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{{short description|Finely ground smokeless tobacco product}}
{{short description|Finely ground smokeless tobacco product}}
{{Use dmy dates|date=September 2020}}
{{Use dmy dates|date=September 2020}}
[[File:Smokeless tobacco is no healthier than smoking 130226-M-ZB219-007.jpg|thumb|Dipping tobacco]]''' Dipping tobacco ''' is a type of finely ground or shredded, moistened [[Smokeless tobacco|smokeless]] [[tobacco product]]. It is commonly and idiomatically known as ''dip''. Dipping tobacco is used by placing a pinch, or "dip", of tobacco between the lip and the gum ([[sublabial administration]]). The act of using it is called ''dipping''. Dipping tobacco is colloquially called ''chaw'', ''snuff'', ''rub'', or ''fresh leaf'' among other terms; because of this, it is sometimes confused with other tobacco products—namely [[dry snuff]].
[[File:Smokeless tobacco is no healthier than smoking 130226-M-ZB219-007.jpg|thumb|Dipping tobacco]]
''' Dipping tobacco ''' is a type of finely ground or shredded, moistened [[Smokeless tobacco|smokeless]] [[tobacco product]]. It is commonly and idiomatically known as ''dip''. Dipping tobacco is used by placing a pinch, or "dip", of tobacco between the lip and the gum ([[sublabial administration]]). The act of using it is called ''dipping''. Dipping tobacco is colloquially called ''chaw'', ''snuff'', ''rub'', or ''fresh leaf'' among other terms; because of this, it is sometimes confused with other tobacco products—namely [[dry snuff]].


Using dipping tobacco can cause a various harmful effects such as [[oral cancer]], [[Esophageal cancer|oesophagus cancer]], and [[Pancreatic cancer|pancreas cancer]], [[Coronary artery disease|coronary heart disease]], as well as negative reproductive effects including [[stillbirth]], [[premature birth]] and [[low birth weight]].<ref name="VidyasagaranSiddiqi20165">{{cite journal |last1=Vidyasagaran |first1=A. L. |last2=Siddiqi |first2=K. |last3=Kanaan |first3=M. |year=2016 |title=Use of smokeless tobacco and risk of cardiovascular disease: A systematic review and meta-analysis |url=http://eprints.whiterose.ac.uk/101100/1/EJPC_D_16_00085_R1_2016.pdf |journal=European Journal of Preventive Cardiology |volume=23 |issue=18 |pages=1970–1981 |doi=10.1177/2047487316654026 |issn=2047-4873 |pmid=27256827 |s2cid=206820997}}</ref><ref name=":23">{{Cite journal |last1=Gupta |first1=Ruchika |last2=Gupta |first2=Sanjay |last3=Sharma |first3=Shashi |last4=Sinha |first4=Dhirendra N |last5=Mehrotra |first5=Ravi |date=2019-01-01 |title=Risk of Coronary Heart Disease Among Smokeless Tobacco Users: Results of Systematic Review and Meta-Analysis of Global Data |url=https://academic.oup.com/ntr/article/21/1/25/4793346 |journal=Nicotine & Tobacco Research |language=en |volume=21 |issue=1 |pages=25–31 |doi=10.1093/ntr/nty002 |issn=1469-994X |pmc=6941711 |pmid=29325111}}</ref> Dipping tobacco poses a lower health risk than traditional combusted products.<ref name=":02">{{Cite journal |last1=Hajat |first1=C. |last2=Stein |first2=E. |last3=Ramstrom |first3=L. |last4=Shantikumar |first4=S. |last5=Polosa |first5=R. |date=4 December 2021 |title=The health impact of smokeless tobacco products: a systematic review |journal=Harm Reduction Journal |language=en |volume=18 |issue=1 |page=123 |doi=10.1186/s12954-021-00557-6 |issn=1477-7517 |pmc=8643012 |pmid=34863207 |doi-access=free}}</ref> However it is not a healthy alternative to cigarette smoking.<ref name="Lipari20174">{{cite journal |last1=Lipari |first1=R. N |last2=Van Horn |first2=S. L |date=31 May 2017 |title=Trends in Smokeless Tobacco Use and Initiation: 2002 to 2014 |publisher=Substance Abuse and Mental Health Services Administration |pmid=28636307}}{{PD-notice}}</ref> The level of risk varies between different types of products and producing regions.<ref name="AbramsGlasser2018">{{cite journal |last1=Abrams |first1=David B. |last2=Glasser |first2=Allison M. |last3=Pearson |first3=Jennifer L. |last4=Villanti |first4=Andrea C. |last5=Collins |first5=Lauren K. |last6=Niaura |first6=Raymond S. |year=2018 |title=Harm Minimization and Tobacco Control: Reframing Societal Views of Nicotine Use to Rapidly Save Lives |journal=Annual Review of Public Health |volume=39 |issue=1 |pages=193–213 |doi=10.1146/annurev-publhealth-040617-013849 |issn=0163-7525 |pmc=6942997 |pmid=29323611 |doi-access=free}}{{CC-notice|cc=by4|url=https://www.annualreviews.org/doi/pdf/10.1146/annurev-publhealth-040617-013849|author(s)=David B. Abrams, Allison M. Glasser, Jennifer L. Pearson, Andrea C. Villanti, Lauren K. Collins, and Raymond S. Niaura}}</ref><ref name=":02" /> There is no safe level of dipping tobacco use.<ref name="Lipari20174" /> Globally it contributes to 650 000 deaths each year.<ref name=":33">{{Cite journal |last1=Chugh |first1=Aastha |last2=Arora |first2=Monika |last3=Jain |first3=Neha |last4=Vidyasagaran |first4=Aishwarya |last5=Readshaw |first5=Anne |last6=Sheikh |first6=Aziz |last7=Eckhardt |first7=Jappe |last8=Siddiqi |first8=Kamran |last9=Chopra |first9=Mansi |last10=Mishu |first10=Masuma Pervin |last11=Kanaan |first11=Mona |last12=Rahman |first12=Muhammad Aziz |last13=Mehrotra |first13=Ravi |last14=Huque |first14=Rumana |last15=Forberger |first15=Sarah |date=June 2023 |title=The global impact of tobacco control policies on smokeless tobacco use: a systematic review |url=https://linkinghub.elsevier.com/retrieve/pii/S2214109X2300205X |journal=The Lancet Global Health |language=en |volume=11 |issue=6 |pages=e953–e968 |doi=10.1016/S2214-109X(23)00205-X |pmid=37202029}}</ref>
== History ==
Dipping tobacco evolved from the use of [[snuff (tobacco)|dry snuff]] in early American history. Up until the late 1700s, dry snuff was taken nasally, but then early Americans would take snuff orally by chewing the end of a twig until it resembled a brush, and then "dipping" the twig in the snuff and placing it in their mouths until the snuff dissolved.<ref>{{cite web|url=http://www.americansnuffco.com/Timeline.aspx|title=American Snuff Company - Est. 1900 - Timeline|access-date=19 September 2014|archive-url=https://web.archive.org/web/20111201035702/http://www.americansnuffco.com/Timeline.aspx|archive-date=1 December 2011|url-status=dead}}</ref> Using dry snuff orally eventually evolved into modern day moist snuff, which [[Copenhagen (tobacco)|Copenhagen]] introduced in 1822 and then [[Skoal (tobacco)|Skoal]] started producing in 1934. Most varieties of dipping tobacco are much more recent inventions.

