HomeHealth articlestobaccoWhat Are the Effects of Oral Smokeless Tobacco on Health?

Smokeless tobacco has many oral effects, including oral cancer, oral submucous fibrosis, leukoplakia, and erythroplakia.

Medically reviewed by

Dr. Basti Bharatesh Devendra

Published At November 9, 2022
Reviewed AtNovember 9, 2022


Smokeless tobacco is the product of tobacco that is used for habits other than smoking. Smokeless tobacco includes sniffing, chewing, placing tobacco between the gums and cheeks or lips, or inhaling through the nose like dry stuff. Different types of smokeless tobacco include chewing, snuff, snus, and other dissolvable products. It can cause various diseases, especially cancers of the mouth.

What Is Smokeless Tobacco?

Tobacco is derived from Nicotiana rustica and Nicotiana tabacum. Smokeless tobacco is used to chew, sniff, etc. It is made from different dried parts of the tobacco plant. The most important ingredient of tobacco is nicotine. Nicotine is a very stimulant and addictive drug. Nicotine mainly affects the central nervous system by binding to the receptors and increasing the brain's dopamine levels, making it addictive. It has serious health effects. Chewing tobacco or smokeless tobacco is known to be harmful to oral health. Greater prevalence is seen in using smokeless tobacco than in smoking tobacco. The use of smokeless tobacco differs by age, gender, and socioeconomic class. Smokeless tobacco is available in loose-leaf or plug form. Loose leaves are a lot like tea leaves. The plug is a compressed block of tobacco.

What Are the Different Types of Smokeless Tobacco?

The main types of smokeless tobacco include chewing tobacco, snus, snuff, and dissolvable tobacco products.

  1. Chewing Tobacco - Chewing tobacco is available as loose-leaf or braided, twisted, and compressed leaves as plugs. It is placed between the cheeks and the gum. It can be either chewed or swallowed. It can also be flavored.

  2. Snus - Snus is pronounced as snoos. It originated in Sweden. It is sold loose or in pouches. It is pasteurized to kill bacteria that can produce cancer-causing chemicals. However, some evidence suggests that snus users are not at as significant a risk as cigarette users are for mouth cancer, heart disease, stroke, lung cancer, and other lung problems.

  3. Snuff - Snuff is also called dipping. Snuff is finely ground tobacco. It can be dry or moist. It is available in tins or pouches. It can also be flavored. It is placed along the gum line, behind the lips, or between the cheeks and the gum.

  4. Dissolved Tobacco - Dissolved tobacco is a powdered form of tobacco that is then processed to form tablets, sticks, or stripes to make it attractive. Some may contain flavoring agents so that they appear like candy. The compressed tobacco is then held in the mouth until it dissolves.

What Are the Health Consequences of Smokeless Tobacco?

There are different consequences of using smokeless tobacco. The main categories of smokeless tobacco are oral squamous cell carcinoma, verrucous carcinoma, and other malignant disorders like erythroplakia, leukoplakia, tobacco pouch keratosis, and submucous fibrosis. Nicotine is a highly addictive ingredient of tobacco. Young people who use smokeless tobacco become addicted to it, and there is a high chance of becoming cigarette smokers in the future. Smoking tobacco is dangerous, and when used in any form, it increases one's risk of certain types of cancer and other health conditions.

How Does Smokeless Tobacco Affect Teeth, Periodontal Tissues, and Gingiva?

Chewing tobacco and using smokeless tobacco products affect the oral cavity in different ways:

  • Teeth - It causes staining of teeth. Discoloration of teeth is the most common complication of chewing tobacco. The stains are brown colored, affecting the teeth' enamel, dentin, and root surfaces. It also involves the prosthesis and the dentures and makes them discolored. There is tooth loss seen eventually. There is a risk of increased incidence of dental caries.

  • Periodontal Tissues and Gingiva - Gingival recession is seen in people who chew tobacco. There is also an exposure of root surfaces, periodontal pocket formation, plaque, and calculus accumulation, which leads to periodontitis.

What Is the Health Risk of Smokeless Tobacco?

There are oral as well as other health risks. Many people are aware of oral cancer risks but not other health risks. The health risks are:

  • Cancer - Chewing tobacco has serious health risks. Cancers include oral cancer, pancreatic cancer, and esophageal cancer.

  • Cardiovascular Health - It is found that smokeless tobacco products increase the risk of heart disease more than smoking tobacco.

  • Oral Health - Chewing tobacco increases the risk of oral cancers. It affects periodontal health. Oral lesions include squamous cell carcinoma, verrucous carcinoma, erythroplakia, and leukoplakia.

  • Pregnancy - Chewing tobacco affects pregnant women as there are chances of premature birth.

What Are the Tips To Prevent Using SmokelessTobacco?

