Dipping tobacco: Difference between revisions

Latest revision as of 18:50, 24 June 2015

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Dipping tobacco (also known as American moist snuff or spit tobacco) is a form of smokeless tobacco. It is commonly referred to as dip while the act of using it is known as dipping, having a dip, or packing a lip.

Usage

Dipping tobacco, sometimes called "chew," is commonly confused with chewing tobacco. Rather than chewing on tobacco, dipping consists of placing a small clump of tobacco between the lower or upper lip and gums. The dip rests on the inside lining of the mouth for approximately 20-30 minutes as saliva carries nicotine to the inferior or superior labial arteries.

While dipping, users often produce excess saliva, which is typically spat out. Swallowing this excess saliva can cause irritation to the oesophagus, nausea, and vomiting, though some long-time users can swallow this saliva with no unusual effects.

Dipping is often seen as a way of experiencing the effects of nicotine without inhaling smoke into one's lungs.

Cut sizes

The difference between cut sizes are shown in the length of the individual strands of tobacco. The common cut types are:

Dong Cut - Thin strands of tobacco, typically .7 cm long.
Mid Cut - Small granules, approximately .1 cm cubed.
Fine Cut - Very small granules, slightly larger than a grain of sand.
Pouches - Very finely cut and wrapped in a small envelopes.

Surface area and absorption

Many smokeless tobacco users have preferences in texture and nicotine absorption rates. The finer cut the tobacco is, the greater its surface area, which correlates with increased nicotine absorption. Additionally, the amount of moisture in dipping tobacco can be affected by cut size, with finer cuts retaining more moisture.

Health issues

Cancer dangers

Dipping tobacco has been shown to cause various types of cancer, including oral cancer, esophageal cancer, and pancreatic cancer. Most researchers emphasize that while smokeless tobacco may be a "less harmful" alternative to smoking, as it causes fewer fatalities, it is not a "safe" alternative to smoking.^[1] One recent study indicated that smokeless tobacco users are exposed to more NNK, a carcinogen, than cigarette smokers.^[2]

Cardiovascular effects

Studies are inconclusive as to how significantly smokeless tobacco affects users' cardiovascular systems. One study states that, "Although the evidence is not conclusive, the adverse cardiovascular effects of smokeless tobacco use are less than those caused by smoking but are more than those found in non-users."^[3] Other studies also indicate that smokeless tobacco related cardiovascular risks are lower than that of smoked tobacco.^[4]^[5] One study states that smokeless tobacco use has a "modest effect on cardiovascular risk factors in young physically fit men."^[6]

However, it is important to note that one Indian study from the state of Rajasthan states, "There is a significantly greater prevalence of multiple cardiovascular risk factors [sic] obesity, resting tachycardia, hypertension, high total and LDL cholesterol, and low HDL cholesterol, and electrocardiographic changes in tobacco users, chewing or smoking, as compared-to tobacco non-users. Chewing tobacco is associated with similar cardiovascular risk as smoking."^[7]

Due to contrasting results in studies, many conclude that further research should be done on the cardiovascular risks of smokeless tobacco.^[8]^[9]

Addiction potential

Smokeless tobacco contains nicotine, which is its primary addictive agent.

According to European Union policy, Scandinavian or some American smokeless tobaccos are at least 90% less hazardous than cigarette smoking.^[10] However, dipping tobacco is still addictive.

Warning labels

The following three warning labels must be rotated on all tins of smokeless tobacco sold in the US:

WARNING: This product may cause mouth cancer.
WARNING: This product may cause gum disease and tooth loss.
WARNING: This product is not a safe alternative to smoking.

Smokeless tobacco companies

Connecticut-based UST Inc. held 62.5 percent of the market as of the third quarter of 2006, according to Morningstar investment research firm. The company's brands include Copenhagen, Skoal, Husky, and Red Seal. The next two largest entities are the Conwood subsidiary of Reynolds American Inc., and Swedish Match. In 2006, smokeless and "spit-less" tobacco products were test-marketed by Altria Group Inc. (formerly Phillip Morris Companies) and R.J. Reynolds Tobacco Company, the former named Taboka and the latter under the brand name Camel Snus^[11].