Moist snuff is available throughout the United States. Dipping tobacco is predominantly used by males.<ref>{{Cite journal|last=Cornelius|first=Monica E.|date=2020|title=Tobacco Product Use Among Adults — United States, 2019|url=https://www.cdc.gov/mmwr/volumes/69/wr/mm6946a4.htm|journal=MMWR. Morbidity and Mortality Weekly Report|language=en-us|volume=69|issue=46|pages=1736–1742|pmid=33211681| doi=10.15585/mmwr.mm6946a4|issn=0149-2195|pmc=7676638}}</ref> Also, dipping tobacco has a similar presence in [[Canada]]. Smokeless tobacco use by professional [[baseball]] players was widespread throughout the 20th century until more recent years with the [[Major League Baseball|MLB]] cracking down on tobacco consumption, although a 1999 survey reported that "31 percent of the league's rookies used smokeless tobacco".<ref>{{Cite news|url=http://www.slate.com/articles/news_and_politics/explainer/2009/11/why_do_so_many_baseball_players_chew_tobacco.html|title=Why Do So Many Baseball Players Chew Tobacco?|last=Palmer|first=Brian|date=2009-11-02|work=Slate|access-date=2018-02-16|language=en-US|issn=1091-2339}}</ref> According to recent reports from NFL players, many professional football players chew tobacco in locker rooms, with some teams reporting that up to 75% of players admit to dipping.<ref>{{Cite news|url=http://www.espn.com/nfl/story/_/id/13463209/nfl-smokeless-tobacco-habit-too-not-just-baseball|title=Fowler: NFL has a smokeless tobacco habit, too|work=ESPN.com|access-date=2018-02-16}}</ref>


== Description ==
== Description ==
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== Health issues ==
== Health issues ==
Even though it is less dangerous than smoking, dipping tobacco is addictive, represents a major health risk, has no safe level use and is not a safe substitute for smoking.<ref name="WHO2017">{{cite web |year=2017 |title=Recommendation on smokeless tobacco products |url=http://apps.who.int/iris/bitstream/10665/42658/1/9241590556.pdf |publisher=[[World Health Organization]] |pages=1–9}}</ref><ref name="ACS015">{{cite web |date=13 November 2015 |title=Health Risks of Smokeless Tobacco |url=https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer/smokeless-tobacco.html |publisher=[[American Cancer Society]]}}</ref><ref name="NCI2010">{{cite web |date=25 October 2010 |title=Smokeless Tobacco and Cancer |url=https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/smokeless-fact-sheet |publisher=United States Department of Health and Human Services |agency=[[National Cancer Institute]] at the National Institutes of Health}}{{PD-notice}}</ref><ref name="NCI2010" /><ref name="Group2002">{{cite book |author=Royal College of Physicians of London. Tobacco Advisory Group |url=https://books.google.com/books?id=fpUgCBGb5SwC&pg=PA5 |title=Protecting Smokers, Saving Lives: The Case for a Tobacco and Nicotine Regulatory Authority |publisher=Royal College of Physicians |year=2002 |isbn=978-1-86016-177-3 |pages=5–}}</ref> Globally it contributes to 650 000 deaths each year with a significant proportion of them in [[Southeast Asia]].<ref name="SinhaSuliankatchi2016">{{cite journal |last1=Sinha |first1=Dhirendra N |last2=Suliankatchi |first2=Rizwan A |last3=Gupta |first3=Prakash C |last4=Thamarangsi |first4=Thaksaphon |last5=Agarwal |first5=Naveen |last6=Parascandola |first6=Mark |last7=Mehrotra |first7=Ravi |year=2016 |title=Global burden of all-cause and cause-specific mortality due to smokeless tobacco use: systematic review and meta-analysis |journal=Tobacco Control |volume=27 |issue=1 |pages=tobaccocontrol–2016–053302 |doi=10.1136/tobaccocontrol-2016-053302 |issn=0964-4563 |pmid=27903956 |s2cid=10968200}}</ref><ref name=":3">{{Cite journal |last1=Chugh |first1=Aastha |last2=Arora |first2=Monika |last3=Jain |first3=Neha |last4=Vidyasagaran |first4=Aishwarya |last5=Readshaw |first5=Anne |last6=Sheikh |first6=Aziz |last7=Eckhardt |first7=Jappe |last8=Siddiqi |first8=Kamran |last9=Chopra |first9=Mansi |last10=Mishu |first10=Masuma Pervin |last11=Kanaan |first11=Mona |last12=Rahman |first12=Muhammad Aziz |last13=Mehrotra |first13=Ravi |last14=Huque |first14=Rumana |last15=Forberger |first15=Sarah |date=June 2023 |title=The global impact of tobacco control policies on smokeless tobacco use: a systematic review |url=https://linkinghub.elsevier.com/retrieve/pii/S2214109X2300205X |journal=The Lancet Global Health |language=en |volume=11 |issue=6 |pages=e953–e968 |doi=10.1016/S2214-109X(23)00205-X |pmid=37202029}}</ref>


Using dipping tobacco can cause a number of adverse health effects such as dental disease, oral cancer, oesophagus cancer, and pancreatic cancer, cardiovascular disease, asthma, and deformities in the female reproductive system.<ref name="NiazMaqbool2017">{{cite journal |last1=Niaz |first1=Kamal |last2=Maqbool |first2=Faheem |last3=Khan |first3=Fazlullah |last4=Bahadar |first4=Haji |last5=Ismail Hassan |first5=Fatima |last6=Abdollahi |first6=Mohammad |year=2017 |title=Smokeless tobacco (''paan'' and ''gutkha'') consumption, prevalence, and contribution to oral cancer |journal=Epidemiology and Health |volume=39 |pages=e2017009 |doi=10.4178/epih.e2017009 |issn=2092-7193 |pmc=5543298 |pmid=28292008}}{{CC-notice|cc=by4|url=https://www.e-epih.org/journal/view.php?doi=10.4178/epih.e2017009|author(s)=Kamal Niaz, Faheem Maqbool, Fazlullah Khan, Haji Bahadar, Fatima Ismail Hassan, Mohammad Abdollahi}}</ref> It also raises the risk of fatal [[coronary artery disease]], fatal [[stroke]] and non-fatal ischaemic heart disease<ref name="VidyasagaranSiddiqi2016">{{cite journal |last1=Vidyasagaran |first1=A. L. |last2=Siddiqi |first2=K. |last3=Kanaan |first3=M. |year=2016 |title=Use of smokeless tobacco and risk of cardiovascular disease: A systematic review and meta-analysis |url=http://eprints.whiterose.ac.uk/101100/1/EJPC_D_16_00085_R1_2016.pdf |journal=European Journal of Preventive Cardiology |volume=23 |issue=18 |pages=1970–1981 |doi=10.1177/2047487316654026 |issn=2047-4873 |pmid=27256827 |s2cid=206820997}}</ref><ref name=":2">{{Cite journal |last1=Gupta |first1=Ruchika |last2=Gupta |first2=Sanjay |last3=Sharma |first3=Shashi |last4=Sinha |first4=Dhirendra N |last5=Mehrotra |first5=Ravi |date=2019-01-01 |title=Risk of Coronary Heart Disease Among Smokeless Tobacco Users: Results of Systematic Review and Meta-Analysis of Global Data |url=https://academic.oup.com/ntr/article/21/1/25/4793346 |journal=Nicotine & Tobacco Research |language=en |volume=21 |issue=1 |pages=25–31 |doi=10.1093/ntr/nty002 |issn=1469-994X |pmc=6941711 |pmid=29325111}}</ref>
=== Effects ===
Dipping tobacco, like other tobacco products, contains the stimulant [[nicotine]]. Effects include increased heart rate, an increase in systolic blood pressure, and an increase in adrenaline.<ref>{{cite journal |last1=Wolk |first1=Robert |last2=Shamsuzzaman |first2=Abu S.M. |last3=Svatikova |first3=Anna |last4=Huyber |first4=Christine M. |last5=Huck |first5=Corey |last6=Narkiewicz |first6=Krzysztof |last7=Somers |first7=Virend K. |title=Hemodynamic and autonomic effects of smokeless tobacco in healthy young men |journal=Journal of the American College of Cardiology |volume=45 |issue=6 |pages=910–4 |pmid=15766828 |doi=10.1016/j.jacc.2004.11.056 |year=2005 |doi-access=free }}</ref>