One can only prevent the adverse health effects of chewing smokeless tobacco by quitting it. Quitting is very difficult as it has an addictive effect. There are a few tips that can help to quit tobacco:

  • Replace the tobacco with any other substitutes, like chewing gum.

  • Consult a professional for help.

  • Try using medication that might help in quitting.

How to Quit Tobacco?

There are different types of methods to quit tobacco and other smokeless tobacco products:

  • Behavioral Interventions - There are telephonic services available that can provide you with help and support.

  • Nicotine Replacement Therapy - One can use a patch, gum, or lozenges which help in reducing the cravings.

  • Non-nicotine Medications - They can help to reduce nicotine withdrawal symptoms.


Smokeless tobacco has increased the risk of oral cancer and other malignant diseases in individuals. Therefore, the healthcare provider should assess the patient's tobacco usage and help them with prevention, cessation, and treatment. Though quitting can be challenging, one should try and quit as it has severe ill effects.

Frequently Asked Questions


How Many Cigarettes Are Equal to a Can of Dip?

The dip is a smokeless, shredded, fine variety of tobacco. It is stated that around 80 cigarettes are equal to a can of dip. A person who chews a can of dip ingests nicotine equal to four packets of cigarettes. 


What Are the Consequences of Chewing Tobacco Every Day?

If tobacco is chewed in the long term, it may increase the incidence of fatal diseases like congestive heart failure and oral cancer. Chewing tobacco impacts the person's oral health, and the person may suffer from cavities, periodontal diseases, etc.


What Does Smokeless Tobacco Cause to the Gums?

Smokeless tobacco damages the gums permanently. The gums start receding and expose the tooth surface, which eventually causes tooth sensitivity. The periodontal issue rises, and teeth loss is evident. 


For How Long Does the Chewed Tobacco Stay in the System?

Physicians state that tobacco, after chewing, releases nicotine in the system the nicotine. According to certain studies, it is written that nicotine stays up to 11 hours in the system, and also, in heavy use of tobacco, it may stay in the system for four to five days.


Which Is Stronger, Dip or Cigarettes?

The nicotine level is more in the dip as compared to the cigarettes. If chewed, tobacco stays around in the mouth for 20-30 minutes, equal to the effect of smoking three cigarettes.


What Is Difficult to Quit Smoking Tobacco or Dip?

It is stated that more nicotine goes into the system through the dip compared to smoking cigarettes. And as the dip stays in the mouth longer and has a stronger effect. Thus, quitting dip is more difficult than quitting smoking.


How the Tobacco Affects the Stomach?

Tobacco releases nicotine in the system, and the nicotine weakens the sphincter. Because the sphincter weakens, the person suffers from gastrointestinal reflux disease (GERD). It may also cause peptic ulcers.


Do Teeth Get Yellow Because of Dip?

When a person chews tobacco, the nicotine turns brown or yellow after reacting with oxygen. This causes the enamel of the teeth to stain. Thus, the teeth get yellow because of the dip.


Can a Dentist Predict That the Person Chews Tobacco After Observing the Oral Cavity?

Yes, a dentist can tell if a person eats tobacco or not. The dentist may see the yellow teeth which are caused by nicotine. The receding gums, plaque, and stains may indicate that the person is a tobacco chewer.


Do a Person Get Smelly Breath After Chewing Tobacco?

The chewing of tobacco results in a dry mouth and debris around the teeth, which are prime factors for bad breath. Halitosis is a common consequence of chewing tobacco and poor oral health. 


What Impact Does Tobacco Have On the Brain?

Chewing Tobacco releases nicotine which activates epinephrine which is responsible for the production of adrenaline. It mimics the neurotransmitters and gives a pleasurable sensation. A person develops nicotine tolerance, and thus the demand for nicotine increases.  In this way, a person also gets addicted to nicotine.


How Can One Quit Chewing Tobacco?

One needs to decide to quit smoking and understand the steps of quitting. The person should handle nicotine withdrawal with proper nicotine therapy. The person can also visit the counselor. The combination of nicotine therapy and counseling may help the person quit chewing tobacco.


Can Anxiety Be Caused by Chewing Tobacco?

Yes, initially, it gives you a sense of calm, but eventually, your heart rate increases, muscles tighten, and vessels constrict, resulting in a reduced supply of oxygen which stops the healthy coping of the body. 


Which Is the Worse, Amongst Smoking and Dipping?

The effect of chewing tobacco is more than smoking it. The dip is chewed for longer, and the nicotine release is more than smoking. Thus, dipping is worse than smoking.


Is Dipping Better Than Vaping?

Any type of nicotine ingestion, be it dipping, smoking, or vaping is dangerous and highly addictive to health. It is stated that vaping is less harmful than dipping, but it cannot be denied that consuming nicotine in any form is bad.
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Dr. Basti Bharatesh Devendra
Dr. Basti Bharatesh Devendra


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