Tobacco control and smoking

Smokeless tobacco

Almost all types of smokeless tobacco can cause mouth cancer but some types or brands can be more dangerous than others; this is because different products can have very different levels of cancer-causing chemicals.

Most smokeless tobacco products in the UK are used by South Asian communities.  In these communities, dry chewing tobacco is often used as part of a ‘betel quid’ or ‘paan’.  These consist of a mixture of betel nut, slaked lime and various herbs and spices wrapped in a betel leaf.  Betel nut itself can cause cancer, so chewing betel quids can cause mouth cancer even if no tobacco is added.

Most types of smokeless tobacco contain at least 28 different chemicals that can cause cancer (1). The worst of these are a group of chemicals called tobacco-specific nitrosamines (TSNAs).  Some smokeless tobacco brands can contain up to 100 times more TSNAs than any other product, including cigarettes. 

Smokeless tobacco contains as much, if not more, nicotine than smoked tobacco products do so like cigarettes, it is highly addictive.  People who use smokeless tobacco absorb three to four times as much nicotine as smokers do.


Last updated Friday, 22nd April 2016