Quitting dipping tobacco use is as challenging as [[smoking cessation]].<ref name="Lipari2017">{{cite journal |last1=Lipari |first1=R. N |last2=Van Horn |first2=S. L |date=31 May 2017 |title=Trends in Smokeless Tobacco Use and Initiation: 2002 to 2014 |publisher=Substance Abuse and Mental Health Services Administration |pmid=28636307}}{{PD-notice}}</ref> There is no scientific evidence that using dipping tobacco can help a person quit smoking.<ref name="NCI20102">{{cite web |date=25 October 2010 |title=Smokeless Tobacco and Cancer |url=https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/smokeless-fact-sheet |publisher=United States Department of Health and Human Services |agency=[[National Cancer Institute]] at the National Institutes of Health}}{{PD-notice}}</ref><ref name=":1">{{Cite web |last=ERS |date=2019-05-29 |title=ERS Position Paper on Tobacco Harm Reduction |url=https://www.ersnet.org/news-and-features/news/ers-position-paper-on-tobacco-harm-reduction-2/ |access-date=2024-05-30 |website=ERS - European Respiratory Society |language=en-GB}}</ref>
=== Long-term effects ===
Long term use results in whitening of the [[oral mucosa]], termed [[smokeless tobacco keratosis]]. There is relatively low risk of transformation of this lesion into mouth cancer (sometimes [[verrucous carcinoma]]). Dipping tobacco causes fatal [[oral cancer]]s, tooth and gum loss. Associated cancers include: tongue cancer, lip cancer, cheek cancer, gum cancer, throat cancer, and cancer in the roof and floor of the mouth.<ref>{{cite web|url=http://www.cancer.gov/cancertopics/tobacco/smokeless-tobacco |title=Smokeless Tobacco&nbsp;– National Cancer Institute |access-date=19 June 2011}}</ref>


=== Cancer ===
Over the past decades, there have been publications both emphasizing and understating the risks of developing cancer from the use of smokeless tobacco. A 2002 epidemiological literature review noted "The use of moist snuff and chewing tobacco imposes minimal risks for cancers of the oral cavity and other upper respiratory sites, with relative risks ranging from 0.6 to 1.7.",<ref>{{cite journal |last1=Rodu |first1=Brad |last2=Cole |first2=Philip |title=Smokeless tobacco use and cancer of the upper respiratory tract |journal=Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology |volume=93 |issue=5 |pages=511–5 |year=2002 |pmid=12075196 |doi=10.1067/moe.2002.123497 }}</ref> although these estimates may be severely biased due to methodological flaws.<ref>{{Cite journal |last1=Critchley |first1=Julia |last2=Unal |first2=Belgin |date=June 2003 |title=Misleading meta-analysis |url=https://doi.org/10.1067/moe.2003.236 |journal=Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology |volume=95 |issue=6 |pages=638 |doi=10.1067/moe.2003.236 |pmid=12809135 |issn=1079-2104}}</ref> A study comparing oral cancer mortality rates of West Virginia (the state with the highest consumption of smokeless tobacco) in the early nineties to the US overall average throughout the years 1950 to 1980 found no apparent increased incidence or mortality.<ref>{{cite journal |last1=Bouquot |first1=J.E |last2=Meckstroth |first2=R.L |title=Oral cancer in a tobacco-chewing US population—no apparent increased incidence or mortality |journal=Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology |volume=86 |issue=6 |pages=697–706 |year=1998 |pmid=9868728 |doi=10.1016/S1079-2104(98)90207-4 }}</ref> A study, pooling results from 11 studies between 1981 and 2006, found that users of smokeless tobacco are at elevated risk of getting head and neck cancer, particularly oral cavity cancer.<ref>{{Cite journal|last1=Olshan|first1=Andrew F.|last2=Boffetta|first2=Paolo|last3=Zevallos|first3=Jose P.|last4=Gillison|first4=Maura L.|last5=Yu|first5=Guo-Pei|last6=Schantz|first6=Stimson|last7=Winn|first7=Deborah M.|last8=McClean|first8=Michael|last9=Kelsey|first9=Karl T.|date=2016-11-15|title=Smokeless Tobacco Use and the Risk of Head and Neck Cancer: Pooled Analysis of US Studies in the INHANCE Consortium|journal=American Journal of Epidemiology|language=en|volume=184|issue=10|pages=703–716|doi=10.1093/aje/kww075|pmid=27744388|pmc=5141945|issn=0002-9262}}</ref> The US [[National Cancer Institute]] concludes that there is sufficient evidence that smokeless tobacco products cause precancerous lesions and cancer in the oral cavity and other areas.<ref name=":0">{{Cite web |title=Smokeless Tobacco and Public Health: A Global Perspective {{!}} Division of Cancer Control and Population Sciences (DCCPS) |url=https://cancercontrol.cancer.gov/brp/tcrb/smokeless-tobacco |access-date=2024-03-26 |website=cancercontrol.cancer.gov}}</ref>
Dipping tobacco is a cause of [[oral cancer]], [[Esophageal cancer|oesophagus cancer]], and [[Pancreatic cancer|pancreas cancer]].<ref name="VidyasagaranSiddiqi20162">{{cite journal |last1=Vidyasagaran |first1=A. L. |last2=Siddiqi |first2=K. |last3=Kanaan |first3=M. |year=2016 |title=Use of smokeless tobacco and risk of cardiovascular disease: A systematic review and meta-analysis |url=http://eprints.whiterose.ac.uk/101100/1/EJPC_D_16_00085_R1_2016.pdf |journal=European Journal of Preventive Cardiology |volume=23 |issue=18 |pages=1970–1981 |doi=10.1177/2047487316654026 |issn=2047-4873 |pmid=27256827 |s2cid=206820997}}</ref> Increased risk of oral cancer caused by dipping tobacco is present in countries such as the United States but particularly prevalent in [[Southeast Asia|Southeast Asian countries]] where the use of smokeless tobacco is common.<ref name="Aupérin 178–186">{{cite journal |vauthors=Aupérin A |date=May 2020 |title=Epidemiology of head and neck cancers: an update |journal=Current Opinion in Oncology |volume=32 |issue=3 |pages=178–186 |doi=10.1097/CCO.0000000000000629 |pmid=32209823 |s2cid=214644380}}</ref><ref>{{cite journal |display-authors=6 |vauthors=Wyss AB, Hashibe M, Lee YA, Chuang SC, Muscat J, Chen C, Schwartz SM, Smith E, Zhang ZF, Morgenstern H, Wei Q, Li G, Kelsey KT, McClean M, Winn DM, Schantz S, Yu GP, Gillison ML, Zevallos JP, Boffetta P, Olshan AF |date=November 2016 |title=Smokeless Tobacco Use and the Risk of Head and Neck Cancer: Pooled Analysis of US Studies in the INHANCE Consortium |journal=American Journal of Epidemiology |volume=184 |issue=10 |pages=703–716 |doi=10.1093/aje/kww075 |pmc=5141945 |pmid=27744388}}</ref>


