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  • Smokeless tobacco is about as addictive as cigarettes and has certain negative health effects and thus is not a safe alternative to cigarettes.
  • Smokeless tobacco interventions should begin before age 12 as this is the median age for initiating use.
  • Smokeless tobacco can deliver a higher dose of nicotine per use than cigarettes.
  • Smokeless tobacco use is highest

    • in males aged 18 to 25
    • in India, Africa, and central Asian countries
    • among Native Americans (both males and females), and second among white males in the United States
    • in rural areas and in the southern United States
  • Smokeless tobacco users are more likely to move on to cigarettes.
  • The negative health consequences of using smokeless tobacco include abrasion of teeth, recession of gums, bad breath, oral keratosis (leukoplakia), transient high blood pressure, and increased risk for cardiovascular disease and oral cancer.
  • Intervention by healthcare professionals can decrease smokeless tobacco use, especially in the dental field, where health effects are visible.
  • Pharmacotherapy treatments have not been approved by the FDA for smokeless tobacco cessation.
  • With the possible exception of the nicotine patch, pharmacotherapy treatments have not been proven to achieve long-term abstinence. They may, however, decrease craving.
  • Another aid in smokeless tobacco cessation is flavored, non-nicotine substitute for snuff.
  • Many young people start using smokeless tobacco to imitate famous athletes or because of peer influence.
  • Many Major League Baseball players use smokeless tobacco, although the majority do not and most who do use it want to quit.
  • Other sports, such as automobile racing, still use smokeless tobacco manufacturers as sponsors.