat and hope for the best. For snuff users, they cut out most of the nose and perhaps the throat. Welcome to cancer country; smokeless tobacco is part of it. 
The researchers concluded, "Prevention though education of young potential users of smokeless tobacco promises to be the most effective therapeutic measure." That is understandable because a miserable, later death is the only other alternative.
What about snuff, also called oral snuff or snuff dipping? This is a powdered product. It is said to be safer than smoking, a good way to quit the use of cigarettes and pipes.

But on May 5, 2000, BBC News reported that Dr. John Spangler told a medical conference, in Orlando, that a research study found that taking snuff produced significantly high levels of cancer, both of the oral and nasal cavities.

Cigarette and pipe smokers also have oral cavity cancers, with pipe smokers especially at risk for cancer of the cheek and lower lip.

An April 1998 Amherst College report, by Ned B. Friend, noted that "snuff composition is generally 0.6% to 0.9% nicotine, the most addictive drug on the market." He added, "Both dip and snuff contain many added chemicals, including cyanide, arsenic and lead. Because of its high nicotine content, smokeless tobacco is highly addictive. Its harmful effects, like cancer, do not show up until long after the initial use of the drug."

There are more problems than cancer in these products: The use of snuff decreases the sense of smell and damages the inside of the nose, along with the throat and lungs.

Aside from long term problems, such as cancer and heart disease, there are also others that come more quickly: Dipping produces brown teeth and bad breath, decreases the sense of taste, causes dental problems and the gums to recede. Both add nicotine to the bloodstream, causing the blood vessels to constrict, which inhibits sports performance in young men and later leads to heart attacks. Users of both are 15 times more likely than nonusers to develop cancer after only one year of use.

Throughout the remainder of this book, we will assume you smoke. But all the methods for quitting apply equally to smokeless tobacco.

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