References

↑ Public health implications of smokeless tobacco use as a harm reduction strategy. PubMed. Accessed on July 31, 2007.
↑ Snuff Not Safe: Smokeless Tobacco Delivers More Of Some Dangerous Carcinogens Than Cigarettes. ScienceDaily. Accessed on August 11, 2007.
↑ Smokeless tobacco and cardiovascular risk. PubMed. Accessed on June 1, 2007.
↑ Smokeless tobacco and cardiovascular disease. PubMed. Accessed on June 1, 2007.
↑ Overview of knowledge of health effects of smokeless tobacco. Increased risk of cardiovascular diseases and mortality because of snuff. PubMed. Accessed on June 1, 2007.
↑ Smokeless tobacco, cardiovascular risk factors, and nicotine and cotinine levels in professional baseball players. PubMed. Accessed on June 1, 2007.
↑ Cardiovascular risk factors in tobacco-chewers: a controlled study. PubMed. Accessed on May 8, 2007.
↑ Epidemiology of cancer and other systemic effects associated with the use of smokeless tobacco. PubMed. Accessed on June 1, 2007.
↑ Is smokeless tobacco a risk factor for coronary heart disease? A systematic review of epidemiological studies. PubMed. Accessed on June 1, 2007.
↑ European Union policy on smokeless tobacco: a statement in favour of evidence based regulation for public health. Accessed on July 31, 2007.
↑ ABC News: Smokeless Tobacco: No Chewing, No Spitting, and Fewer Cancer-Causing Chemicals? Accessed on July 31, 2007.

External links

Smokeout: Not as easy as ABC - Commentary - The Washington Times, America's Newspaper
Effect of smokeless tobacco (snus) on smoking and public health in Sweden
No Smoke, No Problem?
Tobacco harm reduction: an alternative cessation strategy for inveterate smokers. By Brad Rodu and William T. Godshall, published in December 2006 in Harm Reduction Journal.

For information regarding the dangerous and addictive nature of this product and other "smokeless tobacco products" they can visit www.lostjaw.ca

de:Smokeless Tobacco

[1] Public health implications of smokeless tobacco use as a harm reduction strategy. PubMed. Accessed on July 31, 2007.

[scidaily1"-2] Snuff Not Safe: Smokeless Tobacco Delivers More Of Some Dangerous Carcinogens Than Cigarettes. ScienceDaily. Accessed on August 11, 2007.

[pb_15451758-3] Smokeless tobacco and cardiovascular risk. PubMed. Accessed on June 1, 2007.

[pm_12704595-4] Smokeless tobacco and cardiovascular disease. PubMed. Accessed on June 1, 2007.

[pm_9411127-5] Overview of knowledge of health effects of smokeless tobacco. Increased risk of cardiovascular diseases and mortality because of snuff. PubMed. Accessed on June 1, 2007.

[pm_1536359-6] Smokeless tobacco, cardiovascular risk factors, and nicotine and cotinine levels in professional baseball players. PubMed. Accessed on June 1, 2007.

[pb_cardio-7] Cardiovascular risk factors in tobacco-chewers: a controlled study. PubMed. Accessed on May 8, 2007.

[pm_9524431-8] Epidemiology of cancer and other systemic effects associated with the use of smokeless tobacco. PubMed. Accessed on June 1, 2007.

[pm_15187813-9] Is smokeless tobacco a risk factor for coronary heart disease? A systematic review of epidemiological studies. PubMed. Accessed on June 1, 2007.

[10] European Union policy on smokeless tobacco: a statement in favour of evidence based regulation for public health. Accessed on July 31, 2007.

[11] ABC News: Smokeless Tobacco: No Chewing, No Spitting, and Fewer Cancer-Causing Chemicals? Accessed on July 31, 2007.

