Smoking Cessation: Snuffing Out Smokeless Tobacco Use

Assessing Your Habit
Health Risks of Smoking
Tips to Help You Stop Smoking
Cigars: Coolish or Foolish?
Managing Nicotine Withdrawal Symptoms
Secondhand Smoke: Protect Yourself and Your Loved Ones
UPMC Patient Education Fact Sheets on Smoking

UPMC holds smoking cessation classes throughout the year. To find one near you, please visit www.upmc.com/Events.htm or call 800-533-UPMC (8762).

Want something to chew on? Don't let it be smokeless tobacco! Smokeless or "spit" tobacco comes in two forms: chewing tobacco and snuff, and both can cause cancer and serious oral health problems.

Chewing tobacco can be found as leaf tobacco which is packaged in a pouch, or plug tobacco, which is in a brick form. Both are put between the cheek and gum for several hours, and produce a continuous nicotine high in users. Snuff, usually sold in cans, is a powdered form of tobacco that's put between the lower lip and gum. Only a very small amount will quickly release nicotine into the bloodstream, producing a quick high.

More nicotine than cigarettes
Because smokeless tobacco puts more nicotine into the bloodstream than cigarettes, people who "chew" on a regular basis often find it harder to quit than cigarette smoking. In fact, an average sized "dip" that's held in the mouth for 30 minutes releases as much nicotine as smoking two or three cigarettes. When someone uses smokeless tobacco, his or her body adjusts to the amount of tobacco needed to produce that high. Then he or she needs a little more tobacco to achieve the same feeling and ends up addicted.

Harmful chemicals
It may be smokeless, but it isn't harmless! In addition to nicotine, smokeless tobacco contains at least 28 known cancer-causing chemicals. Here are just a few of the substances found in smokeless tobacco:

• Lead (nerve poison)
• Arsenic
• Cyanide
• Benzene
• Polonium 210 (nuclear waste)
• Cadmium (in car batteries)
• Formaldehyde (used for embalming)
• N-Nitrosamines (cancer-causing)

Physical and social concerns
Smokeless tobacco users put themselves at a high risk for many serious and visible health problems such as:

• Cancer — cancer of the mouth (the lip, tongue, and cheek) and of the throat (the pharynx, larynx, and esophagus)
  Surgery to treat cancer of the mouth (oral cancer) is disfiguring and sometimes involves removing parts of the face, cheek, tongue, or lip. Oral cancer can spread quickly to other parts of the body. The average oral cancer patient lives only five years after diagnosis.
• Tooth and gum disease
  Smokeless tobacco permanently discolors the teeth. It scratches the teeth and wears away the hard surface or enamel. It causes bad breath, cavities, gum recession, and tooth loss.
• Leukoplakia
  When smokeless tobacco irritates the mouth, it can cause pre-cancerous changes in the mouth. They are marked by white, leathery patches which can be different shapes and sizes. Anyone noticing these changes should see their doctor immediately.
• Nicotine dependence
  The constant flow of nicotine in the blood causes increased heart rate, blood pressure and sometimes irregular heart beats. In addition, it causes the blood vessels to constrict, which can lead to decreased athletic performance and reduced endurance levels.
• Social embarrassment
  There's nothing socially desirable about bad breath, gunk-filled and discolored teeth, and constant spitting. Smokeless tobacco users risk hurting their social lives with this habit. Even worse, their appearance could be permanently altered with surgery for oral cancer.

Danger signals for users
Anyone who uses smokeless tobacco (or has used it in the past), should check regularly for early signs of oral cancer:

• A sore in the mouth that bleeds and doesn't heal
• A lump or red or white patch that doesn't go away
• A lump or thickening anywhere in the mouth or neck
• Difficulty chewing, swallowing, or moving the tongue or the jaw
• Feeling that something is in the throat

Tobacco users should be vigilant about seeing their dentists every few months to have their mouths checked for oral cancer. The earlier the cancer is detected, the greater the chances for curing it.

The good
It may be difficult to quit using smokeless tobacco, but many people succeed at it. If you want to quit, here are some tips that can help:

1. Think of all the reasons you want to quit. You may want a healthy lifestyle. You don't want cancer, bad breath, or stained teeth. Maybe you're concerned about how the habit may be offensive to others.



2. Look for support from others. Join a support group or tobacco cessation class. Ask your friends, family, teachers, and health care providers for encouragement and support.
   
   
3. Pick a quit date. Put it on your calendar, and tell your plans to supportive others. Throw out all your chewing tobacco and snuff.
   
   
4. Don't give up! If you've failed before, remember that it often takes several tries to give up tobacco.



5. Seek advice. Ask your health care provider about nicotine chewing gum and cessation programs.
   
   
6. Find alternatives to smokeless tobacco. Try sugar-free gum or low calorie snacks such as popcorn, vegetables, and fruit.
   
   
7. Stay busy. Hobbies and other activities can help you keep your mind off chewing. Go get some exercise to relieve tension, listen to music, talk to friends, do some research on your computer.



8. Reward yourself. Give yourself positive reinforcement-every day, if necessary. With the money you'll be saving, you could treat yourself to a movie or buy something nice.
   
   
9. Develop a plan that works for you. Everyone is different, and what works for someone else may not work for you. Experiment and see what does and doesn't work. Above all, set realistic goals and don't give up because of a setback or two.

Read more about the health risks of using tobacco