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Monograph 2 Smokeless Tobacco or Health: An International Perspective

  1. Behavioral Research Program
  2. Tobacco Control Research Branch (TCRB)
  3. Tobacco Control Monograph Series
  4. Monograph 2
Monograph 2 Cover

Describes the epidemiology, clinical and pathological effects, carcinogenesis, nicotine effects and addiction, prevention, and cessation research findings in the area of smokeless tobacco use. Evidence-based recommendations for smokeless tobacco control strategies are provided.

Suggested Citation

National Cancer Institute. Smokeless Tobacco or Health: An International Perspective. Tobacco Control Monograph No. 2. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. NIH Pub. No. 92-3461, September 1992.

View Individual Chapters

Chapters and key topics covered within each chapter are listed below. Chapters generally include an introductory section, details on methodology, a chapter summary, research needs, and a reference list.

  • Keynote Address (PDF, 64 KB)
  • Foreword (PDF, 128 KB)
  • Contents (PDF, 64 KB)
  • Acknowledgments (PDF, 64 KB)
  • Overview and Summary (PDF, 288 KB)
  • Chapter 1. Epidemiology (PDF, 192 KB)
    • The Smokeless Tobacco Problem: Risk Groups in North America
    • Surveillance of and Knowledge About Cancer Associated With Smokeless Tobacco Use
    • Smokeless Tobacco Use in India
    • Smokeless Tobacco in Professional Baseball: Patterns of Players’ Use
  • Chapter 2. Clinical and Pathological Effects (PDF, 448 KB)
    • Oral Mucosal Lesions: Clinical Findings in Relation to Smokeless Tobacco Use Among U.S. Baseball Players
    • Smokeless Tobacco Use in India: Effects on Oral Mucosa
    • Smokeless Tobacco-Associated Epithelial And Langerhans Cell Changes
    • The Use of Smokeless Tobacco in Sweden
    • Periodontal Effects Associated With the Use of Smokeless Tobacco: Results After 1 Year
  • Chapter 3. Carcinogenesis (PDF, 1.5 MB)
    • Oral Carcinoma and Smokeless Tobacco Use: A Clinical Profile
    • Chemical Composition of Smokeless Tobacco Products
    • Carcinogenesis of Smokeless Tobacco
    • Oncogenes in Head and Neck Cancer
  • Chapter 4. Nicotine Effects and Addiction (PDF, 192 KB)
    • Pharmacology of Smokeless Tobacco Use: Nicotine Addiction and Nicotine-Related Health Consequences
    • Recent Advances in Understanding the Actions of Nicotine in the Central Nervous System
    • Dependence on Smokeless Tobacco
  • Chapter 5. Prevention (PDF, 160 KB)
    • Marketing Smokeless Tobacco: Implications for Preventive Education
    • Applying the Social Inoculation Model to a Smokeless Tobacco Use
    • Prevention Program With Little Leaguers
  • Chapter 6. Cessation (PDF, 160 KB)
    • Enough Snuff: ST Cessation From the Behavioral, Clinical, and Public Health Perspectives
    • Smokeless Tobacco Cessation and Nicotine Reduction Therapy
    • Role of Dentists in Cessation Counseling: Survey Findings
    • An Intervention Study of Tobacco Habits Among Rural Indian Villagers
  • Chapter 7. Policy (PDF, 128 KB)
    • WHO Strategies To Curb Smokeless Tobacco: A Global Perspective Legal and Administrative Strategies for Control and Prevention of the Use of Smokeless Tobacco
    • National Cancer Institute's Role in Reducing Tobacco Use
  • Chapter 8. Recommendations (PDF, 96 KB)
    • Recommendations for the Control of Smokeless Tobacco