Spit Tobacco: A Guide for Quitting

Introduction

So you're a dipper and you'd like to quit.
Maybe you've already found that quitting dip or chew is not easy. But you can do it! This guide is intended to help you make your own plan for quitting.

Many former dippers have shared advice o­n quitting that can help you. This guide is the result of advice from chewers and dippers who have canned the habit.

Like most dippers, you probably know that the health-related reasons to quit are awesome. But you must find your own personal reasons for quitting. They can motivate you more than the fear of health consequences. It's important to develop your own recipe for willpower.

In this guide we refer more to dip than chew, just to keep it simple. Also, note that we call it spit tobacco, not smokeless tobacco. Smokeless tobacco is the term preferred by the tobacco industry. It makes the products sound safe; they aren't.

The Dangers of Dip and Chew

Here's a brief summary of the harm dipping does.
Sugar in spit tobacco may cause decay in exposed tooth roots.
Dip and chew can cause your gums to pull away from the teeth in the place where the tobacco is held. The gums do not grow back.
Leathery white patches, called leukoplakia (loo-ko-play-kia), and red sores are common in dippers and chewers and can turn into cancer.
Mouth Cancer - among the toughest cancers to treat. Surgery needed to treat mouth cancer is often difficult and disfiguring. The disease can spread quickly. o­n average, o­nly half of those with mouth cancer will survive more than five years.
Need more reasons to quit?
It's expensive!

A can of dip costs an average of nearly $3. A two-can-a-week habit costs about $300 per year. A can-a-day habit costs nearly $1,100 per year. Likewise, chewing tobacco costs about $2. A pouch-a-day habit costs over $700 a year. Think of all the things you could do with that money instead of dipping or chewing. It adds up.

It's disgusting!

If the health effects don't worry you, think of how other people see your addiction.

The smell of spit tobacco in your mouth is not pleasant. While you may have become used to the odor and don't mind it, others around you notice.

Check out your clothes. Do you have tobacco juice stains o­n your clothes, your furniture, or o­n your car's upholstery? Your tobacco spit and drool could be making a mess.

Look at your teeth. Are they stained from tobacco juice? Brushing your teeth won't make this go away.

Understanding your Addiction Nicotine Levels of Popular Brands
Highest to Lowest

Kodiak Wintergreen
Skoal Longcut Straight
Copenhagen Snuff
Copenhagen Long Cut
Skoal Bandits Mint
Hawken Wintergreen
* This list is provided for information o­nly. NIDCR and NCI do not endorse the use of any tobacco product.

Hard to believe you're a nicotine addict?
Believe it.

Nicotine, found in all tobacco products, is a highly addictive drug that acts in the brain and throughout the body.

Dip and chew contain more nicotine than cigarettes.

Some facts:

Holding an average-size dip in your mouth for 30 minutes gives you as much nicotine as smoking three cigarettes. A 2-can-a-week snuff dipper gets as much nicotine as a 1-1/2 pack-a-day smoker does.

To the right is a chart comparing the nicotine levels of some popular snuff brands.

Think about your own habit. Check how many of the following apply to you.

How Addicted Are You?
I no longer get sick or dizzy when I dip or chew, like I did when I first started.
I dip more often and in different settings.
I've switched to stronger products, with more nicotine.
I swallow juice from my tobacco o­n a regular basis.
I sometimes sleep with dip or chew in my mouth.
I take my first dip or chew first thing in the morning.
I find it hard to go more than a few hours without dip or chew.
I have strong cravings when I go without dip or chew.
The more items you check, the more likely that you are addicted.

Myths and Truths

There are several myths about spit tobacco.
Sometimes these myths make users feel more comfortable in their habits. Below are some myths and the truths that relate to them.

Myth: Spit tobacco is a harmless alternative to smoking.

Truth: Spit tobacco is still tobacco. In tobacco are nitrosamines, cancer-causing chemicals from the curing process. Note the warnings o­n the cans.

Myth: Dip (or chew) improves my athletic performance.

Truth: A study of professional baseball players found no connection between spit tobacco use and player performance. Using spit tobacco increases your heart rate and blood pressure within a few minutes. This can cause a buzz or rush, but the rise in pulse and blood pressure places an extra stress o­n your heart. That may actually reduce your overall performance.

Myth: Good gum care can offset the harmful effects of using dip or chew.

Truth: There is no evidence that brushing and flossing will undo the harm that dip and chew are doing to your teeth and gums.

Myth: If you dip or chew for o­nly 5 to 10 years, you won't get cancer.

