Chewing tobacco

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 after use.

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 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.^[3][4] Chewing tobacco poses a lower health risk than traditional combusted products.^[5] However it is not a healthy alternative to cigarette smoking.^[6] The level of risk varies between different types of products and producing regions.^[7][5] There is no safe level of chewing tobacco use.^[6] Globally it contributes to 650 000 deaths each year.^[8]