The link between smokeless tobacco use and cancer is well-known, but a Brigham Young University researcher has found new dangers for chewing tobacco users: elevated cholesterol levels and increased risk of heart disease.
A study by health scientist Larry Tucker shows a strong relationship between the use of smokeless tobacco and elevated serum cholesterol levels. Compared with non-tobacco users, smokeless tobacco users in his study had 21/2 times the rate of hypercholesterolemia (high cholesterol). Heavy smokers were twice as likely to have high cholesterol as non-tobacco users.Elevated serum cholesterol is considered a major risk factor for heart disease. Other risks include high blood pressure, a sedentary lifestyle and a family history of heart disease.
"We know that smokeless tobacco destroys the tissues in the mouth - there's about a 50-fold increase in some cancers of the mouth, gum and tongue," Tucker said. "But, until now, no one has investigated the relationship between smokeless tobacco use and health beyond the oral cavity, particularly serum cholesterol levels."
The BYU study measured the tobacco habits and cholesterol levels of 2,840 employed men across the United States.
"Carrying `a pinch between the cheek and gum' may lead to hypercholesterolemia and ultimately to cardiovascular disease as well as to oral cancer," Tucker reported in the American Journal of Public Health. "Clearly, increased efforts directed toward elucidating the non-oral health effects of using smokeless tobacco are warranted."
While cigarette smokers and smokeless tobacco users are at risk for different types of cancer, all regular tobacco users experience nicotine addiction, Tucker said. Nicotine is the highly addictive element in tobacco that elevates cholesterol.
"Nicotine is one of the most addictive substances known to man. Lately it has been paired by the surgeon general with heroine, cocaine and other frightening drugs. We don't realize how powerful nicotine is - once a person uses it, whether it be through cigarettes or whether it be through smokeless tobacco, it's very difficult to give up."
Tucker said there are relatively few users of smokeless tobacco but, unlike cigarette smokers, their numbers have increased substantially in the past 15 years, even as the health dangers of tobacco use have been revealed.
"Over the past decade or two, cigarette smoking levels have been decreasing steadily, while smokeless tobacco use has been increasing," he said. Smokeless tobacco use has leveled off recently but has not declined in most regions of the United States.
A 1986 surgeon general's report revealed that 6 million Americans were using smokeless tobacco at least weekly; 16 percent of males ages 12 to 25 reported using smokeless tobacco in the previous year. The highest usage rates are consistently reported among young adult males.
A study in Utah, the state with the lowest smoking rate among adults (18 percent), showed that 12 percent of male junior and senior high school students said they were using smokeless tobacco regularly.
Tucker said users of smokeless tobacco in his study were generally younger and less educated than non-tobacco users. The men in the study averaged 41 years of age, and 73 percent had some college education. Participants were studied for overall fitness, body fat percentage and serum cholesterol levels as well as cigarette smoking and use of smokeless tobacco.