Questions About Smoking, Tobacco, and Health

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Are spit tobacco and snuff safe alternatives to smoking?

Many terms are used to describe tobacco that’s 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’s less lethal than smoking tobacco, but less lethal is a far cry from safe.

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.

For more details, 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’s often flavored with spices or fruit, and is usually packaged like small tea bags. It’s 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’s steam-heated rather than fermented, Swedish snus has fewer tobacco-specific nitrosamines (TSNAs) that are known to cause cancer (see above). In the US, snus is not labeled as to processing or TSNA content. The TSNA levels in US brands have been tested and they vary by region of the country and over time, as formulas change. The type of snus made in Sweden may cause less cancer than other snuff, but that still doesn’t mean snus is safe. This is especially true in the US, where the TSNA levels are unknown.

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.

You can learn more about snus in Smokeless Tobacco.

Last Medical Review: 02/13/2014
Last Revised: 02/13/2014