Facts You Should Know About Smokeless (Spit) Tobacco

OBob Gold
OBob Gold

December 21st, 2003, 12:56 am #11

From: John (Gold)                                  (Original Message) Sent: 12/18/2003 5:01


Release Date: Dec. 15, 2003
By Becky Ham, Science Writer
Health Behavior News Service

The most popular brands of smokeless tobacco also contain the highest amounts of nicotine that can be readily absorbed by the body, according to a new study.

Moist snuff brands that have the highest market share, like Skoal, Copenhagen and Kodiak, contained high amounts of unprotonated or "free-base" nicotine, researchers at the Centers for Disease Control and Prevention report in the  December issue of Nicotine & Tobacco Research.
The most popular brand of loose-leaf smokeless tobacco, Levi Garrett, also had the highest levels of free-base nicotine, but the relationship between market share and nicotine content in loose-leaf tobacco was not as consistent as with moist snuff.
Smokeless tobacco products with a high percentage of free-base nicotine can be rapidly absorbed in the mouth, and speed is a "major determinant of addiction," says Patricia Richter, Ph.D. Some researchers suggest the amount of free-base nicotine in snuff and loose-leaf tobacco can be controlled by manipulating the product's pH levels.
Tobacco companies are required to report the amount of nicotine in their smokeless tobacco products to the CDC, but by law this information is kept confidential as a corporate trade secret. Separate from these reports, Richter and Francis Spierto, Ph.D., analyzed 18 brands of smokeless tobacco to determine their free-base nicotine content.
"The purpose of the study was to provide consumers, researchers and public health officials with information on these levels in popular smokeless tobacco brands," Richter explains.

Richter and Spierto sent 18 different brands of moist snuff and loose-leaf smokeless tobacco from five different companies for testing to a private and independent lab in Canada. Together the brands represent nearly 91 percent of the market share for moist snuff and 76 percent for loose-leaf chewing tobacco.

"Consumers need to know that smokeless tobacco products, including loose-leaf and moist snuff, are not safe alternatives to smoking," Richter says. "The amount of nicotine absorbed per dose from using smokeless tobacco is greater than the amount of nicotine absorbed from smoking one cigarette."

# # #

Health Behavior News Service: (202) 387-2829 or www.hbns.org.
Interviews: Contact Patricia Richter at [url=mailto:pir1@cdc.gov]pir1@cdc.gov[/url].
Nicotine & Tobacco Research: Contact Gary E. Swan, Ph.D., at (650) 859-5322.
Center for the Advancement of Health
Contact: Ira R. Allen
Director of Public Affairs
Last edited by OBob Gold on April 8th, 2011, 1:11 pm, edited 2 times in total.

John (Gold)
John (Gold)

December 21st, 2003, 1:24 am #12

Last edited by John (Gold) on April 8th, 2011, 1:15 pm, edited 1 time in total.

John (Gold)
John (Gold)

May 26th, 2004, 4:11 am #13

Personal tragedy turned into
warning against teen tobacco use
January 23, 2004
by Maggie O'Neill, Staff Writer
Beware: Gruen Von Behrens, an oral cancer patient, speaks to students at Carson Valley Middle School on Wednesday morning about his fight. The cause? Chew.
Students at Carson Valley Middle School listened -- and listened well -- as oral cancer survivor Gruen Von Behrens relayed a message on Wednesday.

"I didn't think it'd happen to me," he said.

Von Behrens, once a popular 17-year-old baseball player at an Illinois high school, stood as a 26-year-old advocate before middle school students, telling how tobacco took his good looks away.

"I know I'm a little hard to understand, so you're going to have to bear with me and listen," he said to the packed auditorium.

"This isn't a mask I can take off and throw in the closet. I'm like this 365 days a year."

"This" began for Von Behrens when he was 17 and noticed a white spot on his tongue that began to grow and cause it to split.

He told his mother the drooling she noticed was from a painful wisdom tooth.

"I didn't want my mom to see what was going on in my mouth," he said.

At the same time, he holed up in the bathroom, asking God why this was happening to him.

"This" began with chewing tobacco when he was 13, a decision he regrets 33 surgeries later.

"I liked the way it tasted," he said at the assembly. "It made me feel good."

