Smokeless Tobacco Products

Smokeless tobacco causes significant health risks and is not a safe alternative to smoking cigarettes. It contains the same addictive chemical (nicotine) that is in cigarettes, which can lead to addiction and dependence.1  The amount of nicotine absorbed from smokeless tobacco is 3 to 4 times the amount delivered by a cigarette.2 


Key Facts About Smokeless Tobacco Use:

  • Smokeless tobacco contains 28 cancer-causing agents (carcinogens) or known causes of human cancer. It also increases the risk of developing cancer of the oral cavity and pancreas.3
  • There are two main types of smokeless tobacco used in the U.S., chewing tobacco and snuff. Chewing tobacco comes in loose leaf, plug and twist form. Snuff is finely ground tobacco that can be dry, moist, or in bag-like pouches. Most smokeless tobacco users place the product in the cheek or between their gum and cheek, suck on the tobacco and spit out or swallow the juices, which is why smokeless tobacco is often referred to as spit tobacco.4
  • However, several tobacco companies have started to develop and test market new smokeless tobacco products such as snus, a product that does not require the user to spit and tobacco products that dissolve when put into the mouth.5
  • In 2006, the five largest smokeless tobacco manufacturers spent over $354 million on advertising and promotion, the highest amount ever recorded.  The majority of these dollars (57.5%) were spent on price discounts to smokeless tobacco retailers or wholesalers to reduce the price to consumers.6


Smokeless Tobacco Use in the U.S.:

  • In the U.S., an estimated 3.3 percent of adults are current smokeless tobacco users; use is much higher among males than females (6.5% vs. 0.4%).  Amongst specific populations, American Indian/Alaska natives have the highest use (7%) followed by white males (4.3%).7
  • An estimated 7.4 percent of high school students are current smokeless tobacco users. Smokeless tobacco use is much more common among male then female high school students (13.4% vs. 2.3%). It is estimated that African American high school students use smokeless tobacco (1.2%) less than White (10.3%) and Hispanic (4.7%) students.8 
  • An estimated 2.6 percent of middle school students are current smokeless tobacco users.9 

The American Lung Association has more information available on quitting smoking and our programs to help you do so, our advocacy efforts to reduce tobacco use and exposure to secondhand smoke, and tobacco use trends on our website at, or through the Lung HelpLine at 1-800-LUNG-USA (1-800-586-4872).



1. National Cancer Institute. Smokeless Tobacco or Health: An International Perspective. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute; 1992.
2. National Cancer Institute. Smokeless Tobacco and Cancer: Questions and Answers. Accessed November 19, 2009.

3. World Health Organization. Smokeless Tobacco and Some Tobacco-Specific N-Nitrosamines. International Agency for Research on Cancer, Monographs on the Evaluation of Carcinogenic Risks to Humans, Vol. 89. Lyon, France: World Health Organization, 2007.
U.S. Department of Health and Human Services. Preventing Tobacco Use Among Young People: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1994.

5. Federal Trade Commission. Smokeless Tobacco Report for the Year 2006; Issued in 2009.

6. Centers for Disease Control and Prevention. Factsheet: Smokeless Tobacco. Accessed October 21, 2009.  Also see Wiki site Tobacco Products' Smokeless Tobacco list for specific product information.
Substance Abuse and Mental Health Services Administration. Results From the 2007 National Survey on Drug Use and Health: Detailed Tables. Rockville (MD): Substance Abuse and Mental Health Services Administration, Office of Applied Studies, 2008.
Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance—United States, 2007. Morbidity and Mortality Weekly Report 2007;57(SS-4):1–136.
Centers for Disease Control and Prevention. 2006 National Youth Tobacco Survey and Key Prevalence Indicators.