Smokeless Tobacco Use

Smokeless tobacco is a loose, fine, or stringy tobacco. The tobacco is not smoked like a cigarette, but it is chewed or held in the lips or cheeks. It resembles tea and comes from the leaves of the tobacco plant. Smokeless tobacco is usually flavored, sweetened, or processed in some way. Although smokeless tobacco is not smoked into the lungs, its chemicals are absorbed through the membranes in the mouth and into the bloodstream. Its chemicals are also swallowed in saliva. The chemicals (nicotine and other toxins) are known to cause cancer. Smokeless tobacco contains up to 28 different carcinogens.


Nicotine is addictive. Smokeless tobacco contains nicotine, which is a stimulant. This stimulant can give you a "buzz" or altered state. People can become addicted to the feeling it delivers.


Smokeless tobacco can cause health problems, including: 

  • Bad breath.

  • Yellow-brown teeth.

  • Mouth sores.

  • Cracking and bleeding lips.

  • Gum disease, gum recession, and bone loss around the teeth.

  • Tooth decay.

  • Increased or irregular heart rate.

  • High blood pressure, heart disease, and stroke.

  • Cancer of the mouth, lips, tongue, pancreas, voice box (larynx), esophagus, colon, and bladder.

  • Precancerous lesion of the soft tissues of the mouth (leukoplakia).

  • Loss of your sense of taste.


Talk with your caregiver about ways you can quit. Quitting tobacco is a good decision for your health. Nicotine is addictive, but several options are available to help you quit including: 

  • Nicotine replacement therapy (gum or patch).

  • Support and cessation programs. 

The following tips can help you quit:

  • Write down the reasons you would like to quit and look at them often.

  • Set a date during a low stress time to stop or cut back.

  • Ask family and friends for their support.

  • Remove all tobacco products from your home and work.

  • Replace the chewing tobacco with things like beef jerky, sunflower seeds, or shredded coconut.

  • Avoid situations that may make you want to chew tobacco.

  • Exercise and eat a healthy diet.

  • When you crave tobacco, distract yourself with drinking water, sugarless chewing gum, sugarless hard candy, exercising, or deep breathing.


  • See your dentist for regular oral health exams every 6 months.

  • Follow up with your caregiver as recommended.


  • You have bleeding or cracking lips, gums, or cheeks.

  • You have mouth sores, discolorations, or pain.

  • You have tooth pain. 

  • You develop persistent irritation, burning, or sores in the mouth.

  • You have pain, tenderness, or numbness in the mouth.

  • You develop a lump, bumpy patch, or hardened skin inside the mouth.

  • The color changes inside your mouth (gray, white, or red spots).

  • You have difficulty chewing, swallowing, or speaking.