By now, most of us
know that smoking cigarettes isn't healthy: The smoke you inhale contains toxic
compounds that increase your risk of lung cancer. But what about smokeless
tobacco? Is that "little pinch" really going to hurt you?
Yes. "Smokeless tobacco is not a safe alternative to smoking," says
David Albert, D.D.S., M.P.H., an associate professor of clinical dentistry
at Columbia University College of Dental Medicine. "Smokeless tobacco
greatly increases your risk for cancer of the mouth," Dr. Albert says. "It
causes periodontal disease and cavities. Because smokeless tobacco contains
abrasives, your teeth will wear away faster than the teeth of somebody who
does not use smokeless tobacco products. In addition, stains and bad breath
are always associated with its use"
In the United States, about 4% of men and less than 1% of women use smokeless
tobacco. The rate varies by state. For example, 18.4% of men in West Virginia
use smokeless tobacco, but only 2.6% of men in Arizona use it.
Rates of smokeless tobacco use among U.S. adults are highest in young men,
American Indians, and people who live in the South or in rural areas.
Overall, about 22 million Americans use smokeless tobacco, which comes in
three basic forms: chew, snuff and plug. Chew, or chewing tobacco, consists
of shredded tobacco leaves. Snuff is loose, ground tobacco leaves. A plug is
a firm compressed chunk of ground tobacco leaves. Sugar, salts or flavorings
sometimes are added to improve the taste.
Just like cigarettes, smokeless tobacco contains chemicals. But unlike cigarettes,
smokeless tobacco is in direct contact with the tissues in your mouth. This
may make smokeless tobacco even more addictive than cigarettes, because nicotine
— the addictive substance in tobacco — enters your bloodstream faster. Holding
smokeless tobacco in your mouth for 30 minutes exposes you to the same amount
of nicotine as smoking four cigarettes.
Using smokeless tobacco heavily or for a long time dramatically increases
your risk of developing oral cancer. "Oral cancer is a major concern with
smokeless tobacco use," says Dr. Albert. "Treatment of oral cancer
can result in disfigurement of the mouth and jaws. I advise patients not to
use tobacco products in any form."
As little as one year of use can cause a white patch to develop in your mouth.
These patches should be tested because they may contain cancer cells. Don't
wait for symptoms before you visit your doctor: Until it spreads, oral cancer
causes no symptoms.
Using smokeless tobacco can cause other problems:
- Smokeless tobacco is a breeding ground for bacteria, collects food and
other debris, and sits in your mouth for hours at a time. It is also sweetened
to improve the flavor. The result? Tooth decay.
- Using smokeless tobacco has been associated with receding gums and periodontal
disease.
- The area where the tobacco sits can become unusually dry, which increases
your risk of tooth decay.
- Using smokeless tobacco can reduce your senses of taste and smell, and
can contribute to bad breath and discolored teeth.
- You are more likely to get a coating of bacteria and debris on your tongue
if you use smokeless tobacco. An advanced stage of this condition is called
black hairy tongue. Your risk of these conditions decreases if you practice
good oral-hygiene habits.
