Many terms are used to describe tobacco that is put in the mouth, such as spit, oral, smokeless, chewing, and snuff tobacco. Using any kind of spit or smokeless tobacco is a major health risk. It is less lethal than smoking cigarettes, but less lethal is a far cry from safe.

The amount of nicotine absorbed is usually more than the amount delivered by a cigarette. Overall, people who dip or chew get about the same amount of nicotine as regular smokers. The most harmful cancer-causing substances in spit tobacco are tobacco-specific nitrosamines (TSNAs) which have been found at levels 100 times higher than the nitrosamines that are allowed in bacon, beer, and other foods. These carcinogens cause lung cancer in lab animals, even when injected rather than inhaled.

The juice from smokeless tobacco is absorbed directly through the lining of the mouth. This causes sores and white patches (called leukoplakia) that often lead to cancer of the mouth.

People who use spit and other types of smokeless tobacco greatly increase their risk of other cancers, including those of the mouth, pharynx (throat), esophagus (the swallowing tube that connects the mouth and the stomach), stomach, and pancreas. Other effects of using spit tobacco include chronic bad breath, stained teeth and fillings, gum disease, tooth decay, tooth loss, tooth abrasion, and loss of bone in the jaw. Users may also have problems with high blood pressure and may be at increased risk for heart disease.

To learn more, please read our document called Smokeless Tobacco.

What is snus? Is it safe?

Snus (sounds like “snoose”) is a type of moist snuff first used in Sweden. It is often flavored with spices or fruit, and is usually packaged like small tea bags. It is also sold loose, as a moist powder. Like snuff and other spit tobaccos, snus is held between the gum and mouth tissues where the juice is absorbed into the body.

Because it is steam-heated rather than fermented, Swedish snus has fewer tobacco-specific nitrosamines that are known to cause cancer. (See the previous section, “Are spit tobacco and snuff safe alternatives to cigarette smoking?”)

Snus users in Sweden have lower rates of some types of cancer than Swedish smokers. Because of this, some people believe snus is safe. But snus users may have a higher risk of cancer of the pancreas than non-users. They also get sores or spots in the mouth (lesions) where the snus is held. It appears that snus users may have mouth cancer more often than non-users, though more studies need to be done to confirm this.

Since US tobacco sellers are not required to list what is in their products, it would be hard to know how the US versions of snus might compare to the Swedish versions without doing studies here. Since snus is still new in the United States, it is uncertain what other problems it might cause. Still, snus is not a safe alternative to smoking.