Type of smokeless tobacco product
American Red Man loose leaf chewing tobacco and Danish pelletized Oliver Twist dip
Chewing tobacco is a type of smokeless tobacco product that is placed between the cheek and lower gum to draw out its flavor. It consists of coarsely chopped aged tobacco that is flavored and often sweetened; it is not ground fine like dipping tobacco . Unwanted juices are spat while chewing.
Chewing tobacco is a source of nicotine and therefore highly addictive .[ 1] Quitting chewing tobacco use is as challenging as smoking cessation .[ 2]
Using chewing tobacco can cause various harmful effects such as dental disease, oral cancer , oesophagus cancer , and pancreas cancer , coronary heart disease , as well as negative reproductive effects including stillbirth , premature birth and low birth weight .[ 3] [ 4] Chewing tobacco poses a lower health risk than traditional combusted products.[ 5] However it is not a healthy alternative to cigarette smoking.[ 2] The level of risk varies between different types of products and producing regions.[ 5] [ 6] There is no safe level of chewing tobacco use.[ 2] Globally it contributes to 650,000 deaths each year.[ 7]
^ Vidyasagaran, A. L.; Siddiqi, K.; Kanaan, M. (2016). "Use of smokeless tobacco and risk of cardiovascular disease: A systematic review and meta-analysis" (PDF) . European Journal of Preventive Cardiology . 23 (18): 1970–1981. doi :10.1177/2047487316654026 . ISSN 2047-4873 . PMID 27256827 . S2CID 206820997 .
^ a b c Lipari, R. N; Van Horn, S. L (31 May 2017). "Trends in Smokeless Tobacco Use and Initiation: 2002 to 2014" . Substance Abuse and Mental Health Services Administration. PMID 28636307 . This article incorporates text from this source, which is in the public domain .
^ Vidyasagaran, A. L.; Siddiqi, K.; Kanaan, M. (2016). "Use of smokeless tobacco and risk of cardiovascular disease: A systematic review and meta-analysis" (PDF) . European Journal of Preventive Cardiology . 23 (18): 1970–1981. doi :10.1177/2047487316654026 . ISSN 2047-4873 . PMID 27256827 . S2CID 206820997 .
^ Gupta, Ruchika; Gupta, Sanjay; Sharma, Shashi; Sinha, Dhirendra N; Mehrotra, Ravi (2019-01-01). "Risk of Coronary Heart Disease Among Smokeless Tobacco Users: Results of Systematic Review and Meta-Analysis of Global Data" . Nicotine & Tobacco Research . 21 (1): 25–31. doi :10.1093/ntr/nty002 . ISSN 1469-994X . PMC 6941711 . PMID 29325111 .
^ a b Hajat, C.; Stein, E.; Ramstrom, L.; Shantikumar, S.; Polosa, R. (4 December 2021). "The health impact of smokeless tobacco products: a systematic review" . Harm Reduction Journal . 18 (1): 123. doi :10.1186/s12954-021-00557-6 . ISSN 1477-7517 . PMC 8643012 . PMID 34863207 .
^ Abrams, David B.; Glasser, Allison M.; Pearson, Jennifer L.; Villanti, Andrea C.; Collins, Lauren K.; Niaura, Raymond S. (2018). "Harm Minimization and Tobacco Control: Reframing Societal Views of Nicotine Use to Rapidly Save Lives" . Annual Review of Public Health . 39 (1): 193–213. doi :10.1146/annurev-publhealth-040617-013849 . ISSN 0163-7525 . PMC 6942997 . PMID 29323611 . This article incorporates text by David B. Abrams, Allison M. Glasser, Jennifer L. Pearson, Andrea C. Villanti, Lauren K. Collins, and Raymond S. Niaura available under the CC BY 4.0 license.
^ Chugh, Aastha; Arora, Monika; Jain, Neha; Vidyasagaran, Aishwarya; Readshaw, Anne; Sheikh, Aziz; Eckhardt, Jappe; Siddiqi, Kamran; Chopra, Mansi; Mishu, Masuma Pervin; Kanaan, Mona; Rahman, Muhammad Aziz; Mehrotra, Ravi; Huque, Rumana; Forberger, Sarah (June 2023). "The global impact of tobacco control policies on smokeless tobacco use: a systematic review" . The Lancet Global Health . 11 (6): e953–e968. doi :10.1016/S2214-109X(23)00205-X . hdl :20.500.11820/e0442377-9f02-4360-8d09-292d86110e45 . PMID 37202029 .