My boyfriend has started using chewing tobacco. Every time I ask him to stop, he argues that it's safer than cigarettes. How safe is it?
Your boyfriend is not unlike many other adolescents and adults who view smokeless tobacco use as "the lesser of two evils."
But in reality, users of smokeless tobacco are trading one kind of cancer risk for another. An estimated 30,000 new cancers of the mouth will be detected this year, most of them due to either smoking or smokeless tobacco use.
Spit tobacco, moist tobacco and/or snuff (which is not sniffed but placed in the mouth) contain nicotine, and absorption through the mouth will lead to addiction as would cigarette smoking.
Some users keep a wad in the mouth for 30 minutes and chew up to six wads per day. So, while they may spare their lungs exposure to cigarette smoke, their gums and the lining of their mouths are bathed in high levels of nicotine (equal to two packs of cigarettes), as well as nitrosamine and other cancer-causing agents.
Since some youngsters start to use tobacco as early as age 11, these cancer-causing agents have a long time to exert their effect. Smokeless tobacco users also develop gum disease, which can lead to gum recession and exposure of the root surface of the tooth.
We support your efforts to get your boyfriend to stop. Maybe you can suggest that if he doesn't quit now, your relationship will go ++ up in smoke.
Dr. Wilson is director of general pediatrics at the Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.