Smokeless tobacco is a tobacco product that is used by means other than smoking. Their use involves chewing, sniffing, or placing the product between gum and the cheek or lip. Smokeless tobacco products are produced in various forms, such as chewing tobacco, snuff, snus, and dissolvable tobacco products. Smokeless tobacco is widely used in South Asia and this accounts for about 80% of global consumption. All smokeless tobacco products contain nicotine and are therefore highly addictive. Quitting smokeless tobacco use is as challenging as smoking cessation.
Using smokeless tobacco can cause various harmful effects such as dental disease, oral cancer, oesophagus cancer, and pancreas cancer, coronary heart disease, as well as negative reproductive effects including stillbirth, premature birth and low birth weight. Smokeless tobacco poses a lower health risk than traditional combusted products. However it is not a healthy alternative to cigarette smoking. The level of risk varies between different types of products (e.g., low nitrosamine Swedish-type snus versus other smokeless tobacco with high nitrosamine levels) and producing regions. There is no safe level of smokeless tobacco use. Globally it contributes to 650 000 deaths each year.