CA: A Cancer Journal for Clinicians, Vol 36, 310-316, Copyright
© 1986 by American Cancer Society
National Institutes of Health Consensus Development Conference Statement: Health Implications of Smokeless Tobacco Use. January 13-15, 1986
Use of smokeless tobacco has a long history in the United States, but trends in recent years, in particular the increasing use of snuff by children and young adults, have led to concerns about possible health consequences. National data suggest that at least 10 million persons have used smokeless tobacco of one kind or another within the past year. Patterns of use by age and sex appear to be similar across the country.
The human evidence that use of snuff causes cancer of the mouth is strong. Risk is particularly high for parts of the mouth where the snuff is usually placed. Data are currently insufficient to come to any conclusions regarding the relationship of smokeless tobacco use to cancers at other sites. Repeated experimental studies in animals have failed to provide adequate evidence that chewing tobacco, snuff, or extracts derived from them induce cancer. However, nitrosamines chemically related to nicotine occur at high levels in snuff and, generally, at lower levels in chewing tobacco. These compounds are highly carcinogenic in animals. The concentrations of nitrosamines in smokeless tobacco are far higher than the levels of these compounds allowed in any US food or beverage.
Smokeless tobacco use increases the frequency of localized gum recession and leukoplakia where the snuff is usually placed, but evidence of its relationship to other diseases of the oral cavity is inadequate. The presence of lead in smokeless tobacco may pose a special risk for the developing fetus.
Use of smokeless tobacco releases nicotine into the bloodstream and produces blood levels of nicotine comparable to those produced by smoking tobacco. The primary behavioral consequence of regular use of smokeless tobacco is long-term nicotine dependence and its associated health risks.
Use of smokeless tobacco is one of a number of health-endangering behaviors that frequently coincide, raising the clear potential for long-term and serious consequences.
