Smokeless Tobacco

Scientific Name(s): Nicotiana tabacum L.
Common Name(s): Ariva, Betel quid (India), Chewing tobacco, Commit, Compressed tobacco lozenges, Copenhagen, Dry snuff, Iq-mik (Alaska), Moist snuff, Revel, Skoal Dry, Smokeless tobacco, Snus (Sweden)., Stonewall

Medically reviewed by Drugs.com. Last updated on Dec 6, 2021.

Clinical Overview

Use

The role of smokeless tobacco in smoking cessation is debated. Issues relate to the lack of evidence for efficacy in achieving long-term smoking cessation (greater than 6 months) and the health risks of smokeless tobacco products. Concern has been raised that smokeless tobacco use serves as a gateway to smoking.

Dosing

Users of smokeless tobacco regulate consumption to meet cravings and withdrawal symptoms.

Contraindications

None well documented.

Pregnancy/Lactation

Avoid use. Smokeless tobacco use during pregnancy is associated with decreased birth weight and increased risk of preterm delivery.

Interactions

None well documented.

Adverse Reactions

An increased risk of oropharyngeal cancer exists. Data for other cancers are less consistent. An association between the risk of fatal myocardial infarction and fatal stroke in users of smokeless tobacco has been shown. Other oral pathologies, such as inflammation, leukoplakia, and tooth decay have been described with smokeless tobacco use.

Toxicology

The International Agency for Research on Cancer (IARC) recognizes that smokeless tobacco contains at least 30 cancer-causing agents and is carcinogenic to humans.

Scientific Family

• Solanaceae (nightshade)

Botany

Smokeless tobacco products are derived from the same botanical source as smoking tobacco (Nicotiana tabacum). The tobacco plant originated in South America more than 7,000 years ago. Smokeless tobacco products often are flavored with sugar or artificial sweeteners.Hatsukami 2007, USDA 2010

History

American Indians may have been using tobacco throughout North and South America by the time the first European explorers arrived in the late 1400s and early 1500s. Tobacco use spread to Europe, Africa, China, and Japan over the next few centuries. Snuff use (at the time, finely ground tobacco that primarily was sniffed through the nose) was introduced to North American colonists in Jamestown, VA in 1611. Tobacco chewing by colonists probably began in the early 1700s and was widely accepted by the 1850s. Snuff was the most popular form of smokeless tobacco in Europe and America prior to the 1800s. A current practice in the United States and many other parts of the world is "snuff dipping" in which, the small amount of powdered tobacco is placed in the buccal area between the gum and cheek where it is retained for a period of time. The resultant saliva is then usually spit or swallowed. Snuff is taken as loose portions or from small prepackaged bags of tobacco. In many parts of the world, the tobacco is mixed with other stimulants such as betel or areca nut. Some users chew a portion of smokeless tobacco.Grasso 1998, Hatsukami 2007, National Toxicology Program 2002

Chemistry

Tobacco contains more than 2,500 chemical constituents. Some of these constituents are present naturally while others are added during cultivation, harvesting, and processing. For example, chewing tobacco consists of the tobacco leaf with the stem removed, with added sweeteners, and flavorings (eg, honey, licorice, rum). Snuff consists of the entire tobacco leaf (dried and powdered or finely cut) and additives such as menthol, peppermint oil, camphor, attar of rose...