How addictive is chewing tobacco?

A form of smokeless tobacco, chewing tobacco contains nicotine, which is highly addictive. The other types of smokeless products are snuff, snus (which are oral pouches that don’t produce excess saliva), and dissolvable tobacco—which is also spit-less and frequently flavored. Chewing tobacco is available in three forms: loose leaves, plugs, or twists.

All these options have different nicotine strength based on their formulations, but are still derived from tobacco, which has naturally occurring nicotine as part of the plant. Research suggests that people who use smokeless tobacco get just as much, and sometimes more, nicotine in their bodies as those who smoke cigarettes.

This isn’t a new finding; the Surgeon General concluded in 1986 that smokeless tobacco is an addictive drug, and shares many qualities with other drugs of abuse, such as morphine and cocaine.

Like all tobacco products, smokeless tobacco creates tolerance with repeated use, which causes someone to increase how much they’re using in order to get the same effect, so they receive a higher boost of nicotine.

Nicotine changes the way the brain operates, kicking off an addiction response by driving the release of dopamine, a chemical that signals pleasure and reward. That’s why quitting can be so difficult; the sharp drop in dopamine leads to cravings, irritability, anxiety, and depressive symptoms.

Also, because young people who use smokeless tobacco can become addicted to nicotine, they are more likely to become cigarette smokers.

Although chewing tobacco doesn’t have as many risks to lung health as smoking or vaping, it’s still associated with many health problems. These include heart disease, pregnancy complications, and cancers of the mouth, esophagus, and pancreas. Smokeless tobacco also greatly increases the chances of costly dental problems like gum disease and tooth loss.

If you are an adult age 18+ and are trying to quit chewing tobacco, see if your employer or health plan offers the EX Program to you for free. Visit EX and enter your employer or health plan when you register to see if you’re eligible.