Concerned about his wisdom tooth, Von Behrens' mother took him to a dentist. Von Behrens told the dentist he wasn't there due to a tooth. He had cancer. The dentist agreed.

"I've never seen my mom cry like that," Von Behrens said. "It ripped her heart out."

Doctors gave Von Behrens a 25 percent survival chance for his first surgery. The operation took 13 hours as friends and family gathered anxiously in a waiting room.

"At 17, you're not supposed to think about life and death issues," he said.

He did survive, but doctors severed his tongue as part of the operation. The 5-foot-10 baseball player recuperated a month and a half later to discover another face in the mirror.

"I said, 'Man this ****. I'm not that good-looking guy anymore.'"

Next came painful radiation and when he reached 19, a time he said should be "the best years of life," doctors transplanted three inches of bone from his back to his face to give him a jaw. The transplant lasted two days. Then his body rejected it.

In February 2002, doctors cut bone from his left leg to again attempt to shape a jaw for Von Behrens. The surgery was a success, but left Von Behrens with a flattened calf and on crutches.

None of "this" has stopped the courageous man, scheduled to undergo his 34th surgery March 10. None of it has stopped Von Behrens from making a passionate plea that people should not be judged on appearance.

"Be your own person and be yourself," he said at the assembly. "Friends don't care what you look like. Talk to the person sitting next to you. They could (turn out to be) your best friend."

He spoke of the small things and of family and of friends who make life meaningful.

"Be thankful for what you have guys and enjoy life. Be nice to your parents and nice to your friends. Tell them you love them."

He encouraged students to speak out and tell others who are smoking or using chew to stop, to tell them it smells, to say they won't give them a kiss with a stinky mouth.

"Take what I have told you to heart guys," he said. "If you see someone using (tobacco), say 'You're going to look like (Von Behrens).'"

Toward the end of his talk, he said he is thankful every day for one thing. He walked across the gymnasium floor.

"I can still walk," he said.
Maggie O'Neill can be reached at [url=mailto:mo'neill@recordcourier.com]mo'neill@recordcourier.com[/url]
Copyright Record-Courier2004
Last edited by John (Gold) on April 8th, 2011, 1:18 pm, edited 1 time in total.

John (Gold)
John (Gold)

June 1st, 2004, 1:40 am #14

Say So Long to Spit Tobacco
MONDAY, May 31 (HealthDayNews) -- Smokers have no doubt been barraged with warnings about the dangers of their bad habit, but those who use smokeless tobacco might also want to heed the health cautions.

"Smokeless tobacco is not without health risks," said Dr. John Spangler, a family medicine specialist at Wake Forest University who studies tobacco use. "Although it doesn't seem to cause cardiovascular disease or cancers to the same rate that cigarette smoking does, it definitely does cause them."

It seems a perfect time to stop, since May 31 has been designated World "No Tobacco" Day, when smokers will put away their cigarettes in a gesture to good health.

The American Cancer Society says people who use chewing tobacco and snuff face 50 times the risk of developing cancers in their cheeks and gums as those who don't chew. Every day, an estimated 24 Americans die of oral cancer -- nearly 8,800 a year -- according to the Oral Cancer Foundation.

The habit is also linked to cancer of the pancreas, kidneys, prostate and possibly the breast, Spangler said.

Chewing tobacco and snuff -- another form of the leaf that's put in the mouth -- should be a particular concern for America's youth. Nearly 10 percent of the nation's high school students (almost 16 percent of boys and 1.5 percent of girls) say they've used smokeless tobacco in the past month, according to the U.S. Centers for Disease Control and Prevention.

One misconception about spit tobacco is that it's chemically more benign than tobacco that's smoked. Untrue, Spangler said. Both products contain the same litany of cancer-causing chemicals, especially tobacco-specific nitrosamines (TSNAs). However, smokeless tobacco users ingest far greater concentrations of these TSNAs than do smokers, 10 times more, on average, according to the Oral Cancer Foundation.

Less serious but by no means pleasant, smokeless tobacco use is associated with cosmetic problems such as chronic bad breath, stained teeth and gum and tissue disease.

One "dip" of spit tobacco is said to contain 10 times the nicotine jolt of a cigarette, and that sends the heart racing, constricts blood vessels, kicks up blood pressure and strains the heart, Spangler said. It also makes spit tobacco more addictive than cigarettes, and therefore potentially more difficult to give up, he added.

