Why Snuff May Be More Toxic Than Smokes

Carcinogen, nicotine exposure may be higher among smokeless tobacco users than among smokers

/ Author:  / Reviewed by: Jennifer Gershman, PharmD, CPh

(RxWiki News) If you think chewing or dipping tobacco is safer than smoking, you may want to think again.

A new study found that US adults who exclusively used smokeless tobacco products were exposed to higher levels of nicotine (the primary addictive ingredient in tobacco) and cancer-causing carcinogens than those who only smoked cigarettes.

"Our findings demonstrate the need for continuing study of the toxic constituents of smokeless tobacco as well as their health effects on the individuals who use them," said lead study author Brian Rostron, PhD, an epidemiologist at the Center for Tobacco Products at the US Food and Drug Administration (FDA), in a press release.

Smokeless tobacco — also known as chew, dip and snuff, among other terms — is any tobacco product that is not smoked. Nicotine in the tobacco is absorbed through the lining of the mouth.

According to the National Cancer Institute, at least 28 chemicals in smokeless tobacco have been found to cause cancer. The most harmful of these are tobacco-specific nitrosamines, which are formed during the growing, curing, fermenting and aging of tobacco. The level of tobacco-specific nitrosamines varies by product.

For this study, Dr. Rostron and team looked at 23,684 US adults who participated in the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2012. Of these patients, 16,313 didn't use tobacco, 6,791 only smoked cigarettes, 488 only used smokeless tobacco and 92 used both.

Levels of biomarkers of exposure to nicotine and the tobacco-specific nitrosamine NNK were significantly higher among exclusive smokeless tobacco users than exclusive cigarette smokers, Dr. Rostron and team found.

This finding suggests that smokeless tobacco products may put users at an even higher risk of adverse health effects than traditional cigarettes. However, more research is still needed, Dr. Rostron and colleagues noted.

Because the NHANES is a general health survey, there was no data on the type, quantity or duration of smokeless tobacco use.

This study was published Nov. 18 in the journal Cancer Epidemiology, Biomarkers & Prevention.

Dr. Rostron and team disclosed no funding sources or conflicts of interest.

Review Date: 
November 18, 2015
Last Updated:
November 19, 2015