All tobacco products, including dipping, contain cancer-causing chemicals.<ref name="Lipari20172">{{cite journal |last1=Lipari |first1=R. N |last2=Van Horn |first2=S. L |date=31 May 2017 |title=Trends in Smokeless Tobacco Use and Initiation: 2002 to 2014 |publisher=Substance Abuse and Mental Health Services Administration |pmid=28636307}}{{PD-notice}}</ref><ref name="NiazMaqbool20172">{{cite journal |last1=Niaz |first1=Kamal |last2=Maqbool |first2=Faheem |last3=Khan |first3=Fazlullah |last4=Bahadar |first4=Haji |last5=Ismail Hassan |first5=Fatima |last6=Abdollahi |first6=Mohammad |year=2017 |title=Smokeless tobacco (''paan'' and ''gutkha'') consumption, prevalence, and contribution to oral cancer |journal=Epidemiology and Health |volume=39 |pages=e2017009 |doi=10.4178/epih.e2017009 |issn=2092-7193 |pmc=5543298 |pmid=28292008}}{{CC-notice|cc=by4|url=https://www.e-epih.org/journal/view.php?doi=10.4178/epih.e2017009|author(s)=Kamal Niaz, Faheem Maqbool, Fazlullah Khan, Haji Bahadar, Fatima Ismail Hassan, Mohammad Abdollahi}}</ref> These [[Carcinogen|carcinogenic]] compounds occurring in dipping tobacco vary widely, and depend upon the kind of product and how it was manufactured.<ref name="DropeCahn2017">{{cite journal |last1=Drope |first1=Jeffrey |last2=Cahn |first2=Zachary |last3=Kennedy |first3=Rosemary |last4=Liber |first4=Alex C. |last5=Stoklosa |first5=Michal |last6=Henson |first6=Rosemarie |last7=Douglas |first7=Clifford E. |last8=Drope |first8=Jacqui |year=2017 |title=Key issues surrounding the health impacts of electronic nicotine delivery systems (ENDS) and other sources of nicotine |journal=CA: A Cancer Journal for Clinicians |volume=67 |issue=6 |pages=449–471 |doi=10.3322/caac.21413 |issn=0007-9235 |pmid=28961314 |doi-access=free}}</ref> There are 28 known cancer-causing substances in dipping tobacco products.<ref name="DropeCahn2017" />
=== Cardiovascular effects ===
Over the past decades, there have been publications both emphasizing and understating the how smokeless tobacco affects users' [[circulatory system|cardiovascular system]]s. One study states that, "Although the evidence is not conclusive, the adverse cardiovascular effects of smokeless tobacco use are less than those caused by smoking but are more than those found in non-users."<ref name="pb_15451758">{{cite journal |last1=Gupta |first1=Ritesh |last2=Gurm |first2=Hitinder |last3=Bartholomew |first3=John R. |title=Smokeless Tobacco and Cardiovascular Risk |journal=Archives of Internal Medicine |volume=164 |issue=17 |pages=1845–9 |date=September 2004 |pmid=15451758 |doi=10.1001/archinte.164.17.1845 |doi-access=free }}</ref> Other studies also indicate that smokeless tobacco related cardiovascular risks are lower than that of smoked tobacco.<ref>{{cite journal |last1=Asplund |first1=Kjell |title=Smokeless tobacco and cardiovascular disease |journal=Progress in Cardiovascular Diseases |volume=45 |issue=5 |pages=383–94 |year=2003 |pmid=12704595 |doi=10.1053/pcad.2003.00102 }}</ref><ref>{{cite journal |last1=Bolinder |first1=Bolinder |title=Snusning en kontroversiell folkhälsofråga |trans-title=Overview of knowledge of health effects of smokeless tobacco. Increased risk of cardiovascular diseases and mortality because of snuff |language=sv |journal=Läkartidningen |volume=94 |issue=42 |pages=3725–31 |year=1997 |pmid=9411127 |url=http://ltarkiv.lakartidningen.se/artNo40835 }}</ref> One study states that smokeless tobacco use has a "positive effect on cardiovascular risk factors in young physically fit men."<ref>{{cite journal |last1=Siegel |first1=D |last2=Benowitz |first2=N |last3=Ernster |first3=V L |last4=Grady |first4=D G |last5=Hauck |first5=W W |title=Smokeless tobacco, cardiovascular risk factors, and nicotine and cotinine levels in professional baseball players. |journal=American Journal of Public Health |volume=82 |issue=3 |pages=417–21 |date=March 1992 |pmid=1536359 |pmc=1694380 |doi=10.2105/AJPH.82.3.417 }}</ref>
However, one [[India]]n study from the state of Rajasthan states, "There is a significantly greater prevalence of multiple cardiovascular risk factors obesity, resting tachycardia, hypertension, high total and LDL cholesterol, and low HDL cholesterol, and electrocardiographic changes in tobacco users, chewing or smoking, as compared-to tobacco non-users. Chewing tobacco is associated with similar cardiovascular risk as smoking."<ref name="pb_cardio">{{cite journal |last1=Gupta |first1=BK |last2=Kaushik |first2=A |last3=Panwar |first3=RB |last4=Chaddha |first4=VS |last5=Nayak |first5=KC |last6=Singh |first6=VB |last7=Gupta |first7=R |last8=Raja |first8=S |title=Cardiovascular risk factors in tobacco-chewers: a controlled study |journal=J Assoc Physicians India |volume=55 |pages=27–31 |date=January 2007 |pmid=17444341 |url=http://www.japi.org/january2007/O-27.htm }}</ref> Despite these varying results, the US [[National Cancer Institute]] concludes there is "substantive evidence" that the use of smokeless tobacco products "is associated with an increased risk of fatal ischemic heart disease and stroke".<ref name=":0" />