Difficult, but not impossible. Herbert Severson is a researcher who studies spit tobacco cessation programs. He and his colleagues at the Oregon Research Institute are launching an online program to help people quit chewing.

Like other chewing tobacco cessation efforts, ChewFree.com resembles smoking cessation plans in several respects, but it's not identical.

"There are subtle differences," Severson explained. "The kind of withdrawal symptoms people experience with chewing tobacco are a little different." While smokers may become depressed when they quit, chewers are more likely to become agitated and angry and to see their ability to concentrate suffer.

Oral substitutes, such as nicotine gum, are quite important for chewers, and use patterns are different, Severson said. That last point is key, he added, because chewing tobacco often takes on a more central part of a person's life. Ironically, users -- almost always men -- may work at smoke-free companies that have indirectly encouraged employees to go smokeless, Severson said.

Chewing tobacco also provides background activity for typically male pursuits -- hunting, fishing and baseball -- when smoking isn't necessarily possible. "You can use it in a lot of situations where you can't smoke," Severson said.

ChewFree.com, which has received funding from the National Cancer Institute, offers tips for successful cessation. It also provides information on a "blending program" that reduces nicotine exposure by mixing tobacco with nicotine-free plants such as mint snuff or herbal alternatives.

Perhaps the most effective component, Severson said, is encouraging men to take a look at the damage chewing tobacco is doing to their mouth. "It's really quite motivational" to see the lesions that form where the tobacco sits against the gums, he said. Seven in 10 regular users develop these sores; 3 percent to 4 percent of those sores become tumors. Having mouth damage "is directly related to the length of time a man has chewed and the weekly amount," Severson said.
© 2004 Forbes.com Inc.™ All Rights Reserved

John (Gold)
John (Gold)

October 8th, 2004, 11:41 am #15

I photographed this WCU student on Monday afternoon and after doing so he told me that he had heard that his snuff brand had fiberglass in it so that it would cut his mouth tissues and get nicotine into the bloodstream quicker. I still have not been able to verify the accuracy of his contention but was suprised that he'd continue using it believing it to be true, but then I thought about my own thirty years of knowing what smoking was doing to me and understood.
I timed him from when he put a pinch in his mouth until he reported feeling the rush (bolus) arrive inside his brain and it about a minute. I always thought it took longer (about five minutes) but I guess I was wrong. Still only one rule, no nicotine today ... Never Take Another Pinch, Chew, Dip or Plug! John (Gold x5)


October 8th, 2004, 1:01 pm #16


I have quit both smoking and snuff, and remember the dip as being more difficult to stop using. As the article you posted stated, nicotine in this form provides quite a jolt.

I have mentioned in previous posts that I had to get gum grafts. Apparently in some parts of the U.S. this is a semi-common occurance. My dentist has done this procedure many times before. IT REALLY HURT!!! He cut some of the skin off the roof of my mouth and sewed it to the gum area below my bottom front teeth. Before I went through this procedure, I noticed that everyone walking out of his office, through the waiting room, looked unhappy. Yeah, the procedure really hurt.

Living in another (more politically correct?) state now, whenever a hygenist asks about my gums, I tell them what happened and they look at me like I'm crazy. Gee. ya think? Well little do they know it was even worse; parts of my bottom gums had turned white, a pre-cancerous sign.

Do I need to say how my wife felt about Copenhagen? No, I think not. It was so bad, I would go to sleep with a pinch in; when I woke up it was gone. My wife's grandfather used to do the same thing. The stories I could tell you would make you sick.

BTW, I think its great you posted photos of people who had to have their chin/jaw removed. Seeing someone like that in person motivated me to stop dipping. Hopefully more people who dip will see images like this. Removal of a dipper's chin is, unfortunately, more common than most people think.

I wish that I never put nicotine into my body. But I can't change that. I can, however, choose to never do it again. One day at a time.



October 22nd, 2004, 3:17 am #17

Thanks Linda I have come to this thread often for inspiration when my resolve begins to disolve in the least. This is great motivation!! It has never failed to invigorate my determination to Never Take Another Chew.

Kevin, Remaining NicFree & Luv'n It for 126 days. I quit chewing tobacco on 6/17/04, have not spent $631.05 on copenhagen.

