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An Introduction to Substance Use Disorders for Dental Professionals

Course Number: 545

Chewing Tobacco/Snuff

Chewing tobacco, (dip, snus or snuff) is ground up tobacco, placed and held in the vestibule and chewed, not smoked. Nicotine is absorbed through the oral mucosa and into the bloodstream. Because of this rapid absorption, it is much harder for the snuff chewer to quit when compared to the smoker.

There are several forms:

  • Chewing tobacco consists of loose tobacco leaves, sweetened and packaged in pouches. It is also called chew or chaw. A “wad” of the tobacco is placed between the cheek and gum to hold it in place, sometimes for hours at a time. Usually, the tobacco juices are spit out, but in the more addicted, there is a tendency to swallow some of the juices.

  • Plug. This is chewing tobacco that has been pressed into a brick shape, often with the help of syrup, such as molasses, which also sweetens the tobacco. A piece is cut off or bitten off of the plug and held between the cheek and gum. Tobacco juices are spit out.

  • Twist. This is flavored chewing tobacco that has been braided and twisted into rope-like strands. Twist is held between the cheek and gum; tobacco juices are expectorated as nicotine is absorbed.

  • Snuff. This is finely ground or shredded tobacco leaves. It is available in dry or moist forms and is packaged in tins or tea bag-like pouches. A pinch of snuff is placed between the lower lip and gum or cheek and gum. Dry forms of snuff can be sniffed into the nose. Using snuff is also called dipping.

  • Snus. Snus (pronounced snoos) is a newer smokeless, spitless tobacco product that originated in Sweden. It comes in a pouch that is placed between the upper lip and gum. It is left in place for less time, about a half-hour without having to spit, then is discarded.

  • Dissolvable tobacco products. These are pieces of compressed powdered tobacco, similar to small hard candies. They dissolve in the mouth, requiring no spitting of tobacco juices. They are sometimes called tobacco lozenge, but they are not the same as the nicotine lozenges or gum used to help one quit smoking.55

In 2022, 6.1 million Americans used chewing tobacco regularly. In 2023, nearly 1 of every 100 middle school students (.7%) and 2 of every 100 high school students (1.5%) reported current use of smokeless tobacco.15,60,61