Your Health by Dr. Rallie McAllister

If you're looking for a safe alternative to smoking cigarettes, smokeless tobacco isn't it.

Recent research conducted by researchers at the University of Minnesota banished the notion that snuff and chewing tobacco are safer because they don't burn and produce inhalable smoke. The researchers discovered that a single pinch of smokeless tobacco exposes the user to the same amount of another type of carcinogen, called polycyclic aromatic hydrocarbons (PAH), as the smoke produced by five cigarettes.

Polycyclic aromatic hydrocarbons are widespread environmental contaminants formed as a result of incomplete burning of organic matter, including wood, coal, meat and tobacco.

Until recently, many scientists believed that only trace amounts of PAH existed in snuff. Although use of smokeless tobacco doesn't involve burning, moist snuff is contaminated with PAH during manufacturing.

The most likely source of contamination is the curing process used to turn tobacco leaves into snuff. Known as fire-curing, it puts tobacco into direct contact with the smoke generated by smoldering hardwoods, a rich source of PAH.

The research on PAH in smokeless tobacco was reported last month at the 238th National Meeting of the American Chemical Society. It adds to existing evidence that smokeless tobacco contains nearly two dozen carcinogens known to increase the risk of mouth, liver and pancreatic cancers.

Some of the most prevalent and dangerous cancer-causing agents in smokeless tobacco products are chemicals known as tobacco-specific nitrosamines. While only miniscule amounts of nitrosamines are allowed in other consumer products in the U.S., including beer and bacon, smokeless tobacco generally contains nitrosamine at levels that are 1,000 times greater than those found in other commonly consumed items.

While low-nitrosamine smokeless tobacco products are available, including a Swedish-style product called snus, these products still contain measurable levels of the cancer-causing chemicals.

In a study comparing 182 oral snuff users with 420 cigarette smokers, Minnesota researchers found that oral tobacco users were exposed to higher levels of certain nitrosamines than smokers. The researchers concluded that compared to smoking, oral use of tobacco may actually provide a more efficient means for delivering certain carcinogens into the body.

The findings come in the midst of a rise in both the marketing and consumption of smokeless tobacco, which many consumers regard as less dangerous than cigarettes.

Since the 1980s, sales of moist snuff have doubled in the U.S.

In addition to a heightened cancer risk, chronic use of snuff leads to nicotine addiction, just as it does with cigarette smoking. Some studies suggest that smokeless tobacco can be as addictive as morphine or cocaine.

When using snuff and other smokeless tobacco products, nicotine is absorbed directly into the bloodstream through the walls of the mouth and gums. From there, it makes a beeline for the brain.

Holding just one pinch in the mouth for 30 minutes delivers as much nicotine as about four cigarettes. Individuals who dip or chew tobacco 10 times a day could be getting the same amount of nicotine as those who smoke two packs of cigarettes daily.

The nicotine in smokeless tobacco can rev up the pulse by 10 to 20 beats per minute, putting a strain on the heart. Nicotine is also thought to elevate cholesterol levels and increase the chances of developing blood clots, adding to the risk of having a heart attack or stroke.

People who use smokeless tobacco are far more likely to develop mouth cancer than nonusers. Unfortunately, oral cancer is one of the toughest types of cancer to treat and cure.

Surgical removal of the malignancy can leave the face, jaw, chin and neck seriously disfigured. Sadly, only about half of those diagnosed with mouth cancer will survive longer than five years.

For folks who are lucky enough to avoid getting heart disease or cancer of the mouth or pancreas, smokeless tobacco packs other serious health risks. When it mixes with saliva in the mouth, it forms a corrosive acid that damages the teeth and gums, and when it is accidentally swallowed, it can lead to the development of painful stomach ulcers.

Long-term use of smokeless tobacco can cause the gums to pull away from the teeth, exposing the roots and quadrupling the chances of developing serious tooth decay. Gum recession is not only unsightly and unhealthy, it's also irreversible.

Tobacco — in any form — is a serious health hazard. If you're looking for a safe alternative to smoking cigarettes, smokeless tobacco isn't it.

Rallie McAllister is a board-certified family physician, speaker and the author of several books, including "Healthy Lunchbox: The Working Mom's Guide to Keeping You and Your Kids Trim." Her Website is www.rallieonhealth.com. To find out more about Rallie McAllister, M.D., and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com.

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