JAMA : the journal of the American Medical Association
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Historical Article
Health effects of smokeless tobacco. Council on Scientific Affairs.
Tobacco in various forms has been used for centuries. Using snuff and chewing tobacco was popular in the United States during the 18th and 19th centuries, but current data on their use are limited. Pharmacologic and physiologic effects of snuff and chewing tobacco include the gamut of cardiovascular, endocrinologic, neurologic, and psychological effects that are associated with nicotine. ⋯ One group estimated that the relative risk of oral cancer in longtime users of snuff varied from 1.8 to 48 times that of its occurrence in nonusers. But few of the studies have fully utilized accepted scientific and epidemiologic methods. The Council on Scientific Affairs concludes there is evidence demonstrating that the use of snuff or chewing tobacco is associated with adverse health effects such as oral cancer, urges the implementation of well-planned and long-term studies that will further define the risks of using snuff and chewing tobacco, and recommends that the restrictions applying to the advertising of cigarettes also be applied to the advertising of snuff and chewing tobacco.