Populations at Increased Risk: Smokeless Tobacco Users

Smokeless tobacco use is a serious problem in South Dakota. Smokeless tobacco products include spit tobacco, chew, chaw, plug, snuff, snus, pinch, dip, or dissolvables. Many smokeless tobacco users think these products are less harmful than smoking—or even harmless. But smokeless tobacco products are as dangerous and using them can result in serious health consequences.

Tobacco Use Prevalence

• Approximately 5.3% SD adults 18+ use chewing tobacco or snuff.^ⓘ
• 11.7% of SD high school students used smokeless tobacco on at least one day in the past 30 days vs. the national average, 7.3% (2015).^ⓘ
• 26.9% of SD high school students believe smokeless tobacco is safer than cigarettes.^ⓘ
• 2.1% of SD middle school students use smokeless tobacco (2019) vs. the national average, 1.8% (2019).^ⓘ

Risk Factors

It’s just as addictive as cigarettes.

• Because smokeless tobacco contains nicotine, users can become addicted, just as one can with cigarettes.^ⓘ
• Smokeless tobacco is often used constantly, exposing users to high levels of nicotine throughout the day, resulting in high levels of dependence.^ⓘ
• Smokeless tobacco users absorb two to three times the amount of addictive nicotine as those who smoke cigarettes.^ⓘ
• Dipping 8 to 10 times a day can bring as much nicotine into the body as smoking 30-40 cigarettes.^ⓘ

The tobacco industry targets rural populations.

• The five major U.S. smokeless tobacco manufacturers spent $658.5 million on smokeless tobacco advertising and promotion in 2018.^ⓘ
• Ads for smokeless tobacco that depict rugged images of cowboys, hunters, and race car drivers are placed in media and retail outlets most likely to reach rural audiences.^ⓘ
• Rates of spit tobacco use by South Dakotans are highest among young men, American Indians, and farming, ranching, and rodeo/cowboy men and women.

Variety & flavor add to the appeal of smokeless products.

• Although flavorings are not allowed in cigarettes, the tobacco industry can add sweeteners and flavorings in smokeless tobacco, which make it more appealing to young people.^ⓘ
• Tobacco companies regularly introduce new varieties of smokeless products like Snus that can lead to increased levels of dual use (using more than one tobacco product) and increased health risks.^ⓘ

Oral Health Risks

• The single greatest risk factor for oral cancer is tobacco.^ⓘ
• Leukoplakia—oral lesions that appear as white patches on the cheeks, gums, or tongue—are commonly found in smokeless tobacco users.^ⓘ
• About 75% of daily users of smokeless tobacco will get leukoplakia.^ⓘ
• Leukoplakia can be a precancerous lesion which may convert to oral cancer.^ⓘ
• It’s estimated that nearly 54,000 Americans will be diagnosed with oral oropharyngeal cancer this year. An estimated 9,750 people will die. That’s about 1 person per hour every day.^ⓘ

South Dakota Services for Smokeless Tobacco Users

South Dakota QuitLine

The South Dakota QuitLine phone coaching program is just as effective for smokeless tobacco users as it is for smokers. For those who aren’t ready to enroll in phone coaching, the Kickstart Kit includes 2-weeks Nicotine Replacement Therapy (NRT) with your choice of patches, gum, or lozenges and a Quit Guide. Both services are free and available to anyone 13 years of age or older.