Smokeless tobacco

Smokeless tobacco products, also commonly called
“spit tobacco,” are placed in the mouth to allow ab-
sorption of nicotine through the buccalmucosa. Spit
tobacco includes chewing tobacco and snuff. Chew-
ing tobacco,which is typically available in loose leaf,
plug, and twist formulations, is chewed or parked in
the cheek or lower lip. Snuff, commonly available as
loose particles or sachets (resembling tea bags), has
a much finer consistency and is generally held in
the mouth and not chewed. Most snuff products
in the United States are classified as moist snuff.
The users park a “pinch” (small amount) of snuff
between the cheek and gum (also known as dip-
ping) for 30 minutes or longer. Dry snuff is typically
sniffed or inhaled through the nostrils; it is used less
commonly [64].
In 2004, an estimated 3.0%ofAmericans 12 years
of age and older had used spit tobacco in the past
month. Men used it at higher rates (5.8%) than
women (0.3%) [60]. The prevalence of spit tobacco
is the highest among 18- to 25-year-olds and is sub-
stantially higher among American Indians, Alaska
natives, residents of the southern states, and ru-
ral residents [61,66]. The consumption of chew-
ing tobacco has been declining since themid-1980s;
conversely, in 2005, snuff consumption increased by
approximately 2%over the previous year [66], pos-
sibly because tobacco users are consuming snuff in-
stead of cigarettes in locations and situations where
smoking is banned.