National Institutes of Health consensus statement. Health implications of smokeless tobacco use. NIH Consensus Development Panel.

National data indicate that at least 10 million persons have used smokeless tobacco within the past year. The human evidence that use of snuff causes cancer of the mouth is strong. Smokeless tobacco use increases the frequency of localized gum recession and leukoplakia where the snuff is usually placed. The presence of lead in smokeless tobacco may pose a special risk for the developing fetus. Use of smokeless tobacco releases nicotine into the bloodstream and produces blood levels of nicotine comparable to those produced by smoking tobacco. The primary behavioral consequence of regular use of smokeless tobacco is long-term nicotine dependence and its associated health risks.