- Smokeless tobacco in the form of chewing tobacco and dry snuff, which is inhaled, can cause heart attacks and strokes. This is according to an article in the latest issue of the British Medical Journal. The use of smokeless tobacco has increased over the past few decades. Authors of this study set out to determine the dangers of smokeless tobacco.

· The study investigators analyzed 11 previously published medical studies dealing with the use of smokeless tobacco. The studies were carried out in the United States and Sweden.
The authors concluded a 13% increase in risk of a fatal heart attack in users of smokeless tobacco compared to nonusers of smokeless tobacco.
The risk of having a fatal stroke was 40% higher in users of smokeless tobacco compared to nonusers.
The investigators further concluded that 0.5% of the deaths from heart attacks can be attributed to smokeless tobacco and 1.7% of the deaths due to stroke are related to smokeless tobacco.

· Smokeless tobacco, chew and snuff are increasingly popular, especially in the youth. Possibly due to the influence of sports figures or that it may appear as a safe alternative to cigarettes. This study is important in that it shows us some of the dangers of smokeless tobacco.
Additionally pancreatic cancer, throat cancer, bladder cancer and head and neck cancer are all associated with smokeless tobacco.
It is definitely not a safe alternative to cigarettes.

Cristopher Geiler, MD
References
BMJ 2009;339:b3060