=== Cardiovascular disease ===
Due to contrasting results in studies, many conclude that further research should be done on the cardiovascular risks of smokeless tobacco.<ref>{{cite journal |last1=Winn |first1=D.M. |title=Epidemiology of Cancer and Other Systemic Effects Associated with the Use of Smokeless Tobacco |journal=Advances in Dental Research |volume=11 |issue=3 |pages=313–21 |date=September 1997 |pmid=9524431 |doi=10.1177/08959374970110030201 |s2cid=7489017 }}</ref><ref>{{cite journal |last1=Critchley |first1=Julia A. |last2=Unal |first2=Belgin |title=Is smokeless tobacco a risk factor for coronary heart disease? A systematic review of epidemiological studies |journal=European Journal of Cardiovascular Prevention & Rehabilitation |volume=11 |issue=2 |pages=101–12 |date=April 2004 |pmid=15187813 |doi=10.1097/01.hjr.0000114971.39211.d7 |s2cid=36988548 |doi-access=free }}</ref>
Using dipping tobacco increases the risk of fatal [[Coronary artery disease|coronary heart disease]] and [[stroke]].<ref name="VidyasagaranSiddiqi20163">{{cite journal |last1=Vidyasagaran |first1=A. L. |last2=Siddiqi |first2=K. |last3=Kanaan |first3=M. |year=2016 |title=Use of smokeless tobacco and risk of cardiovascular disease: A systematic review and meta-analysis |url=http://eprints.whiterose.ac.uk/101100/1/EJPC_D_16_00085_R1_2016.pdf |journal=European Journal of Preventive Cardiology |volume=23 |issue=18 |pages=1970–1981 |doi=10.1177/2047487316654026 |issn=2047-4873 |pmid=27256827 |s2cid=206820997}}</ref><ref name=":22">{{Cite journal |last1=Gupta |first1=Ruchika |last2=Gupta |first2=Sanjay |last3=Sharma |first3=Shashi |last4=Sinha |first4=Dhirendra N |last5=Mehrotra |first5=Ravi |date=2019-01-01 |title=Risk of Coronary Heart Disease Among Smokeless Tobacco Users: Results of Systematic Review and Meta-Analysis of Global Data |url=https://academic.oup.com/ntr/article/21/1/25/4793346 |journal=Nicotine & Tobacco Research |language=en |volume=21 |issue=1 |pages=25–31 |doi=10.1093/ntr/nty002 |issn=1469-994X |pmc=6941711 |pmid=29325111}}</ref> In 2010 more than 200 000 people died from coronary heart disease due to smokeless tobacco use.<ref name=":32">{{Cite journal |last1=Chugh |first1=Aastha |last2=Arora |first2=Monika |last3=Jain |first3=Neha |last4=Vidyasagaran |first4=Aishwarya |last5=Readshaw |first5=Anne |last6=Sheikh |first6=Aziz |last7=Eckhardt |first7=Jappe |last8=Siddiqi |first8=Kamran |last9=Chopra |first9=Mansi |last10=Mishu |first10=Masuma Pervin |last11=Kanaan |first11=Mona |last12=Rahman |first12=Muhammad Aziz |last13=Mehrotra |first13=Ravi |last14=Huque |first14=Rumana |last15=Forberger |first15=Sarah |date=June 2023 |title=The global impact of tobacco control policies on smokeless tobacco use: a systematic review |url=https://linkinghub.elsevier.com/retrieve/pii/S2214109X2300205X |journal=The Lancet Global Health |language=en |volume=11 |issue=6 |pages=e953–e968 |doi=10.1016/S2214-109X(23)00205-X |pmid=37202029}}</ref> Use of dipping tobacco also seems to greatly raise the risk of non-fatal ischaemic heart disease among users in Asia, although not in Europe.<ref name="VidyasagaranSiddiqi20163" />


=== Addiction potential ===
=== Effects during pregnancy ===
Dipping tobacco can cause adverse reproductive effects including [[stillbirth]], [[Preterm birth|premature birth]], [[low birth weight]].<ref name="VidyasagaranSiddiqi20163" /><ref name="CDC2016">{{cite web |date=1 December 2016 |title=Smokeless Tobacco: Health Effects |url=https://www.cdc.gov/tobacco/data_statistics/fact_sheets/smokeless/health_effects/index.htm |publisher=Centers for Disease Control and Prevention}}{{PD-notice}}</ref> Nicotine in dipping tobacco products that are used during pregnancy can affect how a baby's brain develops before birth.<ref name="CDC2016" />
Smokeless tobacco contains [[nicotine]], which is addictive thus the primary reinforcing agent.

According to [[European Union]] policy advice, [[Scandinavia]]n or some American smokeless tobaccos (specifically snus) may be up to 90% less hazardous than cigarette smoking.<ref>{{cite journal |last1=Bates |first1=C |last2=Fagerström |first2=K |last3=Jarvis |first3=MJ |last4=Kunze |first4=M |last5=McNeill |first5=A |last6=Ramström |first6=L |title=European Union policy on smokeless tobacco: a statement in favour of evidence based regulation for public health |journal=Tobacco Control |volume=12 |issue=4 |pages=360–7 |date=December 2003 |pmid=14660767 |pmc=1747769 |doi=10.1136/tc.12.4.360 }}</ref> However, the habit is still addictive.

[[Taxation]] and restriction of smoking is causing more smokeless tobacco use as "substitution." There have been public health debates regarding risk-reduction for smokers and the reconsideration of smokeless tobacco risks. ''"...There is a substantial body of informed and independent opinion that sees the value of harm reduction strategies based on smokeless tobacco."''<ref>[http://www.ash.org.uk/html/regulation/html/eusmokeless.html UK's Action on Smoking & Health (ASH..)] {{webarchive |url=https://web.archive.org/web/20060210020704/http://www.ash.org.uk/html/regulation/html/eusmokeless.html |date=10 February 2006 }} Accessed on 31 July 2007.</ref>

=== Additives ===
The amount of nicotine absorbed can be controlled by different cutting of the tobacco, increasing the nicotine concentration and raising the [[pH]] of the tobacco by adding various salts.<ref>{{cite journal |author=Centers for Disease Control and Prevention |title=Determination of Nicotine, pH, and Moisture Content of Six US Commercial Moist Snuff Products--Florida, January–February 1999 |journal=JAMA |volume=281 |issue=24 |pages=2279–80 |year=1999 |pmid=10386544 |doi=10.1001/jama.281.24.2279 }}</ref> An alkaline pH causes more nicotine to be absorbed, especially the free, unprotonated form, but is irritating to the [[Mucous membrane|mucosa]]. Nicotine itself can also irritate the mucosa.


