Smokeless tobacco, cancer and dental health

October 20, 2015


All too often, people turn to smokeless tobacco because they consider it a safer alternative to cigarettes, and as a result, these products are becoming increasingly popular. In fact, many smokers use smokeless tobacco as a step in quitting this harmful habit. Unfortunately, they make this switch on unfounded beliefs. Smokeless tobacco comes with its own slew of risks, namely in regard to oral health.

"Smokeless tobacco use can lead to cancer."

What is smokeless tobacco?
The two main types of smokeless tobacco are chewing tobacco and snuff.1 Chewing tobacco is available in several forms, including leaves, plugs and twists of rope. Users usually place the tobacco toward the back of their mouths between their lower gums and cheeks, either chewing it or allowing it to stay in place. They either spit or swallow the produced saliva.

Snuff, on the other hand, comes finely cut or in small pouches. Users typically position it just behind the upper or lower lip. With both forms, the tobacco is in direct contact with the gums.

Smokeless tobacco and cancer
Ongoing research continues to demonstrate just how dangerous smokeless tobacco can be. In an analysis of the global burden of disease in relation to these products, researchers determined that there were more than 62,000 deaths from oral, pharyngeal and esophageal cancers resulting from smokeless tobacco use in 2010 alone.2

There are a few different ways that the use of smokeless tobacco can lead to cancer. Many snuff or chewing tobacco users experience small white patches in their mouths called leukoplakia.3 These oral lesions can appear on the gums, cheeks, tongue and bottom of the mouth, and they cannot be scraped off. Though they are typically benign, they can turn into cancer. Those who notice signs of leukoplakia should see their dentists right away.

Tobacco, smokeless or otherwise, typically has a high level of carcinogens, which are cancer-causing agents. The specific carcinogens in products like snuff and chewing tobacco are called tobacco-specific nitrosamines and can cause several types of cancers.4 In fact, tobacco-specific nitrosamines caused lung cancer when injected into the blood of animals.

Smokeless tobacco in container.
Smokeless tobacco is no safer than cigarettes.

Other oral risks 
There are other less serious risks associated with smokeless tobacco that, though not necessarily life-threatening, can still be still be detrimental to your oral health. Chronic bad breath, otherwise known as halitosis, is a common condition caused by smokeless tobacco use. Not only is halitosis a sign of poor dental hygiene, but it can also cause anxiety due to a constant self-conscious feeling.

Smokeless tobacco use also puts you at a greater risk for periodontal disease. When you press the tobacco up against the inside of your mouth, it pulls the gum away from the tooth. This provides more opportunity for the hardened plaque, called tartar, to delve further down the tooth's surface, which ultimately causes gum disease.

Beyond causing bad breath, irritated and swollen gums, and tooth sensitivity, periodontal disease may also lead to problems for your overall well-being. In fact, scientists have linked this oral condition to higher risk of both heart disease and blood sugar abnormalities.5 Using tobacco products already increases your chances of developing cardiovascular conditions, so the dental repercussions only add to that danger. 

It's extremely important to understand the risks associated with smokeless tobacco so you can make informed decisions about these products. The bottom line is they are not a safe alternative to cigarettes and can cause many severe conditions. Use a dental discount card to schedule your biannual appointments so a dental health professional can evaluate how your habits affect your oral health.


1. "Smokeless tobacco and cancer," National Institutes of Health, Oct. 25, 2010.

2. "Global burden of disease due to smokeless tobacco consumption in adults: analysis of data from 113 countries," Kamran Saddiqi, et. al., BMC Medicine, Aug. 17, 2015.

3. "Leukoplakia," Mayo Clinic, July 26, 2013.

4. "Smokeless tobacco," American Cancer Society, Dec. 03, 2013.

5. "Periodontal (Gum) Disease: Causes, Symptoms, and Treatments," National Institutes of Health, Sept. 2013.


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