Smokeless Tobacco

Aka: Smokeless Tobacco, Chewing Tobacco, Tobacco Chew

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II. Epidemiology

  1. Prevalence: U.S.
    1. Adults: 5 Million (2.1%) total, 4.2% of men in U.S.)
    2. Most common in midwest and south (esp. West Virginia, Wyoming, Montana and Mississippi)
  2. Race
    1. Most common in non-hispanic white patients
  3. Gender
    1. Males
      1. Men: 4.2%
      2. Boys: 1.0% middle school, 2.3% high school
    2. Females
      1. Women: 0.2%
      2. Girls: 0.7% middle school, 0.6% high school

III. Risk Factors

  1. Uninsured
  2. Mental health disorders

IV. Complications

  1. Cerebrovascular Accident
  2. Esophageal Cancer
  3. Latyngeal Cancer

V. Management

  1. See Tobacco Cessation
  2. Most effective measures for smokeless Tobacco Cessation
    1. Tobacco Cessation Counseling (even brief clinic-based measures)
    2. Nicotine Replacement therapy
    3. Varenicline (Chantix)
  3. Other measures which do not appear effective in smokeless Tobacco Cessation
    1. Bupropion (Zyban, Wellbutrin)

VI. Resources

  1. Smokeless Tobacco Product Use in the United States (CDC)
    1. https://www.cdc.gov/tobacco/other-tobacco-products/smokeless-product-use-in-the-us.html

VII. References

  1. Livingstone-Banks (2025) Cochrane Database Syst Rev 4(4):CD015314 +PMID: 40232040 [PubMed]

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