Smokeless Tobacco Facts

Forms of Smokeless Tobacco

The two main types of smokeless tobacco in the United States are chewing tobacco and snuff.^1,2

Chewing tobacco comes in the form of loose leaf, plug, or twist.^2,3,4

Form	Description	Use	Market Share*
*Percentage of U.S. market for smokeless tobacco products5
Loose leaf	Cured tobacco strips typically sweetened and packaged in foil pouches	Piece taken from pouch and placed between cheek and gums	24.1%
Plug	Cured tobacco leaves pressed together into a cake or "plug" form and wrapped in a tobacco leaf	Piece taken from pouch and placed between cheek and gums	0.7%
Twist (or roll)	Cured tobacco leaves (often flavored) twisted together to resemble rope	Piece cut off from twist and placed between cheek and gums	0.4%

 

Snuff is finely ground tobacco that can be dry, moist, or packaged in sachets.^2,3,4

Form	Description	Use	Market Share*
*Percentage of U.S. market for smokeless tobacco products5
Moist	Cured and fermented tobacco processed into fine particles and often packaged in round cans	Pinch or "dip" is placed between cheek or lip and gums	73.2%
Dry	Fire-cured tobacco processed into a powder	Pinch of powder is taken orally or inhaled through the nostrils	1.5%
Sachets	Moist snuff packaged in ready-to-use pouches that resemble small tea bags	Sachet is placed between cheek or teeth and gums	Data unavailable

Although some forms of snuff can be used by sniffing or inhaling into the nose,² most smokeless tobacco users place the product between their gum and cheek.³ Users suck or chew on the tobacco, and saliva can be spat out or swallowed.^3,4 The tobacco industry has also developed newer smokeless tobacco products such as lozenges, tablets, tabs, strips, and sticks.^4,6

Health Effects

Smokeless Tobacco and Cancer

• Smokeless tobacco contains 28 cancer-causing agents (carcinogens).^2,4
• Smokeless tobacco is a known cause of human cancer; it increases the risk of developing cancer of the oral cavity and pancreas.^4,7

Smokeless Tobacco and Oral Health

• Smokeless tobacco is also strongly associated with leukoplakia—a precancerous lesion of the soft tissue in the mouth that consists of a white patch or plaque that cannot be scraped off.³
• Smokeless tobacco is associated with recession of the gums, gum disease, and tooth decay.^3,6

Smokeless Tobacco and Reproductive Health

• Smokeless tobacco use during pregnancy increases the risks for preeclampsia (i.e., a condition that may include high blood pressure, fluid retention, and swelling), premature birth, and low birth weight.⁴
• Smokeless tobacco use by men causes reduced sperm count and abnormal sperm cells.⁴

Smokeless Tobacco and Nicotine Addiction

• Smokeless tobacco use can lead to nicotine addiction and dependence.^2,4
• Adolescents who use smokeless tobacco are more likely to become cigarette smokers.³

Smokeless Tobacco Use in the United States

Smokeless tobacco use in the United States is higher among—

• Young white males
• American Indians/Alaska Natives
• People living in southern and north central states, and
• People who are employed in blue collar occupations or service/laborer jobs or who are unemployed⁸

Adults and Smokeless Tobacco

Current Smokeless Tobacco Users⁹

• 3.3% of adults (aged 18 years and older)
• 6.5% of men
• 0.4% of women
• 7.0% of American Indian/Alaska Natives
• 4.3% of whites
• 1.3% of Hispanics
• 0.7% of African Americans
• 0.6% of Asian Americans

High School Students and Smokeless Tobacco

Current Smokeless Tobacco Users¹⁰

• 7.9%   of all high school students
• 13.4% of male high school students
• 2.3%   of female high school students
• 10.3% of white high school students
• 4.7%   of Hispanic high school students
• 1.2%   of African-American high school students

Middle School Students and Smokeless Tobacco

Current Smokeless Tobacco Users¹¹

• 2.6% of middle school students
• 4.1% of male middle school students
• 1.2% of female middle school students
• 3.4% of Hispanic middle school students
• 2.8% of white middle school students
• 2.0% of Asian middle school students
• 1.7% of African-American middle school students

NOTE: For all data above, "current" user is defined as using smokeless tobacco products on 1 or more of the 30 days preceding the survey.

Tobacco Industry Information

The five largest tobacco manufacturers have spent record amounts of money on smokeless tobacco advertising and promotions:¹

• $354.12 million in 2006
• $250.79 million in 2005

The two leading smokeless tobacco brands for users aged 12 years or older are—

• Skoal^® (with 25% of the market share) and
• Copenhagen^® (with 24% of the market share).⁵

References

1. Federal Trade Commission. Smokeless Tobacco Report for the Year 2006.
   (PDF–689 KB) Washington, DC: Federal Trade Commission; 2009 [accessed 2009 Aug 24].
2. National Cancer Institute. Smokeless Tobacco or Health: An International Perspective . Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute; 1992 [accessed 2009 Feb 9].
3. U.S. Department of Health and Human Services. Preventing Tobacco Use Among Young People: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1994 [accessed 2009 Feb 9].
4. World Health Organization. Smokeless Tobacco and Some Tobacco-Specific N-Nitrosamines . (PDF–3.18 MB) International Agency for Research on Cancer Monographs on the Evaluation of Carcinogenic Risks to Humans Vol. 89. Lyon, France: World Health Organization, 2007 [accessed 2009 April 27].
5. Maxwell JC. The Maxwell Report: The Smokeless Tobacco Industry in 2008. Richmond, VA: John C. Maxwell, Jr., April 2009 [cited 2009 May 13].
6. Campaign for Tobacco-Free Kids. Smokeless Tobacco and Kids. (PDF–144 KB) Washington: Campaign for Tobacco-Free Kids, 2009 [accessed 2009 Aug 24].
7. World Health Organization. Summaries and Evaluations: Tobacco Products, Smokeless (Group 1) . Lyon, France: World Health Organization, International Agency for Research on Cancer, 1998 [accessed 2009 Feb 9].
8. U.S. Department of Health and Human Services. Reducing the Health Consequences of Smoking: 25 Years of Progress. A Report of the Surgeon General . Bethesda, Rockville (MD): U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1989 [accessed 2009 Feb 9].
9. Substance Abuse and Mental Health Services Administration. Results From the 2007 National Survey on Drug Use and Health: Detailed Tables . Rockville (MD): Substance Abuse and Mental Health Services Administration, Office of Applied Studies, 2007 [accessed 2009 Feb 9].
10. Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance—United States, 2007. (PDF–4.47 MB) Morbidity and Mortality Weekly Report 2007;57(SS-4):1–136 [accessed 2009 Feb 9].
11. Centers for Disease Control and Prevention. 2006 National Youth Tobacco Survey and Key Prevalence Indicators (PDF–167 KB) [accessed 2009 Apr 27].

For Further Information

Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Office on Smoking and Health
E-mail: tobaccoinfo@cdc.gov
Phone: 1-800-CDC-INFO

Media Inquiries: Contact CDC's Office on Smoking and Health press line at 770-488-5493.