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+{{CMG}}
 ==Overview==
-'''Dipping tobacco''' (also known as '''American moist snuff''' or '''spit tobacco''') is a form of smokeless [[tobacco]]. It is commonly referred to as '''dip''' while the act of using it as ''dipping'', ''having a dip'', or ''packing a lip''. [[Chewing tobacco]] is often associated with this family of products.
+'''Dipping tobacco''' (also known as '''American moist snuff''' or '''spit tobacco''') is a form of smokeless [[tobacco]].  It is commonly referred to as '''dip''' while the act of using it is known as ''dipping'', ''having a dip'', or ''packing a lip''.
 ==Usage==
-[[Image:Dip in mouth.jpg|thumb|150px|left|An example of how dip is often placed.]]
+Dipping tobacco, sometimes called "chew," is commonly confused with [[chewing tobacco]].  Rather than chewing on tobacco, dipping consists of placing a small clump of tobacco between the lower or upper lip and gums. The dip rests on the inside lining of the mouth for approximately 20-30 minutes as [[saliva]] carries [[nicotine]] to the inferior or [[superior labial]] arteries.
-Dip is sometimes called "chew"; because of this, it is commonly confused with [[chewing tobacco]]. Instead of literally chewing on tobacco, a small clump of dip is 'pinched' out of the tin, and placed between the lower or upper lip and gums. The dip rests on the inside lining of the mouth for approximately 20-30 minutes--ultimately the duration of a dip is determined by the user--where [[saliva]] carries [[nicotine]] to the [[inferior labial|inferior]] or [[superior labial]] arteries.
-Dip tobacco users often produce excess saliva while dipping.  This is typically spat onto the ground, in a bottle, etc. Swallowing can cause irritation to the [[oesophagus]], nausea, and vomiting-- however, some (long-time) users can swallow the tobacco-caused saliva with no unusual effects. Smokeless tobacco is sometimes used in the workplace by employees, especially if the employer does not provide many cigarette breaks or if the employee is constantly using both hands during work (which doesn't provide opportunities for [[Cigarette|cigarette smoking]]).
+While dipping, users often produce excess saliva, which is typically spat out. Swallowing this excess saliva can cause irritation to the [[oesophagus]], nausea, and vomiting, though some long-time users can swallow this saliva with no unusual effects.
-Many athletes, especially American baseball players and folkstyle wrestlers,{{Specify|date=September 2007}} turn to dipping as a way to get the buzz of nicotine without inhaling smoke into their lungs.{{Fact|date=September 2007}}
+Dipping is often seen as a way of experiencing the effects of nicotine without inhaling smoke into one's lungs.
 ==Cut sizes==
 The difference between cut sizes are shown in the length of the individual strands of tobacco.
+The common cut types are:
-===Types===
+*Dong Cut - Thin strands of tobacco, typically .7 cm long.
-*Dong Cut - Long cut comes in thin strands of tobacco around .7 cm long
+*Mid Cut  - Small granules, approximately .1 cm cubed.
-*Mid Cut  - Mid-cut is comparable to small granules about .1 cm cubed.
+*Fine Cut - Very small granules, slightly larger than a grain of sand.
-*Fine Cut - Fine cut comes in granules slightly larger than a grain of sand.
+*Pouches - Very finely cut and wrapped in a small envelopes.
-*Pouches - Pouches are fine cut wrapped in a small tea bag like envelope .
 ===Surface area and absorption===
-Many smokeless tobacco users have preferences in texture and nicotine absorption rates. The finer cut the tobacco is, the tobacco will have more surface area; as the surface area in the tobacco increases, the rate of absorption is slightly increased, which some users prefer. In addition, the amount of moisture in dipping tobacco can be affected by cut size as well; moisture is easier to maintain the finer cut the tobacco is.
+Many smokeless tobacco users have preferences in texture and nicotine absorption rates. The finer cut the tobacco is, the greater its surface area, which correlates with increased nicotine absorption. Additionally, the amount of moisture in dipping tobacco can be affected by cut size, with finer cuts retaining more moisture.
-===Ease of use===
-While the differences between fine, long, and mid-cut tobaccos vary, so does the ease of use. The more finely cut the tobacco the less manageable it becomes than that of long/mid-cuts and will tend to fall out of a person's fingers. Longer-cut tobacco  is the most manageable and tends to cling together between the fingers.
