smokeless tobacco

^[1]^[2]^[3]^[4]^[5]

Adverse effects

associated with elevated risks for
- fatal MI (RR=1.13)
  - cessation of smokeless tobacco use after MI is associated with diminished mortality (RR=0.57)^[3]
- stroke (RR=1.40)^[1]

cessation of smokeless tobacco use
- varenicline may help smokeless tobacco users quit^[2]

↑ ^1.0 ^1.1 Boffetta P and Straif K. Use of smokeless tobacco and risk of myocardial infarction and stroke: Systematic review with meta-analysis. BMJ 2009 Aug 18; 339:b3060. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/19690343 <Internet> http://dx.doi.org/10.1136/bmj.b3060
↑ ^2.0 ^2.1 Fagerstrom K et al. Stopping smokeless tobacco with varenicline: Randomised double blind placebo controlled trial. BMJ 2010 Dec 6; 341:c6549 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21134997
↑ ^3.0 ^3.1 Arefalk G et al Discontinuation of Smokeless Tobacco and Mortality Risk after Myocardial Infarction. Circulation. June 23, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24958793 <Internet> http://circ.ahajournals.org/content/early/2014/05/30/CIRCULATIONAHA.113.007252.abstract
↑ FDA News Release. April 19, 2016 FDA launches first ad campaign focused on dangers of smokeless tobacco among rural teens. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm496631.htm
↑ National Cancer Institute Smokeless Tobacco and Cancer https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/smokeless-fact-sheet