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					                         Tobacco use kills approximately 440,000 Americans each year, with one in every five
U.S. deaths the result of smoking. Smoking harms nearly every organ in the body, causes many diseases, and
compromises smokers' health in general. Nicotine, a component of tobacco, is the primary reason that
tobacco is addictive, although cigarette smoke contains many other dangerous chemicals, including tar,
carbon monoxide, acetaldehyde, nitrosamines, and more.

An improved overall understanding of addiction and of nicotine as an addictive drug has been instrumental in
developing medications and behavioral treatments for tobacco addiction. For example, the nicotine patch and
gum, now readily available at drugstores and supermarkets nationwide, have proven effective for smoking
cessation when combined with behavioral therapy.

Advanced neuroimaging technologies make it possible for researchers to observe changes in brain function
that result from smoking tobacco. Researchers are now also identifying genes that predispose people to
tobacco addiction and predict their response to smoking cessation treatments. These findings—and many
other recent research accomplishments—present unique opportunities to discover, develop, and disseminate
new treatments for tobacco addiction, as well as scientifically based prevention programs to help curtail the
public health burden that tobacco use represents.

We hope this Research Report will help readers understand the harmful effects of tobacco use and identify best
practices for the prevention and treatment of tobacco addiction.

Nora D. Volkow, M.D.
Director
National Institute on Drug Abuse




 Chewing Tobacco Addiction
                           Ok, so it’s not one of the world’s most attractive addictions, at least from a
                           cosmetic standpoint. Chewing tobacco looks like shredded spinach gone bad(real
                           bad). The thought of storing wads of the stuff in your mouth and then spitting
                           out the juices is more than a turn-off for most people. Between the look, the
                           smell, and the taste you wonder, people still do this?

                           The surprising answer is yes, and quite a few. We’ll chalk it up to the amazingly
                           addictive power of nicotine.
We can also chalk it up to ignorance and dis-information. Many people mistakenly believe that chewing
tobacco is much safer than smoking it, which is simply not true. It’s just as dangerous. And while it’s true
you won’t get lung cancer from chewing tobacco, there’s a whole host of other cancers you can get.

Let’s start with some numbers. While many people assume chewing tobacco is a thing of the past, or only
done by Big League baseball players, the surprising numbers prove them wrong. The Centers for Disease
Control (CDC) estimates that up to 11% of high school boys and 2% of high school girls chew tobacco
regularly. Nationally, 3% of American adults use smokeless tobacco on a regular basis.

So, while chewing tobacco can’t boast the through-the-roof numbers like its glowing cousin the cigarette,
it’s still a big problem, especially for our kids. Most people start chewing in middle school, and the most
recent study done by the CDC estimates that 3% of middle school students chew tobacco.

While this may seem like a small amount, consider the fact that by getting hooked on nicotine at such a
young age the likelihood that these kids will be life-long users is very high. Up to 40% of minor and major
baseball players use chewing tobacco, so kids get used to seeing their hero’s using. They think it’s ok, and
when peer pressure or opportunity arises, there’s little incentive for them to say no.

So how addictive is chewing tobacco? Many people think that because they’re not smoking it that it will
take them a very long time to become addicted. This is not true, and in fact it’s actually the opposite. By
holding an average size of dip or chew in your mouth for 30 minutes, you get as much nicotine as smoking
3 cigarettes. The National Cancer Institute states that chewing tobacco is so addictive that many users sleep
with plugs in their mouth so they can keep getting nicotine all through the night.

Yikes.

And we haven’t even gotten to the scary part yet. The list of health complications from chewing tobacco
would make any parent run for the hills with their little ones in tow. The following list is from the National
Cancer Institute (www.cancer.gov).

• Gum recession- This is when the gums fall away from the teeth. It’s very hard to fix this problem.
• Sores- Using chewing tobacco causes sores to form in the mouth within one week of when you first start
using.
• White ones, called leukoplakias, can turn into cancer over time, and red ones, called erythroplakias, have a
high risk of turning into cancer.
• Oral Cancer- This includes cancer of the mouth, throat, and voice box. It’s one of the hardest cancers to
treat, and is often disfiguring when doctors have to operate. The National Cancer Institute estimates that
only half of people diagnosed with oral cancer will live more than 5 years.
• Hypertension- Using chewing tobacco can make your high blood pressure worse.
• Ulcers- Many users accidentally swallow tobacco use from time to time. The nicotine in the juice irritates
the stomach and can cause ulcers.

That’s a scary list, to be sure, but we’re not finished yet. There’s still a whole bunch of other negative
effects from chewing tobacco like teeth stains, bad breath, and drooling, just to name a few.

So if you think your child or someone you know may be addicted to chewing tobacco, what should you
look for?

• Stained teeth
• Bad breath
• Mouth sores
• Brown stained spit

If you do suspect that your child or someone you know is using chewing tobacco they may not know the
full extent of the danger they’re in. Like we stated earlier, many people really have no clue just how
dangerous chewing tobacco is.

There are many profiles of young people online who died just a few years after they started using chewing
tobacco. Mouth cancer can spread extremely fast, and their stories are heartbreaking.

Whoever is using, whether it’s a child, spouse, or friend, they need to know the risks they’re taking. Talk to
them openly and without judgment about their decision to chew. Showing them pictures of mouth cancer
victims can really help drive the point home about what this habit can do to them.

The National Cancer Institute offers free help and counseling for anyone that wants to quit chewing. You
can call them at 1-877-44U-QUIT to talk to a counselor. Quitting chewing tobacco is just like quitting
smoking.

The following tips can help:

• Pick a quit day, perhaps a week after you decide you want to quit. This will give you time to prepare for
quitting.
• Plan lots of fun activities on your quit day. This will keep your mind off tobacco.
• Using nicotine gum or a patch will help with your withdrawal symptoms, and you can slowly wean
yourself off of these in a few weeks. These are available at any pharmacy without a prescription.
• Whether it’s you or someone you know that’s quitting, offer plenty of praise and rewards for getting
through each day. Even if it’s something small like flowers, or going out to eat, it will help them get
through the first week, the first month, etc.

Remember, chewing tobacco is far more dangerous than most people realize. Showing pictures of what can
happen to people that chew might be the best way to get them to quit. Whether you call the National
Cancer Institute’s helpline or do a Google search, there are plenty of resources out there to help you or
someone else quit for good.

				
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