Smokeless tobacco is a type of tobacco that is not burned. Like cigarettes, it contains high levels of nicotine, which can lead to addiction. While smokeless tobacco doesn’t carry risk of lung cancer, there are other risks associated with it. There are three main forms of smokeless tobacco.

Chewing tobacco is usually found as moist, shredded tobacco leaves. It comes loose, in a compressed “brick” or in a small pouch. The tobacco is placed near the back of the mouth, between the lower lip and the gums. Nicotine gets absorbed through the gum tissue. Most chewing tobaccos stimulate saliva production. The saliva mixes with the tobacco juice and needs to be either spit or swallowed. Some chewing tobaccos, however, are “spitless” tobaccos that are designed to produce less tobacco juice and eliminate the need for spitting.

There are many oral health risks associated with chewing tobacco. The tobacco juice can create unsightly stains on teeth and dental work. The tobacco can damage the delicate gum tissue causing or exacerbating gingivitis. Many chewing tobaccos contain sugar, which can promote tooth decay. The biggest threat from chewing tobacco comes from cancer-causing nitrosamines that can lead to cancers of the mouth, throat and stomach. Some companies claim that they use processes to reduce these cancer-causing chemicals, but studies show the risk remains.

Snuff is a dry, finely-ground, powdered version of tobacco that is snorted up the nose. Most snuff is produced with added scents and flavorings. Like all smokeless tobaccos, snuff contains addictive nicotine. An article from the British Medical Journal found that snuff dramatically decreases many of the risks of smoking, but also increases the risk of oral and nasal cancers.

Snus, pronounced snoos, is a type of smokeless tobacco used in Sweden. Similar to chewing tobacco, it comes either loose or in small pouches. The snus is placed under the top lip. Snus does not stimulate salvia production, but may still have staining effects on the teeth and dental work. “White” versions of snus are said to reduce the risk of staining, but cannot eliminate it.

Due to the way it is processed, snus does not contain the same cancer-causing chemicals found in chewing tobacco, but still carries some risks. Snus can damage gum tissue, causing gingivis and gingival recessions. Some snus contains sugar, possibly causing tooth decay. Snus affects the pH levels inside the mouth, putting the user at risk for mouth lesions. Snus is currently banned throughout the EU and cannot be legally purchased in the United Kingdom. Some users purchase it through online stores, but this action is illegal.

Smokeless tobacco should not be considered a safe alternative to smoking. It may not carry the same risks to the lungs, but it has other risks that are just as bad, or even worse. For people interested in quitting cigarettes or smokeless tobacco, a healthcare professional can provide many treatment options, including drug therapy.