What Is Chewing Tobacco?

Types and Health Risks

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Chewing tobacco is not a safer alternative to smoke and poses significant health risks, including addiction. When you think about the dangers of tobacco, your mind probably jumps to cigarette smoke. While smoking tobacco is dangerous, ingesting it in other ways, like chewing it, can be equally harmful.

According to the U.S. Food and Drug Administration (FDA), every day, 840 people under 18 try smokeless tobacco for the first time.  

Nicotine Absorption

Nicotine is a highly addictive substance. When you chew tobacco, nicotine is absorbed orally. According to one study from 2014, nicotine blood levels tend to peak within about a half-hour of ingestion. Smokeless tobacco products are formulated to ensure nicotine absorption.

Your body absorbs nicotine from chewing tobacco a lot slower than with cigarette smoke. Still, the amount that ends up in your body is similar. Studies show that you actually absorb more nicotine from chewing tobacco than you would from smoking cigarettes at 4.5 milligrams (mg) compared to 1 mg.

Tobacco chewing pouches

Douglas Sacha / Getty Images

What Is Chewing Tobacco?

Chewing tobacco is available in various forms. It’s made from different dried parts of the tobacco plant. To use chewing tobacco, you typically place it between your cheek and gums or teeth. You can spit or swallow the juices. Some forms of chewing tobacco are spitless.

When you put chewing tobacco in your mouth, the tissues in your oral cavity absorb the nicotine. Your blood’s nicotine concentration slowly increases. Nicotine tends to make its way to and concentrate in certain organs like the liver, spleen, and kidneys. It also makes its way to the brain. 

Why do people use chewing tobacco? Here are a few possible reasons:

  • Some use it to help quit smoking, though there’s no evidence that it’s useful for this purpose.
  • Some people like the taste.
  • Like cigarettes, smokeless tobacco products are highly addictive. People may return to chewing tobacco because they are addicted.
  • Flavored smokeless tobacco products may be more appealing and may attract new users.

Types of Chewing Tobacco

Chewing tobacco is a dried smokeless tobacco product. It’s available in loose-leaf, twist, or plug form. Loose leaves look a lot like tea leaves. A plug is a compressed block of tobacco, and a twist is a braided leaf product that looks like a very odd, dark-colored pretzel.

Carcinogens in Chewing Tobacco

All tobacco products contain harmful ingredients. Studies show that there is a minimum of 28 carcinogens in smokeless tobacco products.

Some of the carcinogens in chewing tobacco include:

  • Nitrosamines 
  • Aldehydes 
  • Polynuclear aromatic hydrocarbons 
  • Polonium-210 and other heavy metals 

Chewing tobacco and other tobacco products may cause the following types of cancer:

Health Risks of Chewing Tobacco

Chewing tobacco carries a host of health risks, including:


There’s strong evidence that smokeless tobacco products, including chewing tobacco, have serious health risks. Notably that they contain a host of cancer-causing ingredients. 

According to the American Lung Association, these products have links to several cancers, including oral cancers, pancreatic cancer, and esophageal cancer.


Using chewing tobacco can also have impacts on your heart and circulatory system. According to the American Cancer Society, smokeless tobacco products can increase heart disease and stroke risk.

Oral Health

Using chewing tobacco can increase your risk of developing oral cancers, and it can wreak havoc on your oral health. It can cause leukoplakia, erythroplakia, and gum disease. It can also permanently stain your teeth. 

Leukoplakia is a condition where white spots or patches crop up inside your mouth. These lesions are sometimes precancerous. Erythroplakia is a similar condition characterized by red patches in the mouth. You can also develop both simultaneously. This condition is called erythroleukoplakia 


Chewing tobacco while pregnant also carries a risk of stillbirth and premature birth.


Some chewing tobacco products look a lot like candy. Children may mistake them for treats, which can lead to nicotine poisoning.

According to one study, there were over 120,000 reports of child-related nicotine poisoning between 2001 and 2016. The research also suggests that these numbers are likely low due to underreporting.


The only way to prevent adverse health effects caused by chewing tobacco is to quit altogether. Unfortunately, quitting can be difficult because of the highly addictive qualities of nicotine. 

Here are a few strategies to help you tackle quitting this habit:

  • Expect withdrawal symptoms and try to find a replacement for chewing tobacco. Gum is a good substitute.
  • Enlist the help of friends and family.
  • Consult a professional for help and ask about medications that might help you quit.

As of Dec. 20, 2019, the new legal age limit is 21 years old for purchasing cigarettes, cigars, or any other tobacco products in the U.S.

A Word From Verywell

You might think that chewing tobacco is less harmful than smoking. However, evidence suggests that using smokeless tobacco products can have a similar adverse effect to inhaling cigarette smoke. It’s true that your lungs won’t be affected in the same way, but chewing tobacco increases your risk for oral cancers. 

If you’re thinking of using chewing tobacco as a way to quit smoking, think again. Chewing tobacco contains nicotine, too, and can be just as addictive. Seek professional help if you’re struggling with quitting any kind of tobacco product. 

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  1. U.S. Food and Drug Administration. Smokeless tobacco products, including dip, snuff, snus, and chewing tobacco. Updated June 23, 2020.

  2. Pickworth WB, Rosenberry ZR, Gold W, Koszowski B. Nicotine absorption from smokeless tobacco modified to adjust phJ Addict Res Ther. 2014;5(3). doi:10.4172/2155-6105.1000184

  3. Benowitz NL. Nicotine and smokeless tobaccoCA: A Cancer Journal for Clinicians. 1988;38(4):244-247.

  4. American Cancer Society. Health risks of smokeless tobacco.

  5. Benowitz NL, Hukkanen J, Jacob P. Nicotine chemistry, metabolism, kinetics and biomarkersHandb Exp Pharmacol. 2009;(192):29-60. doi:10.1007/978-3-540-69248-5_2

  6. Kostygina G, Ling PM. Tobacco industry use of flavourings to promote smokeless tobacco productsTobacco Control. 2016;25(Suppl 2):ii40-ii49. doi:10.1136/tobaccocontrol-2016-053212

  7. American Cancer Society. Harmful chemicals in tobacco products.

  8. Stepanov I, Villalta PW, Knezevich A, Jensen J, Hatsukami D, Hecht SS. Analysis of 23 polycyclic aromatic hydrocarbons in smokeless tobacco by gas chromatography-mass spectrometry [published correction appears in Chem Res Toxicol. 2010 Apr 19;23(4):845]. Chem Res Toxicol. 2010;23(1):66-73. doi:10.1021/tx900281u

  9. Warnakulasuriya S, Straif K. Carcinogenicity of smokeless tobacco: Evidence from studies in humans & experimental animalsIndian J Med Res. 2018;148(6):681-686. doi:10.4103/ijmr.IJMR_149_18

  10. National Cancer Institute. Smokeless tobacco and cancer.

  11. American Lung Association. Health effects of smokeless tobacco products.

  12. Muthukrishnan A, Warnakulasuriya S. Oral health consequences of smokeless tobacco useIndian J Med Res. 2018;148(1):35-40. doi: 10.4103/ijmr.IJMR_1793_17

  13. Wang B, Rostron B. Tobacco-related poison events involving young children in the US, 2001–2016Tob Regul Sci. 2017;3(4):525-535. doi:10.18001/TRS.3.4.12

  14. American Cancer Society. Making a plan to quit and planning your quit day.