 ==Health issues==
 ===Cancer dangers===
-Studies have shown that dipping tobacco has a relatively low risk for cancer, but some studies give conflicting results. One, done in 2004, shows that tobacco-specific [[nitrosamine]] (TSNA) levels were much higher in American dipping tobacco than those of Swedish products.<ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=15470264 Smokeless tobacco and oral cancer: a review of the risks and determinants.] ''[[PubMed]].'' Accessed on [[July 31]], [[2007]].</ref>
+Dipping tobacco has been shown to cause various types of cancer, including oral cancer, esophageal cancer, and pancreatic cancer.  Most researchers emphasize that while smokeless tobacco may be a "less harmful" alternative to smoking, as it causes fewer fatalities, it is not a "safe" alternative to smoking.<ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17018821&itool=iconabstr&query_hl=23&itool=pubmed_docsum Public health implications of smokeless tobacco use as a harm reduction strategy.] ''[[PubMed]].'' Accessed on [[July 31]], [[2007]].</ref>
+One recent study indicated that smokeless tobacco users are exposed to more [[NNK]], a [[carcinogen]], than cigarette smokers.<ref name=scidaily1">[http://www.sciencedaily.com/releases/2007/08/070809130018.htm Snuff Not Safe: Smokeless Tobacco Delivers More Of Some Dangerous Carcinogens Than Cigarettes.] ''[[ScienceDaily]].'' Accessed on [[August 11]], [[2007]].</ref>
-"[[Tobacco]]-specific [[nitrosamines]] (TSNAs) are believed to play a significant role as causes of [[cancer]] in people who use tobacco products."<ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=15824160&itool=iconfft&query_hl=23&itool=pubmed_docsum Tobacco-specific nitrosamines and their pyridine-N-glucuronides in the urine of smokers and smokeless tobacco users.] ''[[PubMed]].'' Accessed on [[July 31]], [[2007]].</ref>  The risk of [[mouth cancer]] is significantly debated by some American public health professionals, as noted in several recent and past studies.<ref>[http://query.nytimes.com/gst/fullpage.html?sec=health&res=9802E6D91339F935A15750C0A967948260 Researchers Find Snuff Dipping Increases the Risk of Oral Cancer] ''[[New York Times]].'' Accessed on [[July 31]], [[2007]].</ref><ref>[http://dx.doi.org/10.1016/S1079-2104(98)90207-4 Oral cancer in a tobacco-chewing US population—no apparent increased incidence or mortality.]  Accessed on [[July 31]], [[2007]].</ref> However, most researchers emphasize that while smokeless tobacco may be a "less harmful" alternative to smoking, it is not a "safe" alternative to smoking.<ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17018821&itool=iconabstr&query_hl=23&itool=pubmed_docsum Public health implications of smokeless tobacco use as a harm reduction strategy.] ''[[PubMed]].'' Accessed on [[July 31]], [[2007]].</ref>
-One recent study indicated that smokeless tobacco users are exposed to more [[NNK]], a human carcinogen, than cigarette smokers.  NNK is known to cause cancer in laboratory animals.  This study, like others, stresses that smokeless tobacco use is not a ''"safe"'' alternative to cigarettes.<ref name=scidaily1">[http://www.sciencedaily.com/releases/2007/08/070809130018.htm Snuff Not Safe: Smokeless Tobacco Delivers More Of Some Dangerous Carcinogens Than Cigarettes.] ''[[ScienceDaily]].'' Accessed on [[August 11]], [[2007]].</ref>
-"The three leading U.S. snuff brands ([[Copenhagen tobacco|Copenhagen]], [[Skoal tobacco|Skoal fine cut]], and [[Kodiak tobacco|Kodiak]]; making up 92% of the U.S. market) showed not only high levels of pH, nicotine, and unprotonated (free) nicotine, but also high concentrations of the strongly carcinogenic TSNAs in comparison with the fourth and fifth best selling moist snuff brands, Hawken and Skoal Bandits (3% of the U.S. market)."<ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=7494230 Five leading U.S. commercial brands of moist snuff in 1994: assessment of carcinogenic N-nitrosamines.] ''[[PubMed]].'' Accessed on [[July 31]], [[2007]].</ref>
