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Smokeless tobacco

See also: Herbal smokeless tobacco
A historical depiction of a man taking snuff using his thumb and forefinger

Smokeless tobacco is a tobacco product that is used by means other than smoking.[1] Their use involves chewing, sniffing, or placing the product between gum and the cheek or lip.[1] Smokeless tobacco products are produced in various forms, such as chewing tobacco, snuff, snus, and dissolvable tobacco products.[2] Smokeless tobacco is widely used in South Asia and this accounts for about 80% of global consumption.[3] All smokeless tobacco products contain nicotine[4] and are therefore highly addictive.[5] Quitting smokeless tobacco use is as challenging as smoking cessation.[6]

Using smokeless tobacco can cause a 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.[5][7] Smokeless tobacco poses a lower health risk than traditional combusted products.[8] However it is not a healthy alternative to cigarette smoking.[6] The level of risk varies between different types of products (e.g., low nitrosamine Swedish-type snus versus other smokeless tobacco with high nitrosamine levels) and producing regions.[9][8] There is no safe level of smokeless tobacco use.[6] Globally it contributes to 650 000 deaths each year.[10]

Smokeless tobacco products typically contain over 3000 constituents,[11] which includes multiple cancer-causing chemicals.[6] Approximately 28 chemical constituents present in smokeless tobacco can cause cancer, among which nitrosamine is the most prominent.[12]

Smokeless tobacco consumption is widespread throughout the world.[12] Once addicted to nicotine from smokeless tobacco use, many people, particularly young people, expand their tobacco use by smoking cigarettes.[6] Males are more likely than females to use smokeless tobacco.[6]

  1. ^ a b Cite error: The named reference FDA2018 was invoked but never defined (see the help page).
  2. ^ Czoli, Christine D; Fong, Geoffrey T; Mays, Darren; Hammond, David (2016). "How do consumers perceive differences in risk across nicotine products? A review of relative risk perceptions across smokeless tobacco, e-cigarettes, nicotine replacement therapy and combustible cigarettes". Tobacco Control. 26 (e1): tobaccocontrol–2016–053060. doi:10.1136/tobaccocontrol-2016-053060. ISSN 0964-4563. PMID 27625408. S2CID 3367137.
  3. ^ Smokeless tobacco, South Asia. "Smokeless tobacco use in South Asia" (PDF).
  4. ^ Drope, Jeffrey; Cahn, Zachary; Kennedy, Rosemary; Liber, Alex C.; Stoklosa, Michal; Henson, Rosemarie; Douglas, Clifford E.; Drope, Jacqui (2017). "Key issues surrounding the health impacts of electronic nicotine delivery systems (ENDS) and other sources of nicotine". CA: A Cancer Journal for Clinicians. 67 (6): 449–471. doi:10.3322/caac.21413. ISSN 0007-9235. PMID 28961314.
  5. ^ a b 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.
  6. ^ a b c d e f Cite error: The named reference Lipari2017 was invoked but never defined (see the help page).
  7. ^ 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.
  8. ^ 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.
  9. ^ 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.
  10. ^ 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. PMID 37202029.
  11. ^ Lauterstein, Dana; Hoshino, Risa; Gordon, Terry; Watkins, Beverly-Xaviera; Weitzman, Michael; Zelikoff, Judith (2014). "The Changing Face of Tobacco Use Among United States Youth". Current Drug Abuse Reviews. 7 (1): 29–43. doi:10.2174/1874473707666141015220110. ISSN 1874-4737. PMC 4469045. PMID 25323124.
  12. ^ a b Niaz, Kamal; Maqbool, Faheem; Khan, Fazlullah; Bahadar, Haji; Ismail Hassan, Fatima; Abdollahi, Mohammad (2017). "Smokeless tobacco (paan and gutkha) consumption, prevalence, and contribution to oral cancer". Epidemiology and Health. 39: e2017009. doi:10.4178/epih.e2017009. ISSN 2092-7193. PMC 5543298. PMID 28292008. This article incorporates text by Kamal Niaz, Faheem Maqbool, Fazlullah Khan, Haji Bahadar, Fatima Ismail Hassan, Mohammad Abdollahi available under the CC BY 4.0 license.

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