Nicotine Addiction: Other Forms of Tobacco Use

Other major forms of tobacco use are moist snuff deposited between the cheek and gum, chewing tobacco, pipes and cigars, and recently bidi (tobacco wrapped in tendu or temburni leaf and commonly used in India) and clove cigarettes. Oral tobacco use leads to gum disease and can result in oral cancer. All forms of burned tobacco generate toxic and carcinogenic smoke similar to that of cigarette smoke. The differences in disease consequences of use relate to frequency of use and depth of inhalation. The risk of upper airway cancers is similar among cigarette and cigar smokers, while those who have smoked only cigars have a much lower risk of lung cancer, heart disease, and chronic obstructive pulmonary disease. However, cigarette smokers who switch to pipes or cigars do tend to inhale the smoke, increasing their risk; and it is likely that comparable inhalation and frequency of exposure to tobacco smoke from any of these forms of tobacco use will lead to comparable disease outcomes.

A resurgence of cigar and bidi use among adolescents of both genders has raised concerns that these older forms of tobacco use are once again causing a public health problem.