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Health Effects of Smokeless Tobacco
Council on Scientific Affairs
JAMA. 1986;255(8):1038-1044.
Abstract
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Tobacco in various forms has been used for centuries. Using snuff and chewing tobacco was popular in the United States during the 18th and 19th centuries, but current data on their use are limited. Pharmacologic and physiologic effects of snuff and chewing tobacco include the gamut of cardiovascular, endocrinologic, neurologic, and psychological effects that are associated with nicotine. A review of studies appearing in the scientific literature involving various populations and approaches indicates that the use of snuff or chewing tobacco is associated with a variety of serious adverse effects and especially with oral cancer. The studies suggest that snuff and chewing tobacco also may affect reproduction, longevity, the cardiovascular system, and oral health. One group estimated that the relative risk of oral cancer in longtime users of snuff varied from 1.8 to 48 times that of its occurrence in nonusers. But few of the studies have fully utilized accepted scientific and epidemiologic methods. The Council on Scientific Affairs concludes there is evidence demonstrating that the use of snuff or chewing tobacco is associated with adverse health effects such as oral cancer, urges the implementation of well-planned and long-term studies that will further define the risks of using snuff and chewing tobacco, and recommends that the restrictions applying to the advertising of cigarettes also be applied to the advertising of snuff and chewing tobacco.
(JAMA 1986;255:1038-1044)
Author Affiliations
From the Council on Scientific Affairs, American Medical Association, Chicago.
Footnotes
Report B of the Council on Scientific Affairs, adopted by the House of Delegates of the American Medical Association at the Interim Meeting, Dec 8 through 11, 1985.
This report is not intended to be construed or to serve as a standard of medical care. Standards of medical care are determined on the basis of all of the facts and circumstances involved in an individual case and are subject to change as scientific knowledge and technology advance and patterns of practice evolve. This report reflects the views of the scientific literature as of August 1985.
Reprint requests to Council on Scientific Affairs, American Medical Association, 535 N Dearborn St, Chicago, IL 60610 (William R. Hendee, PhD).
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