== List of brands ==
== List of brands ==
Line 92: Line 80:
Several countries have banned the sale (and in some cases the import) of dipping tobacco. Sale of dipping tobacco was banned in South Australia in 1986 and across the country in 1991<ref>{{cite journal |last1=Sachdev |first1=Preeti |last2=Chapman |first2=Simon |title=Availability of smokeless tobacco products in South Asian grocery shops in Sydney, 2004 |journal=Medical Journal of Australia |volume=183 |issue=6 |page=334 |date=September 2005 |doi=10.5694/j.1326-5377.2005.tb07070.x |pmid=16167879 |s2cid=45284231 |url=https://www.mja.com.au/journal/2005/183/6/availability-smokeless-tobacco-products-south-asian-grocery-shops-sydney-2004 }}</ref> and in most of the EU nations in 1993.<ref>{{cite web|url=http://www.batresponsibility.eu/issues3.html |title=British American Tobacco&nbsp;– EU Social Reporting&nbsp;– Issues |publisher=Batresponsibility.eu |access-date=2012-01-26}}</ref> Sweden was exempt from this ban because of the traditionally high usage of [[snus]] in that country. Dipping tobacco is also not currently permitted for sale in the UK. It is not yet clear whether this law will be changed now that the UK has left the EU.<ref>Sharrow Mills, [https://sharrowmills.com/pages/the-encyclopedia-of-tobacco-types-of-tobacco-guide "The Encyclopaedia of Tobacco"], ''Sharrow Mills'', 2018</ref>
Several countries have banned the sale (and in some cases the import) of dipping tobacco. Sale of dipping tobacco was banned in South Australia in 1986 and across the country in 1991<ref>{{cite journal |last1=Sachdev |first1=Preeti |last2=Chapman |first2=Simon |title=Availability of smokeless tobacco products in South Asian grocery shops in Sydney, 2004 |journal=Medical Journal of Australia |volume=183 |issue=6 |page=334 |date=September 2005 |doi=10.5694/j.1326-5377.2005.tb07070.x |pmid=16167879 |s2cid=45284231 |url=https://www.mja.com.au/journal/2005/183/6/availability-smokeless-tobacco-products-south-asian-grocery-shops-sydney-2004 }}</ref> and in most of the EU nations in 1993.<ref>{{cite web|url=http://www.batresponsibility.eu/issues3.html |title=British American Tobacco&nbsp;– EU Social Reporting&nbsp;– Issues |publisher=Batresponsibility.eu |access-date=2012-01-26}}</ref> Sweden was exempt from this ban because of the traditionally high usage of [[snus]] in that country. Dipping tobacco is also not currently permitted for sale in the UK. It is not yet clear whether this law will be changed now that the UK has left the EU.<ref>Sharrow Mills, [https://sharrowmills.com/pages/the-encyclopedia-of-tobacco-types-of-tobacco-guide "The Encyclopaedia of Tobacco"], ''Sharrow Mills'', 2018</ref>


In the United States, the [[Family Smoking Prevention and Tobacco Control Act]] gives the [[Food and Drug Administration]] the power to regulate the tobacco industry.<ref name="The Tobacco Control Act ">{{cite web |url=http://www.gpo.gov/fdsys/pkg/PLAW-111publ31/pdf/PLAW-111publ31.pdf |title=The Family Smoking Prevention and Tobacco Control Act }}</ref> This law prohibits the sale of dipping tobacco to anyone under the age of 21, restricts tobacco product advertising and marketing directed to younger audiences, and requires bigger, more prominent warning labels for dipping tobacco products.<ref name="FDA Website ">{{cite web |url=https://www.fda.gov/TobaccoProducts/GuidanceComplianceRegulatoryInformation/ucm246129.htm |title=Overview of the Family Smoking Prevention and Tobacco Control Act: Consumer Fact Sheet |website=[[Food and Drug Administration]] }}</ref>
In the United States, the [[Family Smoking Prevention and Tobacco Control Act]] gives the [[Food and Drug Administration]] the power to regulate the tobacco industry.<ref name="The Tobacco Control Act">{{cite web |url=http://www.gpo.gov/fdsys/pkg/PLAW-111publ31/pdf/PLAW-111publ31.pdf |title=The Family Smoking Prevention and Tobacco Control Act }}</ref> This law prohibits the sale of dipping tobacco to anyone under the age of 21, restricts tobacco product advertising and marketing directed to younger audiences, and requires bigger, more prominent warning labels for dipping tobacco products.<ref name="FDA Website">{{cite web |url=https://www.fda.gov/TobaccoProducts/GuidanceComplianceRegulatoryInformation/ucm246129.htm |title=Overview of the Family Smoking Prevention and Tobacco Control Act: Consumer Fact Sheet |website=[[Food and Drug Administration]] }}</ref>


==Taxation==
==Taxation==
In the United States, the federal government taxes dipping tobacco at {{convert|0.5033|$/lb|$/kg|2}}, equivalent to 3.15¢ per {{convert|1|oz|g|spell=in|adj=on}} package.<ref>{{cite web |url=http://www.ttb.gov/tax_audit/atftaxes.shtml |title=TTBGov Tax and Fee Rates |publisher=Ttb.gov |access-date=2012-01-26 |archive-url=https://web.archive.org/web/20160226182839/http://www.ttb.gov/tax_audit/atftaxes.shtml |archive-date=26 February 2016 |url-status=dead }}</ref> Excise taxes are also levied at the state level (Pennsylvania being the only exception), and in some instances, at the local level. Sales tax is also applied to the full retail price of dipping tobacco in most jurisdictions. The price of a tin of tobacco can range anywhere from under $1 per tin to more than $8. Price is affected by factors such as brand and especially the varying excise taxes from state to state.
In the United States, the federal government taxes dipping tobacco at {{convert|0.5033|$/lb|$/kg|2}}, equivalent to 3.15¢ per {{convert|1|oz|g|spell=in|adj=on}} package.<ref>{{cite web |url=http://www.ttb.gov/tax_audit/atftaxes.shtml |title=TTBGov Tax and Fee Rates |publisher=Ttb.gov |access-date=2012-01-26 |archive-url=https://web.archive.org/web/20160226182839/http://www.ttb.gov/tax_audit/atftaxes.shtml |archive-date=26 February 2016 |url-status=dead }}</ref> Excise taxes are also levied at the state level (Pennsylvania being the only exception), and in some instances, at the local level. Sales tax is also applied to the full retail price of dipping tobacco in most jurisdictions. The price of a tin of tobacco can range anywhere from under $1 per tin to more than $8. Price is affected by factors such as brand and especially the varying excise taxes from state to state.

== History ==
Dipping tobacco evolved from the use of [[snuff (tobacco)|dry snuff]] in early American history. Up until the late 1700s, dry snuff was taken nasally, but then early Americans would take snuff orally by chewing the end of a twig until it resembled a brush, and then "dipping" the twig in the snuff and placing it in their mouths until the snuff dissolved.<ref>{{cite web |title=American Snuff Company - Est. 1900 - Timeline |url=http://www.americansnuffco.com/Timeline.aspx |url-status=dead |archive-url=https://web.archive.org/web/20111201035702/http://www.americansnuffco.com/Timeline.aspx |archive-date=1 December 2011 |access-date=19 September 2014}}</ref> Using dry snuff orally eventually evolved into modern day moist snuff, which [[Copenhagen (tobacco)|Copenhagen]] introduced in 1822 and then [[Skoal (tobacco)|Skoal]] started producing in 1934. Most varieties of dipping tobacco are much more recent inventions.