John (Gold)
John (Gold)

March 25th, 2005, 11:12 pm #18

Study Abstract:
Hemodynamic and autonomic effects of
smokeless tobacco in healthy young men.
Journal of the American College of Cardiology, March 2005 15;45(6): pages 910-914.

Wolk R, Shamsuzzaman AS, Svatikova A, Huyber CM, Huck C, Narkiewicz K, Somers VK.

Mayo Clinic, Rochester, Minnesota 55905, USA.

OBJECTIVES: The aim of this study was to investigate the acute hemodynamic and autonomic effects of smokeless tobacco.

BACKGROUND: Smokeless tobacco use is increasing. Its cardiovascular effects are not well understood.

METHODS: Sixteen healthy, male, habitual snuff tobacco users (aged 22 1 year) were studied, using a randomized, double-blind, placebo-controlled, crossover design with two separate experimental sessions: placebo and tobacco. Muscle sympathetic nerve activity (MSNA), electrocardiogram, blood pressure, calf blood flow, nicotine, and catecholamines were measured.

RESULTS: Snuff tobacco increased plasma nicotine from 2.8 0.5 ng/ml to 10.4 1.1 ng/ml. Mean blood pressure increased by 10 1 mm Hg, and heart rate increased by 16.2 beats/min. Peripheral vascular resistance, MSNA, and norepinephrine concentration did not change with tobacco, but epinephrine increased by approximately 50%.

CONCLUSIONS: Oral snuff tobacco increases heart rate, blood pressure, and epinephrine. Despite the increase in blood pressure, there is no decrease in either MSNA or peripheral vascular resistance. Smokeless tobacco is a powerful autonomic and hemodynamic stimulus. Catecholamine release from the adrenal medulla likely contributes to this response.

PMID: 15766828 [PubMed - in process]
Last edited by John (Gold) on April 8th, 2011, 1:21 pm, edited 1 time in total.


February 11th, 2006, 3:35 pm #19

Reading this use to make me fearfull, now it brings me joy, because I don't chew any more!!! Great Post!!

Joined: January 16th, 2003, 8:00 am

August 5th, 2006, 6:17 am #20

From above:
Ingredients of Smokeless (Spit) Tobacco
Nicotine: Nicotine is a poisonous and highly addictive drug found in all tobacco products - smokeless (spit) tobacco, cigarettes, cigars and pipe tobacco.

Carcinogens: Many cancer-producing chemicals have been identified in smokeless (spit) tobacco. Nitrosamines are the main carcinogens.

Sweeteners: Because tobacco has an unpleasant taste, brands are heavily sweetened with sugars, which promote tooth decay. Flavourings such as mint, licorice or cherry may be added to improve the taste.

Abrasives: Tobacco leaves contain gritty materials that wear down the surfaces of teeth. These materials also scratch the soft tissues in the mouth, allowing the nicotine and other chemicals to get directly into the blood system.

Salt: Flavouring salts found in smokeless (spit) tobacco contribute to abnormal blood pressure and kidney disease.

Other Chemicals: Hundreds of other chemicals can be found in tobacco which contribute to many health problems.

Never take another puff, dip, or chew!


August 16th, 2006, 7:49 pm #21

Thank you for the education. Yuk!

Amanda x


April 24th, 2007, 4:07 am #22

There is also a thing out there called "hard snuff" which basically looks like lozenges in a blister pack. They are sold here in TX in convenience stores. I've never purchased any (I don't do nicotine, thank you) so I don't know their physical properties exactly.

To me though, in their ads they look suspiciously similar to the NRT lozenges designed to help you "quit smoking."

It would be interesting to know if hard snuff and NRT losenges are different at all.

Don't be fooled!


Lee (aka Beavis)

Joined: November 11th, 2008, 7:22 pm

April 8th, 2011, 12:31 pm #23

Imagine the insanity of a chemical addiction that makes the heart beat 12 beats per minute faster while constricting all blood vessels supplying much needed oxygen to it.  That's like trying to run while holding your breath.  Give it a try sometime.   Want out?   There was always only one rule ... no nicotine today.

Breathe deep, hug hard, live long,

John (Gold x11)       

Acute effects of tobacco chewing on the systemic, pulmonary and coronary circulation

Am J Cardiovasc Drugs. 2011;11(2):109-14. doi: 10.2165/11586750-000000000-00000.

