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Lifesaving Advice: What You Need to Know about Smokeless Tobacco


Amy Lynch for GBMC

October 5, 2018
Where there’s smoke, there’s fire. Cigarettes are a proven contributing factor to a number of health risks. And although people may think smokeless tobacco products are not as dangerous simply because they don’t involve actual smoke, they aren’t necessarily a safer choice.

Smoking vs. smokeless

According to Centers for Disease Control and Prevention (CDC) statistics, smoking is the leading cause of preventable death in the United States, causing harm to nearly every major organ in the body and responsible for more than 480,000 deaths yearly in the U.S. Smokeless tobacco research, however, is a little harder to come by.

“Smoking’s been going on for centuries, but smokeless tobacco is still relatively new, so not much data has been collected on it yet,” said Ari Zaiman, M.D., director of pulmonary medicine at the Greater Baltimore Medical Center. “The surgeon general has studied the progression from cigarette smoking to lung cancer for decades. The newer smokeless products have really only taken off in the past 15 years or so.”

Danger now has many disguises

There are a number of smokeless tobacco products available, many designed to appeal to a younger demographic through flavorings and sleek packaging. Instead of delivering nicotine through smoke inhalation like regular cigarettes, vaping uses a battery-powered e-cigarette device to heat a nicotine-laden liquid, transforming it into aerosol particles that users breathe in. “Juuling” refers to a specific brand of e-cigarette that resembles a USB flash drive.

“Vaping is becoming more and more popular among high-schoolers and even middle-school students,” Dr. Zaiman said. “The vast majority of smokers start smoking in their teens to early adulthood, and although that may be leveling off, the use of e-cigarettes is growing exponentially among that age group. The FDA just declared electronic cigarette use among teens an epidemic.”

The health risks of vaping

Many e-cigarette users believe vaping to be healthier than smoking, and while this may be true to a degree, it doesn’t make vaping healthy. Nicotine poses health risks, no matter what the delivery method.

“Addiction is the biggest risk for adults and teens who vape recreationally, and there are a number of toxic chemicals associated with the practice,” Dr. Zaiman said. “Nicotine levels in e-cigarettes can vary tremendously depending on the product, how deeply and slowly you inhale, and other factors.”

Other vaping risks can include lung damage, pneumonia and reduced ability to fight off infections. Burns and bodily injuries have also occurred in some instances where e-cigarette batteries have exploded or caught on fire.

Chewing tobacco is another form of smokeless tobacco that carries its own specific risks. In addition to nicotine addiction, usage can lead to increased incidence of mouth, tongue, cheek, gum, esophageal and pancreatic cancers.

How to quit

As with smoking, the best way to avoid nicotine addiction through smokeless tobacco is to never try it in the first place. If you’re already a user, though, it is entirely possible to kick the habit.

“With e-cigarettes, you can step down your nicotine intake by gradually reducing the amount or how often you’re using it,” Dr. Zaiman suggested. “Weaning off the nicotine is just one aspect; you’ve also got to recognize and address the social cues and associations that make you want to e-smoke.”

Nicotine withdrawal symptoms depend on the level of addiction and may include feelings of irritability, anger, anxiety and hunger, as well as trouble thinking clearly and intense cravings. Consult your doctor if you need help dealing with these issues.

“There are cessation clinics and support groups out there, and a great deal of help is available online,” Dr. Zaiman added. Primary care practices are often well equipped to assist people with quitting. Visit to find a GBMC Health Partners practice near you.
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