Moist snuff is available throughout the United States. Dipping tobacco is predominantly used by males.<ref>{{Cite journal |last=Cornelius |first=Monica E. |date=2020 |title=Tobacco Product Use Among Adults — United States, 2019 |url=https://www.cdc.gov/mmwr/volumes/69/wr/mm6946a4.htm |journal=MMWR. Morbidity and Mortality Weekly Report |language=en-us |volume=69 |issue=46 |pages=1736–1742 |doi=10.15585/mmwr.mm6946a4 |issn=0149-2195 |pmc=7676638 |pmid=33211681}}</ref> Also, dipping tobacco has a similar presence in [[Canada]]. Smokeless tobacco use by professional [[baseball]] players was widespread throughout the 20th century until more recent years with the [[Major League Baseball|MLB]] cracking down on tobacco consumption, although a 1999 survey reported that "31 percent of the league's rookies used smokeless tobacco".<ref>{{Cite news |last=Palmer |first=Brian |date=2009-11-02 |title=Why Do So Many Baseball Players Chew Tobacco? |url=http://www.slate.com/articles/news_and_politics/explainer/2009/11/why_do_so_many_baseball_players_chew_tobacco.html |access-date=2018-02-16 |work=Slate |language=en-US |issn=1091-2339}}</ref> According to recent reports from NFL players, many professional football players chew tobacco in locker rooms, with some teams reporting that up to 75% of players admit to dipping.<ref>{{Cite news |title=Fowler: NFL has a smokeless tobacco habit, too |url=http://www.espn.com/nfl/story/_/id/13463209/nfl-smokeless-tobacco-habit-too-not-just-baseball |access-date=2018-02-16 |work=ESPN.com}}</ref>


== See also ==
== See also ==

Revision as of 12:08, 2 June 2024

Dipping tobacco

Dipping tobacco is a type of finely ground or shredded, moistened smokeless tobacco product. It is commonly and idiomatically known as dip. Dipping tobacco is used by placing a pinch, or "dip", of tobacco between the lip and the gum (sublabial administration). The act of using it is called dipping. Dipping tobacco is colloquially called chaw, snuff, rub, or fresh leaf among other terms; because of this, it is sometimes confused with other tobacco products—namely dry snuff.

Using dipping tobacco can cause a various harmful effects such as oral cancer, oesophagus cancer, and pancreas cancer, coronary heart disease, as well as negative reproductive effects including stillbirth, premature birth and low birth weight.[1][2] Dipping tobacco poses a lower health risk than traditional combusted products.[3] However it is not a healthy alternative to cigarette smoking.[4] The level of risk varies between different types of products and producing regions.[5][3] There is no safe level of dipping tobacco use.[4] Globally it contributes to 650 000 deaths each year.[6]

Description

Four different cans (or tins) of dipping tobacco (from bottom left, clockwise): Skoal straight, Skoal long cut mint, Copenhagen straight, and Copenhagen long cut.
A can of Copenhagen brand American dipping tobacco

Dipping tobacco is packaged in "tins" or "cans", although they are not typically completely metal anymore. Dipping tobacco is also available in "rolls", "logs", or "sleeves", which is a package of 5 tins of tobacco, a similar concept to that of a carton of cigarettes. Ten tin rolls were also available in the past. Another package of dipping tobacco is the "tub", available in only select brands, equivalent to 6, 10, or 12 cans.

Before opening the can/tin of tobacco, users typically "pack" the can, similar to how cigarette smokers pack a pack of cigarettes. This is done by placing one's thumb and middle finger on the sides of the can, and then quickly turning the can and flicking the wrist so that one's index finger taps the top of the can.

Unlike snus, which is most often placed between the upper lip and gum, moist tobacco users or "dippers" tend to use the lower. Dipping in the upper lip is unusual, though when done, it is colloquially termed an "upper decker" or "top lip dip".[citation needed] The dip rests on the inside lining of the mouth for a period depending upon the user's preference—often 20–40 minutes.[citation needed] Nicotine and other alkaloids found in tobacco are absorbed in saliva sublabially by the inferior or superior labial arteries. Buccal and sublingual absorption may also occur.

Also unlike snus, dip often causes the user to produce excess saliva during the act of dipping. This is typically spit onto the ground or in a container, because swallowing the saliva-tobacco mixture can cause irritation to the esophagus and induce nausea and vomiting. A spittoon can be used, but often users will simply use an empty plastic bottle or a "mudjug," a portable spittoon. Smokeless tobacco is sometimes used in the workplace by employees, especially if the employer does not provide many cigarette breaks or if the employee is consistently using both hands during work (which doesn't provide opportunities for cigarette smoking). Smokeless tobacco is popular in many industrial areas where there is a safety risk in having an open flame, such as oil rigs or refineries.

Etymology and terminology

An example of how dipping tobacco is often placed in the mouth

Dipping tobacco was first popularized and marketed as moist snuff in the 1800s. The term "snuff" in this context is an English cognate of the aforementioned "snus", from Swedish. Dipping tobacco's Scandinavian roots impart a noticeable legacy on modern American brands such as Copenhagen and Skoal (referring to the interlinguistic term skål, which in Danish, Norwegian, Icelandic, Faroese and Swedish roughly translates to "cheers", implying a toast).

A user of dipping tobacco will produce an excess amount of saliva which will be disposed of using a "spitter." A spitter can be an empty bottle, cup or commercially produced spittoon.

Dipping tobacco use is often accompanied by first drinking a liquid, in some areas known as a primer, catalyst, and rinser. A primer is used to initially salivate the mouth, usually during a meal, in order to prepare the mouth to use smokeless tobacco. This is important because a dry mouth or one full of food could lead to a less enjoyable experience for the user. A catalyst, like a primer, is used to fix the issues of a dry mouth or dry tobacco; however, the dipping tobacco is already currently in the user's lip. A rinser is used when the user is finished with their tobacco, and it is swished around in the user's mouth, similar to mouthwash, to dispose of any excess tobacco juice or particulates. All three liquids are usually water, but any liquid may be used.[citation needed]

Primarily in Texas and other southern US states, terminology is unique.[citation needed] Dip or dips refers to a wad of tobacco, whereas snuff refers to any amount of tobacco greater than a dip. For example, a tobacco user may reach for a dip from their can of snuff. Many areas have no such distinction, and may rarely use the word "snuff".

Cut sizes

The difference between cut sizes is the length of the strands of dip.

Common cut sizes

  • Extra Long cuts are a little longer than long cut.
  • Wide cuts are long cut, just a little wider.
  • Long cuts are the most widely available cut size.
  • Fine cuts/snuffs are slightly larger than sand or coffee grounds.
  • Pouches hold fine cut or snuff tobacco in a small, teabag-like pouch. They are initially less messy because the tobacco will not fall out of the user's fingers and mouth. Dipping tobacco in pouches resemble snus "portions", but the difference between these two products lies in the way the tobacco is processed. Dipping tobacco (including pouched products) undergoes fermentation, whereas tobacco in snus is pasteurized. In addition to regular sized pouches, smaller sized pouches, known as Bandits, are also available in the Skoal brand.