-Cancer, however, is not frequently experienced as a consequence in [[Sweden]], where smokeless tobacco use is well-established. It should be noted, however, that Swedish moist [[Snuff (tobacco)|snuff]] ("[[Snus]]") utilizes a different manufacturing process that is speculated to reduce the amount of harmful chemicals delivered to the smokeless tobacco user, specifically by minimizing [[nitrosamine]] content.<ref>[http://www.tobaccoprogram.org/pdf/TC12349.pdf Effect of smokeless tobacco (snus) on smoking and public health in Sweden]</ref>
 ===Cardiovascular effects===
-Studies are inconclusive as to how significantly smokeless tobacco affects users' [[circulatory system|cardiovascular system]]s.  One study states that, "Although the evidence is not conclusive, the adverse cardiovascular effects of smokeless tobacco use are less than those caused by smoking but are more than those found in nonusers."<ref name="pb_15451758">[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=15451758&itool=iconabstr&query_hl=2&itool=pubmed_docsum Smokeless tobacco and cardiovascular risk.] ''[[PubMed]].'' Accessed on [[June 1]], [[2007]].</ref>  Other studies also indicate that smokeless tobacco related cardiovascular risks are lower than that of smoked tobacco.<ref name="pm_12704595">[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=12704595&itool=iconabstr&query_hl=2&itool=pubmed_DocSum Smokeless tobacco and cardiovascular disease.] ''[[PubMed]].'' Accessed on [[June 1]], [[2007]].</ref><ref name="pm_9411127">[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=9411127&itool=iconabstr&query_hl=2&itool=pubmed_DocSum Overview of knowledge of health effects of smokeless tobacco. Increased risk of cardiovascular diseases and mortality because of snuff.] ''[[PubMed]].'' Accessed on [[June 1]], [[2007]].</ref>  One study states that smokeless tobacco use has a "modest effect on cardiovascular risk factors in young physically fit men."<ref name="pm_1536359">[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=1536359&itool=iconpmc&query_hl=2&itool=pubmed_DocSum Smokeless tobacco, cardiovascular risk factors, and nicotine and cotinine levels in professional baseball players.] ''[[PubMed]].'' Accessed on [[June 1]], [[2007]].</ref>
+Studies are inconclusive as to how significantly smokeless tobacco affects users' [[circulatory system|cardiovascular system]]s.  One study states that, "Although the evidence is not conclusive, the adverse cardiovascular effects of smokeless tobacco use are less than those caused by smoking but are more than those found in non-users."<ref name="pb_15451758">[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=15451758&itool=iconabstr&query_hl=2&itool=pubmed_docsum Smokeless tobacco and cardiovascular risk.] ''[[PubMed]].'' Accessed on [[June 1]], [[2007]].</ref>  Other studies also indicate that smokeless tobacco related cardiovascular risks are lower than that of smoked tobacco.<ref name="pm_12704595">[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=12704595&itool=iconabstr&query_hl=2&itool=pubmed_DocSum Smokeless tobacco and cardiovascular disease.] ''[[PubMed]].'' Accessed on [[June 1]], [[2007]].</ref><ref name="pm_9411127">[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=9411127&itool=iconabstr&query_hl=2&itool=pubmed_DocSum Overview of knowledge of health effects of smokeless tobacco. Increased risk of cardiovascular diseases and mortality because of snuff.] ''[[PubMed]].'' Accessed on [[June 1]], [[2007]].</ref>  One study states that smokeless tobacco use has a "modest effect on cardiovascular risk factors in young physically fit men."<ref name="pm_1536359">[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=1536359&itool=iconpmc&query_hl=2&itool=pubmed_DocSum Smokeless tobacco, cardiovascular risk factors, and nicotine and cotinine levels in professional baseball players.] ''[[PubMed]].'' Accessed on [[June 1]], [[2007]].</ref>
-However, it is important to note that one [[India]]n study from the state of Rajasthan states, "There is a significantly greater prevalence of multiple cardiovascular risk factors [sic] obesity, resting tachycardia, hypertension, high total and LDL cholesterol, and low HDL cholesterol, and electrocardiographic changes in tobacco users, chewing or smoking, as compared-to tobacco non-users. Chewing tobacco is associated with similar cardiovascular risk as smoking."<ref name="pb_cardio">[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17444341&itool=iconabstr&query_hl=11&itool=pubmed_docsum Cardiovascular risk factors in tobacco-chewers: a controlled study.] ''[[PubMed]].'' Accessed on [[May 8]], [[2007]].</ref>  This finding may bear on the possibility that smokeless tobacco in India is produced differently than in [[Western world|Western]] countries.{{or}}
