Smokeless tobacco, usually abbreviated as SLT
Smokeless tobacco is a tobacco product that is used by means other than smoking. In other words, this type of tobacco is not burned, its consumption does not involve combustion.
The consumption SLT involves chewing, sniffing, or placing the product between gum and the cheek or lip. They are produced in various forms, such as snuff, snus, chewing tobacco and Dissolvables (lozenges, sticks, strips, orbs)
A significant proportion of SLT s are considered safer than combustion cigarettes because they eliminate over 4000 various compounds, most of which are hazardous carcinogens.
SLTs can be a great answer to the public healthcare if well integrated in the public health system.
It is important to note that because of the ban of such saffer alternatives in some countries gives rise to a "black market" where illicit and unregulated SLTs are sold.
See also Smokeless Tobacco - Pouches (not snus) and Smokeless Tobacco - HnB for other types of smokeless tobacco products.
Risk to health
Smoking is uniquely deadly as a delivery mechanism for nicotine, some risk undoubtedly remains with smokeless products, and there may be considerable variation between products, sometimes with the same name, or that appear almost identical.
Please see the following blog post for details regarding some of these.
Is Snus Safer Than Dip or Chew? Health Effects of All Are Close to Zero Note: that this relates only to american products mentioned in the blog post.
- There are essentially no differences in risk for any of these diseases in the Swedish and American studies.
- New research on the relative safety of American dip/chew products indicates that smokeless users who had never smoked showed no significant risks for numerous diseases.
- In summary, American dip/chew and Swedish snus are indistinguishable with respect to health impact. Smokers who switch to any of these products can make smoking history.
In a press release 16 March 2023 FDA Authorizes Copenhagen Classic Snuff to be Marketed as a Modified Risk Tobacco Product
- FDA authorized U.S. Smokeless Tobacco Company (USSTC) to market its Copenhagen Classic Snuff, a loose moist smokeless tobacco product, as a modified risk tobacco product (MRTP).
- This product is a pre-existing tobacco product that has been marketed in the U.S. for years without modified risk information.
- This action now allows the product to be marketed as a modified risk tobacco product with the claim: “IF YOU SMOKE, CONSIDER THIS: Switching completely to this product from cigarettes reduces risk of lung cancer.”
Please note that other products listed in the table below may be significantly more risky, information on the relative risks and those compared to smoking are not easily available.
Many of these products are likely to have lower risks than smoking, however it is not known how much less for many.
Products such as Snus, and to an extent American smokeless have more information available, some are known to be very much less risky than smoking.
Smokeless products present less danger to bystanders since they are combustion thus smoke free.
Smokeless products are unlikely to cause respiratory problems or lung cancer, but may have increased risk of other cancer, such as throat and mouth.
Little information is available for some products, and many of these products may contain toxic or carcinogenic compounds.
Some products may have a greater risk of oral, nasal and throat cancer than smoking. However they are unlikely to directly cause lung cancer.
They can vary widely and will depend on factors such as curing and treatment of tobacco, some additives might also be problematic.
Even the tobacco free versions of these products may have risks, possibly greater risk, it is suggested to research elsewhere for such issues.
Types of smokeless tobacco
Snus, a product that originated in Sweden, is moist snuff that comes packaged in small pouches and is often flavored. This product does not produce excess saliva like other forms of smokeless tobacco, making it spit-less. Please follow the link to the page detailing the product for full information.
Chewing tobacco (“chew”)
Chewing tobacco is available in loose leaves, plugs, or twists of tobacco, and is placed between the cheek and gum or teeth. Examples of chewing tobacco include Red Man and Levi Garrett.
Snuff is finely ground tobacco packaged in cans or pouches, which can be sold dry (powdered form that is sniffed) or moist (placed between the lower lip or cheek and gum) and is sometimes used in teabag-like pouches. Popular brands of moist snuff are Copenhagen and Skoal.
Dissolvable tobacco is another spit-less, frequently flavored tobacco product that is finely milled and dissolves orally. Ariva and Stonewall are some of the dissolvable products on the market.