Unique cut sizes

The following cuts are either unique to one brand of dipping tobacco or are extremely rare:

  • Fat cuts are a little longer, flatter, and softer than long cut.
  • Mid cuts are comparable to small granules at about 1 mm (0.039 in) cubed. Mid cuts are extremely rare; the original version of Copenhagen Black is the only dip marketed as a mid cut that has made it to the market. However, many consider some products marketed as long cuts to be mid cuts, notably Copenhagen Long Cut Original.
  • ReadyCut is a cut produced only by Skoal (introduced in 2012) which consists of a compressed cube of long cut. As it gets moist from saliva in the mouth, it automatically conforms to the user's mouth.
  • Wide cut is a new cut introduced by Grizzly in select markets. It consists of wider strands than long cut. Grizzly Wide Cut Wintergreen is the only wide cut available.

Flavoring

Dipping tobacco is typically flavored. The most common flavors consist of mint, wintergreen, straight, and natural.

Health issues

Even though it is less dangerous than smoking, dipping tobacco is addictive, represents a major health risk, has no safe level use and is not a safe substitute for smoking.[7][8][9][9][10] Globally it contributes to 650 000 deaths each year with a significant proportion of them in Southeast Asia.[11][12]

Using dipping tobacco can cause a number of adverse health effects such as dental disease, oral cancer, oesophagus cancer, and pancreatic cancer, cardiovascular disease, asthma, and deformities in the female reproductive system.[13] It also raises the risk of fatal coronary artery disease, fatal stroke and non-fatal ischaemic heart disease[14][15]

Quitting dipping tobacco use is as challenging as smoking cessation.[16] There is no scientific evidence that using dipping tobacco can help a person quit smoking.[17][18]

Cancer

Dipping tobacco is a cause of oral cancer, oesophagus cancer, and pancreas cancer.[19] Increased risk of oral cancer caused by dipping tobacco is present in countries such as the United States but particularly prevalent in Southeast Asian countries where the use of smokeless tobacco is common.[20][21]

All tobacco products, including dipping, contain cancer-causing chemicals.[22][23] These carcinogenic compounds occurring in dipping tobacco vary widely, and depend upon the kind of product and how it was manufactured.[24] There are 28 known cancer-causing substances in dipping tobacco products.[24]

Cardiovascular disease

Using dipping tobacco increases the risk of fatal coronary heart disease and stroke.[25][26] In 2010 more than 200 000 people died from coronary heart disease due to smokeless tobacco use.[27] Use of dipping tobacco also seems to greatly raise the risk of non-fatal ischaemic heart disease among users in Asia, although not in Europe.[25]

Effects during pregnancy

Dipping tobacco can cause adverse reproductive effects including stillbirth, premature birth, low birth weight.[25][28] Nicotine in dipping tobacco products that are used during pregnancy can affect how a baby's brain develops before birth.[28]

List of brands

The following is a partial list of brands of dipping tobacco. Other tobacco products, such as chewing tobacco and snus, are excluded.[29]

Legality

Several countries have banned the sale (and in some cases the import) of dipping tobacco. Sale of dipping tobacco was banned in South Australia in 1986 and across the country in 1991[30] and in most of the EU nations in 1993.[31] Sweden was exempt from this ban because of the traditionally high usage of snus in that country. Dipping tobacco is also not currently permitted for sale in the UK. It is not yet clear whether this law will be changed now that the UK has left the EU.[32]

In the United States, the Family Smoking Prevention and Tobacco Control Act gives the Food and Drug Administration the power to regulate the tobacco industry.[33] This law prohibits the sale of dipping tobacco to anyone under the age of 21, restricts tobacco product advertising and marketing directed to younger audiences, and requires bigger, more prominent warning labels for dipping tobacco products.[34]

Taxation

In the United States, the federal government taxes dipping tobacco at $0.5033 per pound ($1.11/kg), equivalent to 3.15¢ per one-ounce (28 g) package.[35] Excise taxes are also levied at the state level (Pennsylvania being the only exception), and in some instances, at the local level. Sales tax is also applied to the full retail price of dipping tobacco in most jurisdictions. The price of a tin of tobacco can range anywhere from under $1 per tin to more than $8. Price is affected by factors such as brand and especially the varying excise taxes from state to state.

History

Dipping tobacco evolved from the use of dry snuff in early American history. Up until the late 1700s, dry snuff was taken nasally, but then early Americans would take snuff orally by chewing the end of a twig until it resembled a brush, and then "dipping" the twig in the snuff and placing it in their mouths until the snuff dissolved.[36] Using dry snuff orally eventually evolved into modern day moist snuff, which Copenhagen introduced in 1822 and then Skoal started producing in 1934. Most varieties of dipping tobacco are much more recent inventions.

Moist snuff is available throughout the United States. Dipping tobacco is predominantly used by males.[37] Also, dipping tobacco has a similar presence in Canada. Smokeless tobacco use by professional baseball players was widespread throughout the 20th century until more recent years with the MLB cracking down on tobacco consumption, although a 1999 survey reported that "31 percent of the league's rookies used smokeless tobacco".[38] According to recent reports from NFL players, many professional football players chew tobacco in locker rooms, with some teams reporting that up to 75% of players admit to dipping.[39]

See also

References

  1. ^ Vidyasagaran, A. L.; Siddiqi, K.; Kanaan, M. (2016). "Use of smokeless tobacco and risk of cardiovascular disease: A systematic review and meta-analysis" (PDF). European Journal of Preventive Cardiology. 23 (18): 1970–1981. doi:10.1177/2047487316654026. ISSN 2047-4873. PMID 27256827. S2CID 206820997.
  2. ^ Gupta, Ruchika; Gupta, Sanjay; Sharma, Shashi; Sinha, Dhirendra N; Mehrotra, Ravi (1 January 2019). "Risk of Coronary Heart Disease Among Smokeless Tobacco Users: Results of Systematic Review and Meta-Analysis of Global Data". Nicotine & Tobacco Research. 21 (1): 25–31. doi:10.1093/ntr/nty002. ISSN 1469-994X. PMC 6941711. PMID 29325111.
  3. ^ a b Hajat, C.; Stein, E.; Ramstrom, L.; Shantikumar, S.; Polosa, R. (4 December 2021). "The health impact of smokeless tobacco products: a systematic review". Harm Reduction Journal. 18 (1): 123. doi:10.1186/s12954-021-00557-6. ISSN 1477-7517. PMC 8643012. PMID 34863207.
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  5. ^ Abrams, David B.; Glasser, Allison M.; Pearson, Jennifer L.; Villanti, Andrea C.; Collins, Lauren K.; Niaura, Raymond S. (2018). "Harm Minimization and Tobacco Control: Reframing Societal Views of Nicotine Use to Rapidly Save Lives". Annual Review of Public Health. 39 (1): 193–213. doi:10.1146/annurev-publhealth-040617-013849. ISSN 0163-7525. PMC 6942997. PMID 29323611. This article incorporates text by David B. Abrams, Allison M. Glasser, Jennifer L. Pearson, Andrea C. Villanti, Lauren K. Collins, and Raymond S. Niaura available under the CC BY 4.0 license.
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