By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

SPIT TOBACCO DANGEROUS, CONTAINS MORE NICOTINE THAN CIGARETTES

Question: Isn’t spit tobacco safer to use than smoking cigarettes? If it isn't safe, how can I quit?

Answer: At the heart of your question is a common misconception. Since public health officials have been so successful in getting the message out about the dangers of smoking, some people assume that smokeless forms of tobacco are safe. This could not be further from the truth.

Let me give you a few facts on spit tobacco, more commonly called chew or dip. According the Centers for Disease Control and Prevention, spit tobacco contains more than 28 cancer-causing agents and is a proven cause of human cancer. Specifically, this type of tobacco can cause cancer of the oral cavity -- including the tongue, lips, gum and cheek. Oral cancer is very serious and has only a 50 percent five-year survival rate.

This five-year survival rate has remained unchanged for the past 50 years. Experts feel that this is due primarily to the unfortunate fact that most oral cancers continue to be diagnosed in advanced stages. A number of studies have shown that the survival rate for oral cancer patients increases dramatically when the diagnosis is made in the early stages. This alone is a good reason to see your dentist twice a year for teeth cleaning and an oral examination. That will insure an early diagnosis of any oral cancer that you might develop.

The best strategy, however, also involves lowering your odds of contracting oral cancer in the first place. This means quitting spit tobacco if you use it. Because spit tobacco contains even more of the addictive drug nicotine than cigarettes, quitting can be hard. For example, a two-can-a-week snuff dipper gets as much nicotine into his or her blood as a pack-and-half-a-day smoker. Though it’s difficult, many people have been successful. It can be done, and you can do it.
Since next week is Through With Chew Week, this might be an especially good time to quit. Here are a few suggestions that will help:

• Pick a definite “quit date” and write it down. Since it’ll take you time to prepare to quit, this should be a date at least a week from now -- but not more than a month away.

• Get mentally prepared to quit by repeating to yourself the reasons you want to quit. This could be health reasons, to save money, because members of your family don’t like your habit, or because your physician or dentist told you to quit.

• Cut back before you quit. This can help reduce the withdrawal symptoms you’ll experience when your quit date arrives. A good rule of thumb is to try to cut back to half your usual amount before you quit. You might try to substitute sugar-free gum, hard candy, or even mint-leaf snuff every other time you’d normally take a dip of your regular snuff or chew.

There are many other places where you can find help in your efforts to kick the spit tobacco habit. You can talk to your dentist or family physician, or call your local chapter of the American Cancer Society or the American Lung Association. Many local health departments are an excellent resource for this kind of information. Also, you can call the National Tobacco Quit Line at 1-800-QUIT-NOW (1-800-784-8669).

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.