How smokeless tobacco differs from smoking and nicotine replacement therapy

Abstract

Smokeless tobacco (ST) differs from smoking and nicotine replacement therapy (NRT) in its composition and cardiovascular side effects. Although ST and smoking have relatively similar effects on addiction, weight, blood pressure, and heart rate, ST has much milder effects on metabolic syndrome, myocardial infarction, stroke, and cardiovascular mortality. On the other hand, NRT has less effect on heart rate and blood pressure and helps to treat nicotine addiction and decrease the weight gain resulting from quitting tobacco products. NRT is considered safer than smoking and ST. The nicotine load from ST is higher than that from smoking, but the burning in smoking causes the release of many substances that are more cardiovascularly toxic than nicotine, which explains the prominent metabolic and cardiovascular effects of smoking. Nicotine seems to have only a secondary role in the cardiovascular effects of smoking.

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“…Smokeless tobacco products, commercially manufactured or traditional, are relatively similar to smoked tobacco in terms of health outcomes and causing addiction, although they are considered to cause milder harms and in some cases recommended as possible substitute in quit smoking schemes (Arabi, 2008). The urgent need for further evaluation of their chemical composition for risk assessment purposes has resulted in studies mainly on manufactured and commercially available products such as American and Swedish snus (International Agency for Research on Cancer, 2007).…”