Smokeless Tobacco, Chew, Dip, Snuff, Snus, and Spit

Chewing tobacco comes in the form of loose leaf, plug or twist but it is typically shredded like short cut grass, generally mildly acidic and is intended to be chewed throughout the day.  Chewing tobacco is placed between the gums, teeth, or cheeks, and as the name implies, chewed for consumption.

Snuff is chopped into particles like large coffee grounds, and it can be dry, moist, or in sachets (tea bag-like pouches).  Snuff users will typically place the product between the gum and cheek then suck on the tobacco and spit out the tobacco juices.  Some forms of snuff are sniffed or inhaled into the nose.

Snus is a variant of snuff and is processed differently and come in moist snuff packages that resemble tea bags and must be kept refrigerated.

Dip is placed on the lower lip and gums that tend to cause extra saliva when dipping.  The nicotine is absorbed through the mouth. And the juices that are formed when dipping are sometimes swallowed or spat depending on one’s preference.

Health risks:

  • Smokeless tobacco contains 28 cancer-causing agents.
  • Smokeless tobacco contains a radioactive element (polonium-210) which is found in tobacco fertilizer and harmful metals like arsenic, beryllium, lead, nickel, and mercury
  • Smokeless tobacco causes cancer of the mouth, esophagus, and pancreas
  • Smokeless tobacco can cause gum disease, tooth decay, and tooth loss
  • Smokeless tobacco increases the risk for death from heart disease and stroke
  • Smokeless tobacco can cause nicotine poisoning in children.


Connolly GN, Richter P, Aleguas A Jr, Pechacek TF, Stanfill SB, Alpert HR. Unintentional Child Poisonings Through Ingestion of Conventional and Novel Tobacco Products. Pediatrics 2010;125(5):896–9 [cited 2014 Oct 31].

Piano MR, Benowitz NL, Fitzgerald GA, Corbridge S, Heath J, Hahn E, et al. Impact of Smokeless Tobacco Products on Cardiovascular Disease: Implications for Policy, Prevention, and Treatment: A Policy Statement from the American Heart Association. Circulation 2010;122(15):1520–44 [cited 2014 Oct 31].

Stanfill SB, Connolly GN, Zhang L, Jia LT, Henningfield JE, Richter P, et al. Global Surveillance of Oral Tobacco Products: Total Nicotine, Unionised Nicotine and Tobacco-Specific N-Nitrosamines. Tobacco Control 2011 May;20(3):e2. doi:10.1136/tc.2010.037465 [cited 2014 Oct 31].

World Health Organization. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Volume 89: Smokeless Tobacco and Some Tobacco-Specific N-Nitrosamines.[PDF–3.18 MB] Lyon (France): World Health Organization, International Agency for Research on Cancer, 2007 [accessed 2014 Oct 31].