Harms of Smokeless Tobacco

Smokeless tobacco includes a range of products, such as pouches, snuff, chew, dip, and dissolvable tobacco. While the majority of people who use tobacco products smoke, a sizable number use smokeless tobacco. In the early 2000s, there was a noticeable increase in the use of smokeless tobacco, and by 2021, approximately 5.2% of adults in the United States reported using these products.

Nicotine pouches have emerged as a particularly popular option. In 2021, about 16.4% of adult tobacco users in the U.S. reported trying nicotine pouches, which contain either synthetic or natural nicotine and are available in various flavors, such as cool mint and citrus. These pouches have become especially popular among younger people, ages 15-24, due to their flavor as well as their discrete method of use, tucked into a cheek. Newer smokeless tobacco products containing nicotine are packaged without gum disease or cancer warnings and may be perceived as safe for users.

Safer than smoked tobacco, smokeless tobacco products carry significant health risk, such as oral cancers, periodontal disease, and a slightly increased risk of pancreatic cancer. Research conducted by Gabriela Gil and her team has highlighted significant associations between smokeless tobacco use and increased risks of esophageal cancer and stroke.

The regulations of smokeless tobacco products are less stringent than the regulations of smoking products. For instance, nicotine pouches are not subject to the Comprehensive Smokeless Tobacco Health Education Act of 1986, which regulates traditional smokeless tobacco products. This regulatory gap has raised concerns about flavors that may appeal to youth and lead to heavy and long-term use that could promote the transition to smoking tobacco. Researchers and public health advocates are calling for stricter oversight and more comprehensive regulations to ensure compliance with existing flavor restrictions.

The public often underestimates the dangers of smokeless tobacco due to corporate marketing strategies that emphasize convenience, novelty, and reduced health risks compared to smoking. Researchers tout the importance of providing young audiences with clear, evidence-based information about the real risks of smokeless tobacco use.

While smoking rates have declined, cigarettes are still a leading cause of preventable death. Unlike smokeless tobacco, cigarettes are heavily regulated due to their well-documented dangers. As we educate the public on the risks of all tobacco products, including smokeless tobacco and cigarettes, ongoing research and stronger regulations are crucial to protect public health.