Non tobacco smokeless nicotine
Pituri Bush (Wikipedia:Duboisia Hopwoodii)
Aboriginal people have used plants both as a bushfood and bush medicine for centuries. Scientists have shown considerable interest in this particular bush and their reports from the 19th century said that they had observed Aboriginal men chewing pituri to give wisdom, feel brave in the face of warfare and allowed them to walk hundreds of kilometres in the desert without thinking about the need for food or water. This bush also has hallucinogenic properties.
The Pituri bush, used by the Aborigines as a bush medicine, grows to around 2.5mtrs. and is classified as a clonal shrub ie not propagated by seed.
TRADITIONAL USE: Leaves, flowers and flowering stalks are highly valued by the Aborigines as chewing tobacco with nicotine and nor-nicotine content being up to 25% of the dry weight of plant material. Pituri is the term used by the Aborigines for the ball of chewing tobacco. Pituri is prepared by drying and powdering the leaves of the nicotine plant and mixing with ash from a variety of different specially selected species. It is rolled up into quids (balls) that are 6cm long and 1.5cm in diameter and then chewed. The mixing of the alkaloid ash with the plant material renders the alkaloids more available when chewed and ingested. When it is not chewed it is put behind the ear like bubblegum. The chewed tobacco is used as a token of friendship, of which it has taken on the significance of a social event. More information here: The Aboriginal Drug Pituri (prehistoricdrugs)
An early account of the effects when smoked in a pipe: The Alkaloid of Pituri obtained from Duboisia hopwoodii Biochem J. 1911; 5(5): 193–206. doi: 10.1042/bj0050193
Non tobacco/nicotine products
Some of the products listed below may not always contain tobacco, or only optionally contain it. It is worth noting that some of these may be harmful without tobacco, it can not be assumed a product without tobacco is safe, or that the tobacco free version is safer.
Table of available SLT products and where available details of ingredients
|Product Name||Region||Mode of use||Form||Ingredients/additives|
|Gundi (kadapan)||India||C, IN||Tobacco (coarsely powdered)||Coriander seeds, other spices, and aromatic, resinous oils|
|Hogesoppu (leaf tobacco)||India||C, IN||Unprocessed tobacco bundled in long strands||None|
|Kaddipudi||India||C, IN||Powdered sticks of raw tobacco stalks and petioles||Sometimes molasses and water|
|Kiwam (qiwam, kimam)||Pakistan, Nepal, India, Bangladesh||C, H, IN||Tobacco (boiled)||Spices (cardamom, saffron, and/or aniseed), additives such as musk, and may contain silver flecks|
|Loose leaf||United States||C, H, S||Tobacco leaves (air-cured)||Sugar and/or licorice and other sweeteners|
|Mishri (masheri, misri)||India||A, D, S||Tobacco (toasted, powdered)||None|
|Moist snuff (low pH)||South Africa, United States, Canada, Mexico||H, S||Tobacco (fermented, air or fire-cured)||Flavorings (spices, essential oils, extracts), sweeteners, inorganic salts, humectants, preservatives|
|Neffa||Algeria, Libya, Tunisia||N||Tobacco (dry)||None|
|Tobacco chewing gum||Gam, Japan||C||Tobacco (finely ground)||Chewing gum base, xylitol|
|Pattiwalla without lime||India||C, IN||Tobacco (sundried, flaked)||None|
|Plug||United States||C, H, S||Tobacco leaves||Licorice, sweeteners|
|Red toothpowder (lal dant manjan)||India||A, D||Tobacco (powdered)||Herbs, flavorings. Additional plant-related ingredients such as ginger, pepper, and camphor, among others, may be used.|
