Smokeless tobacco products have a high risk of addiction and returning to smoking and should not be used as an alternative to cigarettes, cigars or pipes, says the America Heart Association in a policy statement. Smokeless tobacco products are not as safe as many people believe, they are linked to an increased risk of certain cancers, fatal stroke and fatal heart attack.

The American Heart Association’s policy statement has been published in the medical journal Circulation.

Mariann Piano, Ph.D., lead writer of the statement and a professor in the Department of Biobehavioral Health Science at the University of Illinois at Chicago, said:

No tobacco product is safe to consume.

In Sweden, between 1976 and 2002 there was a considerable drop in smoking rates, which corresponded with an increase in smokeless tobacco use – this led many to believe that smokeless tobacco is a healthy alternative to smoking. However, a recent US study found that among people who use smokeless tobacco products, there has been no drop in smoking rates at all.

The author stresses that if you want to quit smoking, nicotine replacement therapy, in the form of nicotine gum or a nicotine-releasing skin patch is a much safer alternative to smokeless tobacco products.

According to clinical studies, there is no link between using nicotine replacement therapy and increased heart attack or stroke risk.

Smokeless tobacco products have been entering the US market in response to the recent smoke-free air laws, which forbid tobacco smoking in many places.

Dr. Piano said:

Smokeless tobacco products are harmful and addictive – that does not translate to a better alternative.

The policy statement informs that adolescent boys are using smokeless tobacco at an increasing rate. The FDA (Food and Drug Administration) issued a final regulation related to the Tobacco Control Act that became effective June 22 that prohibits the sale of tobacco products to anyone younger than 18 years.

Piano said:

Scientists and policy makers need to assess the effect of “reduced risk” messages related to smokeless tobacco use on public perception, especially among smokers who might be trying to quit.

Smokeless tobacco products may refer to:

  • Dipping tobacco, it is placed between the lower or upper lip and gums.
  • Chewing tobacco..
  • Snuff, it is insufflated or “snuffed” through the nose.
  • Snus, a Swedish product similar to dipping tobacco.
  • Creamy snuff, a fluid tobacco mixture marketed as a dental hygiene aid, albeit used for recreation.
  • Tobacco gum.
  • Dissolvable tobacco.
  • Topical tobacco paste, it is applied to the skin.
  • Tobacco water, a mixture of water and tobacco.

“Impact of Smokeless Tobacco Products on Cardiovascular Disease: Implications for Policy, Prevention, and Treatment. A Policy Statement From the American Heart Association”
Mariann R. Piano PhD, RN, FAHA, Chair, Neal L. Benowitz MD, Garret A. FitzGerald MD, Susan Corbridge PhD, APN, ACNP, Janie Heath PhD, Ellen Hahn PhD, Terry F. Pechacek PhD, George Howard DPH, FAHA
Circulation. 2010
Published online before print September 13, 2010, doi: 10.1161/CIR.0b013e3181f432c3

Written by Christian Nordqvist