American Indian and Alaska Natives have the highest rate of smokeless tobacco usage of all races in the U.S. at 9.3%, compared with 5.0% non-hispanic whites, according to a 2012 study by the Centers for Disease Control and Prevention. About 16 of every 100 American Indian and Alaska Native males were current smokeless tobacco users in 2012.
Containing 28 known carcinogens, smokeless tobacco is a known cause of oral, esophageal and pancreatic cancer, gum disease, tooth loss, and increases the risk of chronic conditions like heart disease.
The most commonly used forms of smokeless tobacco are loose-leaf chewing tobacco and dipping tobacco (moist snuff), though some regions may see usage of other forms at higher rates. In Alaska, for example, iqmik is commonly used form of smokeless tobacco, especially among Alaskan Native populations.
Smokeless tobacco may be seen by some users as being a safer form of tobacco because no smoke is inhaled into the lungs; however, smokeless tobacco is not a safe alternative to smoking commercial tobacco. Education regarding the harmful effects of smokeless tobacco is needed within tribal communities and it is important for health practitioners to ask about smokeless tobacco when screening patients for commercial tobacco use.
A comprehensive report on global smokeless tobacco use with public health implications, strategies, and resources, published in 2014 by the National Cancer Institute, Centers for Disease Control and Prevention.
An online fact sheet on smokeless tobacco products and marketing compiled by the Centers for Disease Control and Prevention.