Truth: Long-term users are more likely to develop cancer, but they are not the o­nly o­nes at risk. Cancers have been found in the mouths of guys who have used the product regularly for as few as six years.

Myth: It's easy to quit using dip or chew when you want to.

Truth: Unfortunately, nicotine addiction makes quitting difficult. But those who have quit successfully are very glad they did.

Quitting Plan
Kicking the spit or chew habit can be tough, but it can be done, and you can do it.

The best way to quit spit tobacco is to have a quit date and a quitting plan. These methods make it easier. Try what you think will work best for you.

Decide to quit

Quitting spit tobacco is not something you do o­n a whim. You have to want to quit to make it through those first few weeks off tobacco. You know your reasons for stopping. Don't let outside influence -like peer pressure- get in your way. Focus o­n all you don't like about dipping and chewing.

Reasons to quit

Here are some reasons given by others. Are any of them important to you?

To avoid health problems
To prove I can do it
I have sores or white patches in my mouth
To please someone I care about
To set a good example for my kids or other kids
To save money
I don't like the taste
I have gum or tooth problems
It's disgusting
Because it's banned at work or school
I don't want it to control me
My girlfriend (or a girl I'd like to date) hates it
My wife hates it
My physician or dentist told me to quit
Pick a quit date

Pick your quit date. Even if you think you're ready to quit now, take at least a week to get ready. But don't put off setting a date.

Get psyched up for quitting

Cut back before you quit by tapering down.

Have your physician or dentist check your mouth. Ask whether you need nicotine replacement therapy (gum, nicotine patches, etc.).

There is no "ideal" time to quit, but low-stress times are best. Having a quit date in mind is important, no matter how far off it is. But it's best to pick a date in the next two weeks, so you don't put it off too long.

Pick a date that looks good for you and write it in below.


THIS IS MY QUIT DATE

MONTH: _______

DATE: _______

YEAR: _______

FILL IT IN!

Cut back before you quit

Some people are able to quit spit tobacco "cold turkey". Others find that cutting back makes quitting easier. There are many ways to cut back.

Taper down. Cut back to half of your usual amount before you quit. If you usually carry your tin or pouch with you, try leaving it behind. Carry substitutes instead–sugar-free chewing gum or hard candies, and sunflower seeds. During this period, you might also try a mint-leaf snuff.

Cut back o­n when and where you dip or chew. First, notice when your cravings are strongest. What events trigger dipping or chewing for you? Do you always reach for a dip after meals? When you work out? In your car or truck? o­n your job? Don't carry your pouch or tin. Use a substitute instead. Go as long as you possibly can without giving into a craving, at least 10 minutes. Try to go longer and longer as you approach your quit day. Now, pick three of your strongest triggers and stop dipping or chewing at those times. This will be hard at first. The day will come when you are used to going without tobacco at the times you want it most.

Notice what friends and co-workers who don't dip or chew are doing at these times. This will give you ideas for dip or chew substitutes. It's a good idea to avoid your dipping and chewing pals while you're trying to quit. That will help you avoid the urge to reach for a can or chew.

Switch to lower nicotine snuff. This way, you cut down your nicotine dose while you're getting ready to quit. This can help to prevent strong withdrawal when you quit.

Don't switch to other tobacco products like cigarettes or cigars! In fact, if you already smoke, this is a good time to quit smoking. That way you can get over all your nicotine addiction at o­nce.
Right before your quit day

Let friends, family, and co-workers know you're quitting. Warn them that you may not be your usual self for a week or two after you quit. Ask them to be patient. Ask them to stand by to listen and encourage you when the going gets rough.

Suggest ways they can help, like joining you for a run or a walk, helping you find ways to keep busy, and telling you they know you can do it. If they've quit, ask them for tips. If they use dip or chew, ask them not to offer you any. They don't have to quit themselves to be supportive, but maybe someone will want to quit with you.

Quit day!

Make your quit day special right from the beginning. You're doing yourself a huge favor.

Change daily routines to break away from tobacco triggers. When you eat breakfast, don't sit in the usual place at the kitchen table. Get right up from the table after meals.

Make an appointment to get your teeth cleaned. You'll enjoy the fresh, clean feeling and a whiter smile.

Keep busy and active. Start the day with a walk, run, swim, or workout. Aerobic exercise will help you relax. Plus, it boosts energy, stamina, and all-around fitness and curbs your appetite.

Chew substitutes. Try sugar-free hard candies, cinnamon sticks, gum, mints, beef jerky, or sunflower seeds. Carry them with you and use them whenever you have the urge to dip or chew.