|Snus (low pH)||South Africa, United States, Canada, Brazil, Sweden, Norway, Finland, Denmark, Iceland||H||Tobacco (heat-treated, pasteurized)||Sodium carbonate, moisturizers, salt (sodium chloride), sweeteners, flavorings, water|
|Tapkeer (bajjar, dry snuff)||India||A, H, N||Tobacco (fermented, fire-cured)||Flavorings may be added.|
|Tobacco leaf||India, Bangladesh, Myanmar, Bhutan||C, IN||Tobacco leaves (dry)||None|
|Twist||United States||C, H||Tobacco (dark and air-cured leaf)||Tobacco leaf extracts and sometimes sweetener or flavorings|
|Zarda||Yemen, India, Bangladesh, Myanmar, Nepal, Bhutan||C, IN||Tobacco||Slaked lime or other alkaline agents, spices, vegetable dyes, and sometimes areca nut and/or silver flecks|
|Chimó||Venezuela, Columbia||H, S||Tobacco leaf||Baking soda (sodium bicarbonate), brown sugar, ashes from the Mamón tree (Meliccoca bijuga), and vanilla and anisette flavoring. Ingredients vary by region.|
|Creamy snuff||India||A||Tobacco||Clove oil, glycerin, spearmint, menthol, camphor, water|
|Dissolvables||United States||DI, H, S||Ground tobacco pressed into tablets, strips, or sticks||Binders, humectants, sweeteners, colorings, preservatives, alkaline agents, flavorings|
|Dry snuff||South Africa, Nigeria, Canada, United States, Germany||H, N, S||Tobacco (fermented, firecured||Flavoring, alkaline agents|
|Ghana traditional snuff (tawa)||Ghana||H, N||Tobacco leaves (dry)||Saltpeter (potassium nitrate), ashes|
|Gudakhu/ Gudakha||India||A, H||Tobacco (powdered)||Molasses, red soil, slaked lime|
|Gul||India, Bangladesh||A, D||Pyrolysed tobacco leaves||Sugar or molasses, alkaline modifiers, and other unknown ingredients|
|Iqmik||United States (Alaska)||C||Tobacco||Tree fungus ash (also known as punk, araq, or buluq ash) or other ash derived from burning driftwood or willow bushes|
|Khaini||India, Bangladesh, Nepal, Bhutan||S, H, C||Tobacco||Slaked lime paste and sometimes areca nut|
|Maras||Turkey||A||Sun-dried tobacco||Ashes from oak, walnut, or grapevine|
|Moist snuff (high pH)||South Africa, United States, Canada, Mexico||H, S||Tobacco (fermented, air or fire-cured)||Flavorings (spices, essential oils, extracts), sweeteners, inorganic salts, humectants, preservatives|
|Nass (naswar)||South Africa, Pakistan, Iran, Afghanistan, United Arab Emirates, Turkmenistan||C, H, S||Tobacco||Nass: ash, cotton or sesame oil, water, and sometimes lime or gum Naswar: slaked lime, ash, indigo (or other coloring agent), oil, water, and sometimes flavorings such as cardamom and menthol|
|Nasway (nasvay)||Uzbekistan, Kyrgyzstan||H, S||Tobacco leaves (sun and heat-dried)||Tobacco leaves, slaked lime, water, and sometimes ash from tree bark, butter or oil, flavorings, or coloring agents|
|Nigerian traditional snuff (taaba)||Nigeria, Cameroon, Senegal, Chad, Uganda||H, N, S||Tobacco (dry, fermented)||Natron (a mixture of sodium bicarbonate and sodium chloride)|
|Pituri||Australia||H, N, S||Duboisia hopwodii||mixed with ash of a certain Acacia|
|Shammah||Algeria, Saudi Arabia, Yemen||H, S||Tobacco||Slaked lime, ash, black pepper, oil, flavorings, and bombosa (sodium carbonate)|
|Snus (high pH)||South Africa AMR: United States, Canada, Brazil, Sweden, Norway, Finland, Denmark, Iceland||H||Tobacco (heat-treated, pasteurized)||Sodium carbonate, moisturizers, salt (sodium chloride), sweeteners, flavorings, water|
|Tobacco water (tuiber)||India||G, H||Tobacco smoke||Water, alkaline agents|
|Toombak||Sudan||H, N, S||Tobacco (fermented, sun-dried)||Atrun (sodium bicarbonate)|
