Alberta Cancer Foundation

Whack the Tobacco

There’s no easy way to quit smoking. While the rate of Canadians who still smoke is on the decline, men between the ages of 25 and 29 have the highest prevalence of smoking out of any sample group. For some, nicotine patches or inhalers are helping curb their nicotine addiction, but for others, chewing tobacco is their new crutch.

“There is no safe form of tobacco,” says Dr. Charles Butts, a senior medical oncologist at the Cross Cancer Institute in Edmonton. “Smoking has a lot of cardiovascular issues related to it, such as lung cancer, but chewing tobacco has some significant problems too. There’s some perception that chewing is less harmful.” They are both addictive and both can cause disease.

One of the biggest differences between the two forms of tobacco may be public awareness. While the federal government has recently revamped cigarette packaging to cover 75 per cent of the package with pictures and captions of people harmed by smoking, there’s little advertising regulation when it comes to chewing tobacco.

Another difference is who uses it. Few women chew tobacco. “And smokeless tobacco tends to be more culturally related,” says Dr. Butts.

He says that chewing tobacco has cultural links to First Nations, where tobacco has long been used in traditional ceremonies. But there’s a difference between the ceremonial use of tobacco, and the habitual, daily use.

Chewing tobacco is called “smokeless tobacco.” While it doesn’t have the exact same physical effects that cigarettes have, chewing can cause myriad health problems for the user. Most people think of mouth cancer when it comes to chewing tobacco, but users can also develop other cancers of the head and neck, heart disease, and major dental changes, gum disease, and tooth wear and decay.

“All forms of tobacco have chemicals that are considered cancer-causing agents or potential carcinogens,” says Dr. Butts. He says that one in nine smokers will get cancer. But in 2005 alone, there were 1,050 deaths from oral cancer due to smokeless tobacco. Nearly a third of all oral cancer cases are fatal.

Strategies for quitting smokeless tobacco are as varied as those for cigarettes, and depend on the smoker. “The strategy should be individualized,” says Dr. Butts. Some people can taper off, others find cold turkey more effective. As with smokers, tobacco chewers typically make a few attempts at quitting before they meet with success.

Smokeless tobacco should never be used as a replacement for cigarettes under the delusion that it’s better for your body. “It’s a strategy used in some other countries, but it’s substituting one harmful substance with another,” says Dr. Butts. He says that more education is needed to prevent future chewers from starting. “The message has to be consistent that it’s not a safe tobacco,” he says. “We’ve still got a long way to go.”

What’s with the patch?

Many tobacco users have turned to medicinal products to quit smoking or chewing. Brands such as Nicorette offer consumers patches, inhalers and gums to help curb their addictions. These products replace the nicotine that the body and brain have been getting from tobacco, while gradually reducing those levels until the consumer no longer needs it. This method of nicotine uptake is slower and longer than tobacco, and allows your body to adjust to the levels it gives. It also reduces symptoms of withdrawal after quitting, and the gum offers an oral gratification that helps replace the ritual of smoking.

But is it possible to be dependent on these products for too long? “Those delivery agents are relatively pure nicotine so they don’t have the associated carcinogens that tobacco has,” says Dr. Butts. “They only deliver nicotine.” Tobacco replacement agents programs can help break the habit.

Still, it doesn’t mean spending years on these products is good for you. Their purpose is to wean you off of your reliance on the cigarettes or chewing tobacco. “It’s been relatively successful for smoking,” he says. “You want to reduce the dependence on the nicotine.” Talk to your doctor about using these or other prescription products to help you ditch the weed.

TOP TIP: Don’t forget that most experts also advise changing your behaviour to encourage success. Avoid the usual triggers. Go for a walk at coffee break or after dinner. Keep a stock of crunchy veggies, pretzels and gum (nicotine or otherwise) on hand. Get more exercise and drink lots of water.