What About Medications?Nicotine replacement therapy and non-nicotine replacement therapy (bupropion) are approved by the U.S. Food and Drug Administration (FDA) for smoking cessation. However, these products have not been approved for spit tobacco cessation. Further research is needed to determine their effectiveness for helping spit tobacco users quit.

Your First Week off Spit Tobacco: Coping with Withdrawal
Withdrawal symptoms don't last long.
Symptoms are strongest the first week after you quit. The worst part is over after 2 weeks. After a month, you'll feel better than when you dipped or chewed. So be patient with yourself.

Urges to dip, cravings -- especially in the places you used to dip the most

Wait it out (each urge lasts o­nly 3-5 minutes, whether or not you dip or chew). Deep breathing and exercise help you feel better right away.

Feeling irritable, tense, restless, impatient

Walk away from the situation. Deep breathing and exercise help to blow off steam. Ask others to be patient.

Constipation/irregularity

Add fiber to your diet (whole grain breads and cereals, fresh fruits and vegetables).

Hunger and weight gain

Eat regular meals. Feeling hungry is sometimes mistaken for the desire to dip or chew.

Desire for sweets

Drink fruit juices. Reach for low-calorie sweet snacks (like apples, sugar-free gums and candies).

Headaches

Take a warm bath or shower. Try relaxation or meditation techniques.

ABOUT WEIGHT GAIN
Nicotine speeds up metabolism, so quitting spit tobacco may result in a slight weight gain.

To limit the amount of weight you gain, try the following:

Eat well-balanced meals and avoid fatty foods. To satisfy your cravings for sweets, eat small pieces of fruit. Keep low-calorie foods handy for snacks. Try popcorn (without butter), sugar-free gums and mints, fresh fruits, and vegetables.
Drink 6 to 8 glasses of water each day.
Work about 30 minutes of daily exercise into your routine; try walking or another activity such as running, cycling, or swimming.

Your Second Week: Dealing with Triggers
You've made it through the hardest part - the first week.
If you can stay off o­ne week, then you can stay off two. Just use the same willpower and strategies that got you this far.

Cravings may be just as strong this week, but they will come less often and go away sooner.

Be prepared for temptation
Tobacco thoughts and urges probably still bother you. They will be strongest in the places where you dipped or chewed the most.

The more time you spend in these places without dipping or chewing, the weaker the urges will become. Avoid alcoholic beverages. Drinking them could bust your plan to quit.

Know what events and places will be triggers for you and plan ahead for them.

Write down some of your triggers. And write what you'll do instead of dip or chew. It may be as simple as reaching for gum or seeds, walking away, or thinking about how far you've come.


MY STRONGEST TRIGGERS

TRIGGER 1: _________

TRIGGER 2: _________

TRIGGER 3: _________

FILL IT IN!


Tips for Going the Distance

CONGRATULATIONS! You've broken free of a tough addiction. If you can stay off 2 weeks, then you know you can beat this addiction. It will get easier.

Keep using whatever worked when you first quit. Don't expect new rituals to take the place of spit tobacco right away. It took time to get used to chewing or dipping at first, too.

Keep up your guard. Continue to plan ahead for situations that may tempt you.

What if you should slip?

Try not to slip, not even o­nce. But, if you do slip, get right back o­n track.

Don't let feelings of guilt lead you back to chewing or dipping. A slip does not mean "failure". Figure out why you slipped and how to avoid it next time. Get rid of any leftover tobacco.

Pick up right where you left off before the slip. If slips are frequent, or you are dipping or chewing o­n a regular basis, make a new quitting plan. Quitting takes practice. The spit tobacco habit can be tough to beat. Most users don't quit for good o­n the first try. Don't give up! Figure out what would have helped. Try a new approach next time. Talk to your physician or dentist for extra help.

You can also call the National Cancer Institute's Cancer Information Service (CIS) at 1-800-4-CANCER . The CIS can give you tips and suggestions o­n how to quit and send you free materials.

Call today - it's free!


Celebrate Your Success!
Congratulations! You've done it. You've beaten the spit tobacco habit.
You're improving your health and your future. Celebrate with the people o­n your "support team." Offer your support to friends and co-workers who are trying to quit using tobacco. Pledge to yourself never to take another dip or chew.


This information is not copyrighted. Print and make as many photocopies as you need.

"Spit Tobacco: A Guide for Quitting" is also available as a booklet. Click here to order a free copy.


National Institute of Dental and Craniofacial Research
National Oral Health Information Clearinghouse
1 NOHIC Way
Bethesda, MD 20892-3500
phone: (301) 402-7364
email: nohic@nidcr.nih.gov

NIH Publication No. 03-3270
Updated October 2004