Chewing tobacco ("chaw") is usually sold as leaf tobacco; users place a large wad of it inside their cheek. Users, who tend to be older men, keep chewing tobacco in their mouths for several hours. Snuff, which is much more common today, is powdered tobacco that's usually sold in cans. Users place a pinch of the tobacco between the lower lip and the gum, usually under the canine teeth.
Health risks of using smokeless tobacco
Oral cancer. This disease, which affects the mouth, tongue, cheek, gums and lips, is one of the deadliest forms of cancer. The five-year survival rate is only 59 percent.
Other cancers. Carcinogens in tobacco also increase a user's risk for pharynx, larynx, and esophagus cancers. Breast cancer and cardiovascular disease have been linked to chewing tobacco.
Nicotine dependence. Nicotine levels in smokeless tobacco are even higher than in cigarette tobacco. Nicotine addiction can lead to an artificially increased heart rate and blood pressure.
Tooth abrasion. Grit and sand found in smokeless tobacco products scratch teeth and wear away the enamel.
Gum recession. Constant irritation to the spot in the mouth where a small wad of chewing tobacco is placed can cause the gums to pull away from the teeth, exposing root surfaces and leaving teeth sensitive to heat and cold.
Increased tooth decay. Sugar is added to smokeless tobacco during the curing and processing to improve its taste. (Also, when the gums pull away from the teeth, food can become trapped in the pockets between the teeth and the gums, causing both tooth decay and gum infections.)
Tooth discoloration and bad breath. People who stop using snuff may notice a marked change in the latter.
Unhealthy eating habits. Chewing tobacco lessens a person's sense of taste and ability to smell. As a result, users tend to eat more salty and sweet foods.
While smokeless tobacco users run a lower risk of lung cancer than smokers do, they run a much higher risk of oral cancer.
Symptoms of oral cancer
The most common preliminary symptom is a condition called leukoplakia. These are mouth sores that appear either as a smooth, white patch or as leathery-looking wrinkled skin, usually in the spot(s) where the tobacco is placed. If untreated, these sores can result in cancer.
Other symptoms include:
A sore on the lip or in the mouth that does not heal
A lump on the lip or in the mouth or throat
A white or red patch on the gums, tongue or lining of the mouth
Unusual bleeding, pain or numbness in the mouth
A sore throat that does not go away, or a feeling that something is caught in the throat
Difficulty or pain with chewing or swallowing
Swelling of the jaw that causes dentures to fit poorly or become uncomfortable
A change in the voice
Pain in the ear
When to see a doctor
If you use smokeless tobacco, have your doctor or dentist check you right away. Early detection is crucial. While oral cancer has one of the lowest five-year survival rates of all major cancers (only 59 percent of oral cancer patients live more than five years after being diagnosed), this is probably because most lesions are not discovered until they are well advanced.
When detected early, the probability of surviving oral cancer is significantly better. Also, quitting now will reduce your chance of developing cancer.
Treatment for oral cancer depends on several factors, including the location, size, type and extent of the tumor, as well as the stage of the disease. Treatment can include surgery (to remove parts of the mouth, jaw, and, if the cancer has spread, the lymph nodes in the neck), radiation therapy, or a combination of the two. Some patients also receive chemotherapy.
Prevention
The best thing to do, of course, is quit. People who stop using tobacco -- even after many years of use -- can greatly reduce their risk of oral cancer. If quitting isn't possible, at least ensure your doctor and/or dentist regularly examine your precancerous sores. If oral cancer is detected early, it can often be treated successfully.
