2. Smokeless Tobacco Module 8

3. Tobacco 101: Module 8 3 Smokeless Tobacco SMOKELESS DOESN'T MEAN HARMLESS Smokeless or spit tobacco comes in several forms : snuff (moist and dry) loose leaf (chewing tobacco) plug (looks like a brownie) twist (looks like a twisted rope) snus (looks like a tiny pouch) I don’t smoke. I just dip every now and then. What is the harm? Putting smokeless tobacco in your mouth is every bit as dangerous as smoking.

4. Tobacco 101: Module 8 4 Smokeless Tobacco Smokeless tobacco has more than 28 chemical compounds that are known to cause cancer. Just like cigarette smoking, smokeless tobacco is addictive. Also like smoking, smokeless tobacco is bad for the heart. So, what is in the stuff that makes it so bad? Smokeless tobacco has harmful chemicals, too.

5. Tobacco 101: Module 8 5 Smokeless Tobacco Spit tobacco users are from four-to-seven times more likely than nonusers to get oral cancer. That only happens to a few people. What else can smokeless tobacco do to me? Did you know that most spit tobacco users have mouth sores?

6. Tobacco 101: Module 86 Smokeless Tobacco Slide 3: The Nemours Foundation. “Smokeless Tobacco,” accessed January 11, 2012, http://kidshealth.org/teen/drug_alcohol/tobacco/smokeless.html http://kidshealth.org/teen/drug_alcohol/tobacco/smokeless.html Slide 4: –Centers for Disease Control and Prevention. 2011. “Fact Sheet: Smokeless Tobacco Facts.” http://www.cdc.gov/tobacco/data_statistics/fact_sheets/smokeless/smokeless_facts/ http://www.cdc.gov/tobacco/data_statistics/fact_sheets/smokeless/smokeless_facts/ –North Carolina Health and Wellness Trust Fund, Tobacco Reality Unfiltered website. “Brush Up on Your Tobacco Facts,” accessed January 11, 2012, http://www.realityunfiltered.com/TobaccoFacts.aspxhttp://www.realityunfiltered.com/TobaccoFacts.aspx –North Carolina Health and Wellness Trust Fund. Tobacco Reality Unfiltered website. “TRU Stories,” accessed January 10, 2012, http://www.healthwellnc.com/trustories/default.htmhttp://www.healthwellnc.com/trustories/default.htm Slide 5: North Carolina Health and Wellness Trust Fund. 2010. “North Carolina Spit/Smokeless Tobacco Facts.” http://www.tobaccopreventionandcontrol.ncdhhs.gov/youth/Documents/NorthCarolinaSpitTobaccoFact- 082310.pdfhttp://www.tobaccopreventionandcontrol.ncdhhs.gov/youth/Documents/NorthCarolinaSpitTobacco Fact-082310.pdf http://www.tobaccopreventionandcontrol.ncdhhs.gov/youth/Documents/NorthCarolinaSpitTobaccoFact- 082310.pdfhttp://www.tobaccopreventionandcontrol.ncdhhs.gov/youth/Documents/NorthCarolinaSpitTobacco Fact-082310.pdf References

7. Tobacco 101: Module 87 7 Smokeless Tobacco Slides 1 and 2: Photographs courtesy of iStockphoto. Slide 3: Photographs courtesy of RTI International. Slide 4: Photograph courtesy of North Carolina Health and Wellness Trust Fund. Slide 5: Photograph courtesy of Centers for Disease Control and Prevention Public Health Image Library (photographer Sol Silverman, Jr., DDS). Photographs are used for illustrative purposes only, and any persons depicted are models. Photograph Credits

8. Prepared by Sterling Fulton-Smith, North Carolina Department of Health and Human Services; Sandhya Joshi, RTI International; Caley Burrus, Duke University; Ronny Bell, Maya Angelou Center for Health Equity; and Barri Burrus, RTI International. March 2012