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Smokeless Tobacco

Health Consequences of Smokeless Tobacco

Smokeless tobacco has significant health consequences. Smokeless tobacco contains 28 chemicals that can cause cancer. The harmful health effects of using smokeless tobacco include:

  • Oral (mouth) cancer
  • Pancreatic cancer
  • Addiction to nicotine
  • Sores in the mouth
  • Receding gums
  • Bone loss around the roots of the teeth
  • Abrasion (scratching and wearing down) of teeth
  • Tooth loss
  • Stained teeth
  • Bad breath

Quitting smokeless tobacco is a lot like quitting smoking, however, there are a few parts of quitting that are unique for smokeless tobacco users.

If you use chew, snuff, and/or spit tobacco, this page will provide you with information on how to quit using smokeless tobacco. Several of the tips in the other section may be helpful to you as you try to quit smokeless tobacco. In this section we will point out the differences in quitting for people who use smokeless tobacco.

Quitting Smokeless Tobacco

Making the decision to quit using smokeless tobacco is hard, but it has to be your decision. Many people can encourage you to quit, but you have to want to quit. Quitting smokeless tobacco is a lot like quitting smoking, however, there are a few parts of quitting that are unique for smokeless tobacco users.

  • There is often a stronger need for having something in the mouth to take the place of the chew, snuff, or pouch.
  • Mouth sores often slowly go away and gum problems will get better.

Goal Setting and Preparing to Quit

Are you really ready to quit? If so, it is time to set a quit date. Once you have picked the day, stick to it! Placing the date in your calendar will help to remind you of your promise to yourself to quit!

Self-Assessment

People use smokeless tobacco for a variety of reasons, but one of the main reasons people use smokeless tobacco is because they are addicted to nicotine. Do you think you are addicted to the nicotine in smokeless tobacco? Find out by answering the six questions on the Smokeless Tobacco Self-Assessment [pdf].

Even before your quit date, you can start quitting.

  • Change to a brand with less nicotine. Then use smaller dips.
  • Cut down on the number of times you dip each day, and increase the amount of time between dips.
  • Stock up on other things to put in your mouth
    • sunflower seeds
    • sugarless gum
    • carrots
    • beef jerky
    • cinnamon sticks
    • toothpicks
    • mints
    • sugarless hard candy
  • Remove all snuff or chew and related products from your house and car.
  • Each time you open a new can of chew or dip, write the date on a piece of paper and then keep that paper with the can. Every time you dip or chew, write down four things:
    • What time of day is it?
    • How bad is your craving to dip or chew? Very bad, not bad at all, so-so?
    • What is your mood? Happy, sad, so-so?
    • What are you doing? Driving, working, watching TV, out with friends?
  • Keep track of this information for at least four days. This exercise will help you see what time of day, what situations, and what feelings prompt you to dip or chew. It will help you understand your particular triggers for using smokeless tobacco.

Inform Family and Friends

Make sure you inform your family and friends of your promise to quit using smokeless tobacco. If you have family or friends who dip or chew, ask them not to use when you are around. Try to find a friend who can quit with you so you can motivate each other to stay true to your promise to quit.

Tips to Help You Quit

You have been using smokeless tobacco for years. It is not going to be easy to quit. You will have thoughts about using smokeless tobacco but you can overcome them. Many of the tips used for quitting smoking also apply to quitting smokeless tobacco. However, there are certain things that are specific to quitting snuff and chew that you may want to consider.

Review Previous Quit Attempts

If you have tried quitting before, go over what went wrong. Did you get rid of all your smokeless tobacco products? Maybe you tried to quit on your own without telling anyone? Was there a particular situation that prompted you to start chewing again? If so, what happened and how can you prevent it from happening again?

Coping with Withdrawal Symptoms

While you are quitting, you may get cravings for smokeless tobacco every once and a while. Many people have withdrawal symptoms when they try to quit using snuff or chew tobacco. These symptoms are usually strongest the first week after you quit. The withdrawal symptoms listed in Common Problems in Quitting are some of the most common symptoms for smokers and many also apply to smokeless tobacco users. Review the advice to help with smoking withdrawal symptoms. In addition, the following may help you deal with withdrawal symptoms from quitting smokeless tobacco.

    Remind yourself why you want to quit.
    Keep reminding yourself of these reasons and how far you have come in achieving your goal to remain tobacco-free.

    Rehearse often what you will do to handle the urge when a high-risk situation arises.

    Reward yourself for each urge you overcome.

Other coping strategies:

  • Deep breathing and exercise may be helpful when waiting out the urge to use.
  • Use oral substitutes such as sunflower seeds, beef jerky, sugarless gum or hard candy, or carrots.
  • Brush your teeth more frequently.

Dealing with Triggers

Quitting can be very difficult, so be prepared for temptations to start using smokeless tobacco again by recognizing triggers. These urges will be strongest the first week after quitting and will be strongest in places and situations where you used to use snuff or chew. The following may be helpful when dealing with triggers:

  • Write down events and situations that may trigger use and plan ahead for them.
  • Write down things you will do in these situations instead of using smokeless tobacco (like reaching for gum, brushing your teeth, or simply walking away from the situation).
  • Avoid alcohol, which could trigger use.

The Long-Term Benefits of Quitting Chewing Tobacco

  • No more red, sore gums.
  • Those white patches in your mouth disappear.
  • You will get fewer cavities because your teeth won�t be worn away by tobacco.
  • Your risk of cancers caused by smokeless tobacco (cheek, gums, mouth, tongue, throat, stomach) lessens each year, to the point where it is almost as if you'd never used smokeless tobacco.

Quitting is very difficult and takes a lot of effort. Be easy on yourself if you do relapse. You can learn from the relapse. Whatever you do, DON'T GIVE UP! You are still working on becoming a smokeless tobacco nonuser. It can often take a few tries before you can totally quit, but it is worth it. The benefits of quitting are many and you will notice some of the benefits right away. Within the first few days of quitting smokeless tobacco, you will begin to notice benefits and improvements such as:

  • You will have great breath -- no more trying to hide the tobacco smell with gum or mints!
  • Food will taste better.

Medications to Help You Quit

Anyone who has ever tried to quit using smokeless tobacco "cold turkey" knows how hard it can be. However, there are several medications available that may aid in your quitting process. Many of these medications are the same medications that are used to help people quit smoking. Refer to Medications for additional information.

Nicotine Replacement Therapy (NRT)

Nicotine replacements give you nicotine without the other harmful ingredients in tobacco. The Food and Drug Administration (FDA) has approved several NRT products as effective aids for helping people to quit using tobacco products. These products include:

  • Nicotine gum -- available over the counter
  • Nicotine patch -- available over the counter
  • Nicotine lozenges -- available over the counter
  • Nicotine inhaler -- available only by prescription
  • Nicotine nasal spray -- available only by prescription

While the FDA has NOT approved the use of nicotine replacement therapy to help people quit smokeless tobacco, over-the-counter NRT products have few side effects and may help you quit. If you enjoy the feeling of having something in your mouth, then it may help you to use nicotine gum or lozenges, which are most similar to smokeless tobacco. The 4 mg nicotine lozenge has been shown to be associated with decreased nicotine withdrawal symptoms and tobacco cravings. Refer to Medications for additional information.

Prescription Medications

While Bupropion (Zyban®) and Varenicline (Chantix®) have been shown to help people quit smoking, the research is limited as to their value in quitting smokeless tobacco. However, some people have found these medications to be helpful in quitting smokeless tobacco. You may want to talk with your physician as to whether or not these medications would work for you. Refer Medications for additional information.

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