+However, it is important to note that one Indian study from the state of Rajasthan states, "There is a significantly greater prevalence of multiple cardiovascular risk factors [sic] obesity, resting tachycardia, hypertension, high total and LDL cholesterol, and low HDL cholesterol, and electrocardiographic changes in tobacco users, chewing or smoking, as compared-to tobacco non-users. Chewing tobacco is associated with similar cardiovascular risk as smoking."<ref name="pb_cardio">[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17444341&itool=iconabstr&query_hl=11&itool=pubmed_docsum Cardiovascular risk factors in tobacco-chewers: a controlled study.] ''[[PubMed]].'' Accessed on [[May 8]], [[2007]].</ref>
 Due to contrasting results in studies, many conclude that further research should be done on the cardiovascular risks of smokeless tobacco.<ref name="pm_9524431">[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=9524431&itool=iconfft&query_hl=2&itool=pubmed_DocSum Epidemiology of cancer and other systemic effects associated with the use of smokeless tobacco.] ''[[PubMed]].'' Accessed on [[June 1]], [[2007]].</ref><ref name="pm_15187813">[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=15187813&itool=iconabstr&query_hl=2&itool=pubmed_docsum Is smokeless tobacco a risk factor for coronary heart disease? A systematic review of epidemiological studies.] ''[[PubMed]].'' Accessed on [[June 1]], [[2007]].</ref>
-===Misconceptions===
-According to one study, only a "handful of websites" contain accurate information on the hazards of smokeless tobacco.  1/3 of websites relating to smokeless tobacco "explicitly" claim that smokeless tobacco is comparable to, or worse than, cigarettes.  The conclusion reads:
-:"Through these websites, and presumably other information provided by the same government, advocacy, and educational organizations, ST [smokeless tobacco] users are told, in effect, that they might as well switch to smoking if they like it a bit more. Smokers and policy makers are told there is no potential for harm reduction. These messages are clearly false and likely harmful, representing violations of ethical standards."<ref name="pm15811179">[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=15811179 You might as well smoke; the misleading and harmful public message about smokeless tobacco.] ''[[PubMed]].'' Accessed on [[May 8]], [[2007]].</ref>
 ===Addiction potential===
-Smokeless tobacco contains [[nicotine]], which is the primary [[addictive]] agent.
+Smokeless tobacco contains [[nicotine]], which is its primary [[addictive]] agent.
-According to [[European Union]] policy, [[Scandinavia]]n or some American smokeless tobaccos are at least 90% less hazardous than cigarette smoking.<ref>[http://tc.bmjjournals.com/cgi/reprint/12/4/360.pdf European Union policy on smokeless tobacco: a statement in favour of evidence based regulation for public health.] Accessed on [[July 31]], [[2007]].</ref> However, the habit is still addictive.
+According to European Union policy, Scandinavian or some American smokeless tobaccos are at least 90% less hazardous than cigarette smoking.<ref>[http://tc.bmjjournals.com/cgi/reprint/12/4/360.pdf European Union policy on smokeless tobacco: a statement in favour of evidence based regulation for public health.] Accessed on [[July 31]], [[2007]].</ref> However, dipping tobacco is still addictive.
-[[Taxation]] and restriction of smoking is causing more smokeless tobacco use as "substitution." There are active public health debates regarding risk-reduction for smokers and the reconsideration of smokeless tobacco risks. ''"...There is a substantial body of informed and independent opinion that sees the value of harm reduction strategies based on smokeless tobacco."''<ref>[http://www.ash.org.uk/html/regulation/html/eusmokeless.html UK's Action on Smoking & Health (ASH..)] Accessed on [[July 31]], [[2007]].</ref>
 ===Warning labels===
-The following three [[warning labels]] must be rotated on all tins of smokeless tobacco sold in the US:
+The following three warning labels must be rotated on all tins of smokeless tobacco sold in the US:
 * WARNING: This product may cause [[mouth cancer]].
 * WARNING: This product may cause [[gum disease]] and [[tooth loss]].
 * WARNING: This product is not a safe alternative to smoking.
-===Additives===
