Smokeless Tobacco

You don't smoke it. You don't swallow it. All you do is slosh it around your mouth and spit out the brown juices every few seconds. So smokeless tobacco must be better than smoking, right?

Unfortunately, no. Smokeless doesn't mean harmless. Chewing tobacco can cause cancer and other problems, just like smoking cigarettes. There's no such thing as a "safe" tobacco product.

What Is Smokeless Tobacco?

Smokeless tobacco is also called spit tobacco, chewing tobacco, chew, chaw, dip, plug, and probably a few other things. It comes in two forms: snuff and chewing tobacco.

Snuff is a fine-grain tobacco that often comes in teabag-like pouches; users "pinch" or "dip" it between their lower lip and gum. Chewing tobacco comes in shredded, twisted, or "bricked" tobacco leaves; users put it between their cheek and gum.

Whether it's snuff or chewing tobacco, you're supposed to let it sit in your mouth and suck on the tobacco juices, spitting often to get rid of the saliva that builds up. This sucking and chewing allows to be absorbed into the bloodstream through the tissues in your mouth. You don't even need to swallow.

Why Do People Do It?

Smokeless tobacco has been around for a long time. Native people of North and South America chewed tobacco. Snorting and chewing snuff was popular in Europe and Scandinavia (the word "snuff" comes from the Scandinavian word "snus").

In the United States, chewing tobacco has long been associated with baseball. Players chewed it to keep their mouths moist, spit it into their gloves to soften them up, and used it to make a "spitball," a special pitch that involved dabbing the ball with saliva so it spun off the pitcher's fingers easily, causing the ball to break sharply. (Spitballs were banned from the sport in 1920.)

By the 1950s, chewing tobacco had fallen out of favor in most of America and not too many baseball players were spitting big brown gobs all over the infield. Instead of chewing their tobacco, most people were smoking it.

In the 1970s people became more aware of the dangers of smoking. Thinking it was a safe alternative to lighting up, baseball players started chewing their tobacco again. Some players even developed the habit of mixing their chewing tobacco with bubblegum and chewing the whole thing.

These days, you don't see lots of professional ballplayers with wads of chaw in their cheeks. But plenty of people, athletes or not, still chew and spit.

Who Chews?

About 1 in 5 high school guys and a small number of high school girls use smokeless tobacco.

Peer pressure is just one of the reasons for starting the habit. After you start, the addictive quality of nicotine kicks in: With each use, you need a little more of the drug to get the same feeling. So serious users often switch to stronger brands.

What's the Danger?

Just like smoking cigarettes, chewing smokeless tobacco can eventually kill you — but not before causing some nasty changes in your body.

Take outfielder Bill Tuttle, for example. A lot of Tuttle's baseball cards pictured him with a cheek bulging with chewing tobacco. Thirty-eight years after the end of his baseball career, Tuttle had a more ominous bulge in his cheek — a tumor so big that it came through his cheek and extended through his skin. Doctors removed the tumor, along with much of Tuttle's face. Chewing tobacco as a young man had cost him his jawbone, his right cheekbone, a lot of his teeth and gumline, and his taste buds. Cancer finally took Tuttle's life in 1998. He spent his last years trying to steer people away from smokeless tobacco.

Other baseball players have met a similar fate. Even Babe Ruth was fond of dipping and chewing tobacco. He died at age 52 of an oropharyngeal tumor, which is a cancerous tumor in the back part of the throat. In 2014, Hall of Famer Tony Gwynn, a longtime smokeless tobacco user, died of mouth and salivary gland cancer.

It isn't just baseball players who regret chewing tobacco. Each year about 30,000 Americans learn they have mouth and throat cancers. Nearly 8,000 die of these diseases. Sadly, only about half of people with diagnosed mouth or throat cancer survive more than 5 years.

What Can Chewing Tobacco Do to Me?

Chewing can cause bad breath and yellowish-brown stains on your teeth. You'll also get mouth sores — nearly three quarters of spit tobacco users have them.

It gets a lot more serious, though. Chewing and spitting tobacco can cause:

  • cracking and bleeding lips and gums
  • receding gums, which can eventually make the teeth fall out
  • increased heart rate, high blood pressure, and irregular heartbeats, all leading to a greater risk of heart attacks and brain damage (from a stroke)
  • cancer

Cancer of the mouth (oral cancer) can happen in the lips, the tongue, the floor of the mouth, the roof of the mouth, the cheeks, or gums.

Cancer from chewing tobacco doesn't just happen in the mouth. Some of the cancer-causing agents in the tobacco can get into the lining of your stomach, your , and your .

Quitting the Dipping

If you're a dipper, think about quitting. When you decide to quit, tell friends or family so you have people around to support you.

Try these tips for breaking the habit:

  • Use nicotine gum or a patch (ask your doctor about these options first).
  • Use substitutes such as tobacco-free, mint-leaf snuff; sugarless gum; hard candy; beef jerky; sunflower seeds; shredded coconut; raisins; or dried fruit.
  • Distract yourself with healthier activities: lifting weights, shooting baskets, going for a swim, etc.

It's tough to quit. Backsliding is common, so don't give up trying. Your chances of success increase with each try!

Reviewed by: Steven Dowshen, MD
Date reviewed: June 2014