Ramakrishnan S, Thangjam R, Roy A, Singh S, Ramakrishnan L, Seth S, Narang R, Bhargava B.


Background: Tobacco use is highly prevalent in India, with almost half of adult men consuming tobacco in either smoke or smokeless forms (particularly chewing). Although cigarette smoking is known to produce acute hemodynamic effects, there is a lack of data concerning such effects of chewing tobacco.

Objective: The aim of this study was to determine the acute hemodynamic and coronary vasomotor effects of chewing tobacco. Methods: Twelve habitual tobacco chewers (mean ± SD age 51.3 ± 6.9 years) undergoing elective coronary angiography were included in the study. Following coronary angiography, a 7F thermodilution Swan Ganz continuous cardiac output pulmonary artery catheter was used to continuously measure the right heart pressures and cardiac output. Having obtained baseline hemodynamic data, 1g of tobacco was given to be chewed. Subsequently, hemodynamic data were obtained periodically over a period of 60 minutes. A repeat left coronary injection was performed, 10 minutes after giving the tobacco, in the right anterior oblique view to estimate the diameter of the left anterior descending (LAD) artery by quantitative coronary angiography.

Results: Chewing tobacco led to a significant acute increase in heart rate (from 68.3 ± 12.4 beats/min to 80.6 ± 14.6 beats/min, peaking at 10 minutes) and cardiac output (from 3.8 ± 0.45 L/min to 4.7 ± 0.64 L/min, peaking at 15 minutes). There were no significant changes in the right atrial, pulmonary artery, or wedge pressures and hence no change in the pulmonary vascular resistance. More importantly, chewing tobacco was associated with coronary vasoconstriction (proximal LAD diameter change from 3.17 ± 0.43 mm to 2.79 ± 0.37 mm; p-value 0.02; mid LAD diameter change from 2.75 ± 0.36 mm to 2.40 ± 0.22 mm; p-value 0.03).

Conclusion: Chewing smokeless tobacco leads to coronary vasoconstriction and also produces significant hemodynamic alterations. These changes may have a bearing on excess vascular disease.

http://adisonline.com/cardiovascular/pa ... e=abstract

Joined: November 11th, 2008, 7:22 pm

April 11th, 2011, 1:51 am #24

Glen,  it's my impression that the evidence as to which is easier to stop using, cigarettes or oral tobacco,  is mixed.   It had been my belief that since oral users generally had higher overall blood serum nicotine levels, while smokers reached higher peak levels and far far quicker, that it was probably a toss up.  This was reinforced by knowing that nicotine's blood serum half-life is identical for both, roughly two hours, and we'd seen no studies suggesting that re-sensitization or receptor count down-regulation was different for either group.   

Recent focus has been on one major difference between smoke and all forms of oral nicotine delivery.  We know that aside from nicotine stimulating dopamine pathway acetylcholine receptors, that some other still vague chemical in smoke somehow inhibits MAO A and MAO B (known as killjoy enzymes)  whose function it is to clean-up dopamine (either break it down or return it) once released.  This means that dopamine released by nicotine is allowed to linger longer for smokers than oral users.   Does this help explain why oral users generally have higher blood serum nicotine levels than smokers, that oral users are battling higher levels of MAO A and MAO B?  We don't know.

Your mention of none being remaining in the morning brought back memories of some medical records I was reviewing for a disability claim that included a sleep study.  With the entire world watching, this guy awoke in the middle of the night, put a plug in his mouth and went back to bed.  I must say, as a three pack a day smoker,  although I always smoked heavily on both sides of sleep I can't ever recall getting up because I needed more nicotine.  I found it fascinating that this guy did and wondered how common that was.

As for photos, I've been sent some horrible, horrible mouth cancer images from a cancer doctor in India but I've been reluctant to share them.  I recall a couple of participants in smoking seminars saying afterwards that the few lung cancer images I shared were too much for them to handle and they were tame by comparison.  Those images are out there and available but we certainly don't want to be chasing folks off.  We're just trying to strike some balance.

Thanks for the firsthand input, Glen.  As you know, regardless of how nicotine enters the bloodstream there's just one guiding principle that if followed provides a 100% guarantee to all of us ... no nicotine today!

Breathe deep, hug hard, live long,

John (Gold x11)