-There are few reports confirming exactly what additives are in smokeless tobacco, and it's very likely that brands vary in what and how much of each additive they use.  One popular, and currently unsubstantiated rumour, is that glass or fiberglass is mixed into each tin to cause abrasion to the lip, resulting in higher and faster nicotine absorption.  There is no evidence that this rumour is true, as there are no cited studies referenced in material that spreads this information.
 ==Smokeless tobacco companies==
-Connecticut-based [[UST Inc.]] held 62.5 percent of the market as of the third quarter of 2006, according to [[Morningstar]].{{Specify|date=August 2007}} The company's brands include Copenhagen, Skoal, Husky, and Red Seal. The next two largest entities are the [[Conwood]] subsidiary of [[Reynolds American Inc.]], and [[Swedish Match]]. In 2006, smokeless and "spit-less" tobacco products were test-marketed by [[Altria Group Inc.]] (formerly Phillip Morris Companies) and [[R.J. Reynolds Tobacco Company]], the former named [[Taboka]] and the latter under the brand name [http://www.snuscamel.com Camel Snus]<ref>[http://abcnews.go.com/Health/story?id=2099026&page=1 ABC News: Smokeless Tobacco: No Chewing, No Spitting, and Fewer Cancer-Causing Chemicals?] Accessed on [[July 31]], [[2007]].</ref>.  These companies hope there is an untapped market for "spit-less" tobacco products (such as in smoke-free bars) because they are a discreet alternative to spit dip.
+Connecticut-based UST Inc. held 62.5 percent of the market as of the third quarter of 2006, according to Morningstar investment research firm. The company's brands include Copenhagen, Skoal, Husky, and Red Seal. The next two largest entities are the Conwood subsidiary of Reynolds American Inc., and Swedish Match. In 2006, smokeless and "spit-less" tobacco products were test-marketed by Altria Group Inc. (formerly Phillip Morris Companies) and R.J. Reynolds Tobacco Company, the former named Taboka and the latter under the brand name [http://www.snuscamel.com Camel Snus]<ref>[http://abcnews.go.com/Health/story?id=2099026&page=1 ABC News: Smokeless Tobacco: No Chewing, No Spitting, and Fewer Cancer-Causing Chemicals?] Accessed on [[July 31]], [[2007]].</ref>.
-[[Canada|Canadian]] tins are smaller in size compared to tins produced for the [[United States]].{{Fact|date=February 2007}} US tins are generally 34 grams<ref>Tins of Skoal Long Cut and Copenhagen Long Cut each are labelled "[[Net weight|NT WT.]] 1.2 [[Ounce|OZ.]] (34.02 [[Grams|g]])."</ref> while Canadian tins are 15 grams.{{Fact|date=February 2007}}  Smokeless tobacco products are also more expensive than they are across the border.{{Fact|date=February 2007}}  Prices for a 15 gram tin of average, popular brand smokeless tobacco are normally around $6-7, in Canadian funds.{{Fact|date=February 2007}}  Though prices tend to vary more from one state to the next in the US, it is quite common to find the same brands of smokeless tobacco products in containers twice the size as Canadian ones, for around half the price with currency differences taken into account.{{Fact|date=February 2007}}  Canadian users wait longer for new products to be released and spend, depending on [[Provinces and territories of Canada|province]], up to 40% more.<ref>[http://tc.bmjjournals.com/cgi/content/full/8/4/411 Smokeless tobacco in Canada: deterring market development]</ref> Many flavours are not released in Canadian markets until much later due to tobacco denormalization laws.<ref>[http://www.hc-sc.gc.ca/hl-vs/pubs/tobac-tabac/ns-sn/appendixc-annexec_e.html A National Strategy ISBN 0-662-64463-8 Appendix C]</ref>
-==Alternative products==
-[[Image:Jerky chew.jpg|thumb|150px|right|A tin of jerky chew.]]
-Tobacco-free smokeless products are available on the market such as [http://www.mintsnuff.com Mint Snuff], [http://www.smokeymountainsnuff.com Smokey Mountain Snuff], and [http://www.hoochsnuff.com Hooch Snuff] utilize an [[herbal]] based composition with ingredients such as [[mint leaves]], [[Corn construction|corn silk]] or [[pueraria]]. [http://www.bluewhalesmokeless.com Blue Whale] with ''NicoDip'' is a smokeless product that uses [[tea]] leaves with a tobacco extract. [http://www.kikit.net KIKIT] is a completely edible chewing tobacco alternative made from coconut. Also, some food companies produce ''jerky chew,'' shredded [[beef jerky]] in smokeless tobacco sized tins.
 ==References==