|Traditional South African snuff (snuif)||South Africa, Lesotho, Swaziland||Tobacco leaf (sun-dried)||Ash from local plants (e.g., amaranthus, aloe vera leaves)|
|Betel quid (paan)||Pakistan, United Arab Emirates, India, Sri Lanka, Bangladesh, Myanmar, Thailand, Indonesia, Nepal, Maldives, Lao Democratic People’s Republic, Palau, Cambodia, Malaysia, Vietnam, Federal States of Micronesia||C, H||Tobacco. Other smokeless tobacco products may be used such as kiwam and zarda.||Areca nut, slaked lime, betel leaf, and often catechu. Other ingredients vary regionally: cardamom, saffron, cloves, aniseed, turmeric, mustard, sweeteners|
|Dohra||India||C||Tobacco||Areca nut, slaked lime or other alkaline agents, and other ingredients such as catechu, peppermint, cardamom|
|Gutka||Pakistan, India, Bangladesh, Nepal, Myanmar, Sri Lanka||C, H||Tobacco||Areca nut, slaked lime or other alkaline agents, catechu, sweeteners, and flavorings|
|Kharra||India||C||Tobacco||Areca nut, lime, and catechu|
|Mainpuri (kapoori)||India||C, H, IN||Tobacco||Slaked lime or other alkaline agents, areca nut, camphor, and other spices|
|Mawa SE||India||C||Tobacco||Slaked lime, areca nut|
|Tombol (bitter tombol)||Middle East||C, H||Tobacco||Areca nut (fofal), slaked lime, noura, betel leaf (tombol leaf), catechu, and flavorings such as clove oil, cardamom, or herbal medicine|
|Tombol (sweet tombol)||Yemen||C, H||Tobacco||Areca nut (fofal), slaked lime, noura, betel leaf (tombol leaf), catechu, and sweeteners such as coconut|
|Caffeinated moist snuff||United States||H||Tobacco (fermented, air or fire-cured||Caffeine, flavorings (spices, essential oils, extracts), sweeteners, inorganic salts, humectants, preservatives, ginseng, B and C vitamins|
|Rapé and NuNu||Brazil||N||Tobacco leaf (dried)||One or more ingredients: tonka bean, clove, cinnamon powder, camphor, Peruvian cocoa, cassava, ashes from select trees|
|Tombol with khat||Yemen||C, IN||Tobacco||Areca nut (fofal), slaked lime, noura, betel leaf (tombol leaf), catechu, and khat|
Key to mode of use abbreviations: A=Applied gums C = Chewed D = Dentifrice DI = Dissolves G = Gargled H = Held in mouth IN = Ingredient N = Nasal use S = Sucked
Scientific studies and papers
2023: Physical and chemical characterization of smokeless tobacco products in India.
- The products in question are better described as traditional recipes that contain tobacco (and much else). That doesn't inhibit the authors from drawing conclusions that range far beyond the products and geography of their study and chiming in with something about flavours, as that is the happening thing now.
- Needs reading as it may help differentiate the risk of some Indian SLT
2023: Sudanese smokeless tobacco (Toombak) users harbour significantly altered long-term cortisol body production.
- The effect on body cortisol response over a retrospective period in users of this product has not been previously explored. In addition, the psycho-dependency level distributed amongst users of Toombak has also not been analysed to date.
- FTND - ST scores ranged from 4-9, with 85% of Toombak users reflecting high levels of psycho-dependency (score>5) and nicotine tolerance.
- Cortisol body release in Sudanese smokeless tobacco users was found to be significantly altered. While low cortisol levels do lead to anxiolytic effects, long-term, this can allow for an increased susceptibility to low cortisol associated diseases. (Unfortunately there is no discussion on the possibility that this might be an overall positive regarding anxiety, and no information on what these diseases might be. ed.)