Tobacco: No Healthy Alternative

When it comes to tobacco use, there is no such thing as ‘safe’

smokeless tobacco

Nine million Americans use smokeless tobacco.  Users are often under the impression that smokeless tobacco is “safer” than inhaled alternatives.  The truth is, there are 28 cancer-causing toxins in smokeless products.

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What is it, and what are its effects?

Smokeless tobacco is not burned.  Most people chew or suck the tobacco in their mouth and spit the juices that accumulate in saliva.   

Chewing tobacco, twisted rope, and snuff, powdered tobacco, are the most common forms.

“Because users set the chewing tobacco in the same place of their mouth every time, that’s where we’ll typically find visual signs of tobacco use,” says Brian Burkey, MD, and specialist for head & neck surgery and oncology.

“The best way to avoid oral cancer as a result of smokeless tobacco is to never use it,” Dr. Burkey says, “but if you notice sores or bleeding on the cheek or gums, that’s when you know you have a problem.”

Research shows a link from specific ingredients in smokeless tobacco to oral cancer.  According to the U.S. National Cancer Institute, the culprit is a nitrosamine compound, or cancer-causing agent, known as (S)-NNN.  Nitrosamines are found in all tobacco products, but smokeless tobacco has very high levels.

Absorbing cancer-causing toxins into oral tissues and blood stream from the use of smokeless tobacco is proven to result in mouth, tongue, throat and esophageal cancer, but that’s not all.

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“In addition to the increased oral cancer risk, it can irritate and destroy gum tissue,” says Todd Coy, DMD, a dentistry specialist at Cleveland Clinic.  “Regular smokeless tobacco users risk tooth decay, gum disease, and bone loss.  In severe cases it can result in tooth loss.”

What is the appeal?

Smokeless tobacco, less lethal than cigarettes, still presents deadly consequences.  Advertisers promote smokeless products as “safe.”

Smokers often try to quit by turning to chewing tobacco for a nicotine fix.  What most people don’t know is that an average dose of nicotine in smokeless tobacco is 3.6–4.5 mg, compared to 1–2 mg for cigarettes.

“All forms of tobacco contain nicotine,” Dr. Burkey says.  “Because of the pleasant feelings nicotine provides tobacco users, those addicted tend to use more, decreasing the likelihood that the person will quit altogether.”

Emerging tobacco is still tobacco

Emerging products in the U.S., including snus (dissolvable tobacco), electronic nicotine delivery systems (“e-cigs”), and waterpipes (hookah), continue to gain popularity in group social settings.

These options are promoted as safe and permissible alternatives to real tobacco.  Dissolvable options eliminate spitting, and e-cigs are acceptable in most settings.  Sounds like a healthy option, right?

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Wrong.  Twenty-first century smoking substitutes will do more harm than good.  Research in the Journal of Environmental and Public Health shows that the use of snus, e-cigs and hookah can have negative effects on individuals who have never used tobacco in their life.

“These types of products lure individuals into using real tobacco,” Dr. Burkey says.

Once someone uses these products on a regular basis and they’re exposed to nicotine, they’re more likely to begin – or continue – smoking.

“It’s a slippery slope,” Dr. Burkey says.  “Your best option is to abstain completely, and your doctors can provide help in getting there.”