INDEX

ABBREVIATIONS
constituents of smokeless
  tobacco, 70
ABRASION (DENTAL)
defined, 128
relation to smokeless tobacco, 130
ABUSE LIABILITY OF
NICOTINE
defined, 145,157
evidence for abuse potential,
  166-167
experimental studies, 157-166
implications of studies, 162
phannacodynamic effects, 158
research needs, 184
self-administration, 159-l 62
ACANTHOSIS
clinical report, 115-118
defined, 113
ADENOCARCINOMA
relation to snuff use, 48
ADOLESCENT USE
attitudes, 24
data criteria, 17
ethnic groups, 20
males vs. females, 20
National Program Inspection
  study, 24
peer and family influences, 24
rural vs. urban areas, 20
ADULT USE
patterns, 16-17
ADVISORY COMMIlTEE TO
THE SURGEON GENERAL,
REPORT
carcinogens revealed, vii
conclusions, vii-viii, xxii
gingival recession, viii
historical perspective of report,
  Xvii-xix
nicotine addiction and effects, viii
noncancerous conditions, xxi
oral leukoplakia. viii
organization of report, xvii
overview, xx-xxii
precancerous oral health
  conditions, xxi
review methods, xix-xx

ALCOHOL CONSUMPTION
relation to smokeless tobacco, 35
ANIMAL MODELS
bioassays with chewing tobacco,
  79, 82-83
bioassays with constituents of
  smokeless tobacco, 86-88
bioassays with snuff, 83-86
metabolism of NMOR, 74-75
metabolism of NNK, 71-73
metabolism of NNN, 73-74
mutagenicity assays, 88-89
pharmacodynamic effects of
  nicotine, 158
physiologic effects of nicotine, 178
sdivmy glands, 126-127
short-term tests, 88-89
ASIAN DATA
case-control studies, 42-43, 119
chewing of quids, 42-43, 50
esophageal neoplasms, 50
rates of oral cancer, 42-43
smokeless tobacco products, 42-43
smoking and oral cancer risk,
  43-44

BIOASSAYS FOR CL4RCTVOGEVIC
Ati'UK'TY OF CZEWiVG
TOBACCO OR tZi%`W;wG
iYm4ccoIiYxmAcr$8o
BIOASSAYS FOR CARClhDGEVIC
ACTNITY OF Sh?UFF OR SNUFF
EXlTUCI$81
BIOASSAYS WITH
CHEWING TOBACCO
(See dso ANIMAL MODELS)
application to the cheek pouch,
  79, 82-83
application to the oral mucosa,
  79, 82-83
oral administration, 79
skin application, 83
subcutaneous application, 83
BJOASSAYS WITH
CONSTITUENTS OF
SMOKELESS TOBACCO
(See also ANIMAL MODELS)
inducement of tumors, 86-88

187


BIOASSAYS WITH SNUFF
(See also ANIMAL MODELS)
application to the lip, oral
mucosa, or cheek pouch, 84-86
oral administration, 83-84
relation to herpes simplex virus,
  86-87
subcutaneous administration, 86
Bladder Neophsms, See URINARY
TRACT NEOPLASMS
Blockade Therapy, See NICOTINE
ADDICTION TREATMENT
BUCCAL CARCINOMA
case studies, 34-36

CALCULUS (DENTAL)
defined, 129
use of smokeless tobacco, 130
CARC~OGHCflY OF TOBACCO
SPECIFIC NITROSAMINES 82
CARCINOGENS
daily exposure from snuff and
chewing tobacco usage, 64
in smokeless tobacco, 58-60. 64-65
N-nitrosamines, 58-60, 64
polonium-210 (21oPo), 58, 65
polynuclear aromatic hydra
  carbons (PAH), 58,65
saliva analysis, 64
CARCINOMA hVSlTU
defined, 114
diagnoses differ, 123
squamous cell carcinoma study,
  120
Cardiovascular System, See
PHYSIOLOGIC EFFECTS OF
NICOTINE
Central Nervous System, See
PHYSIOLOGIC EFFECTS OF
NICOTINE
ChXRACTERLSTICS OF SMOKE
I2239 TOBACCO PRODUCT$6
CHEEK NEOPLASMS
(See also ORAL CANCER)
animal models, 79, 82, 84
case study, 120
CHEMICAL COMPOSITION
processed tobacco, 58
nicotine, 58
CHEMICAL CONSTITUENTS
OF SMOKELESS TOBACCO
carcinogens, 58-59,60,6465
chemical composition, 58

CHEVRON KERATINIZATION
case report, 116-l 17
defined, 114
CHEWING TOBACCO (See also
SMOKELESS TOBACCO,
BIOASSAYS)
case-control studies, 36,40
characteristics, 5
looseleaf, 5,7
plug, 5, 7
twist, 5, 7
CommonaIities Between Tobacco
and Other Addictive Substances,
See NICOTINE ADDICTION
CONCEPTUAL MODEL
of smokeless tobacco lesions, 121
CONCEPTUAL NflVRAL HISTORY
OF ORAL MucosAL CRANGES
ASlSOCiWED WITH TdcE USE OF
SMO- TOBACCO, 122
CORONARY AND PERIPHERAL
VASCULAR DISEASE
acute coronary events, 177-178
and nicotine, 177-178
atherosclerosis, 177
effect on platelets, 177
endothelial injury, 177
research needed, 185
ventricular fibrillation, 178
Cotinine, See PHARMACQ
KINETICS OF NICOTINE

CURRENT POPULATION
SURVEY (CPS)
survey data, 12,14

DATA: ABUSE LUBIUTY .!U'tLVm
AT ADDICTION RESEARCH
CENTER 160
DENTAL CARIES
defined, 128
relation to smokeless tobacco,
  129-130

DOSE RESPONSE EFFECTS
(See also ANIMAL MODELS)
and oral leukoplakia, 13 1
nicotine, 147, 152-153, 158,
  182-183
DRUG DEPENDENCE
commonalities between tobacco

and other substances, 146-147,
152-157
defined, 145
physiologic or physical
dependence, 145-146

188


DYSPLASIA
defined, 114

diagnoses differ, 121. 123
relation to oral lesions, 115-l 16

Endocrine System, See
PHYSIOLOGIC EFFECTS
OF NICOTINE
EPIDEMIOLOGIC STUDIES
AND SMOKELESS TOBACCO
data from Asia, 42-44
data from North America and
  Europe, 33-42
oral cancer, 33-44
other cancers, 47-55
EROSION (DENTAL)
defined, 128
ERYTHROPLAKIA
defined, 113
ESOPHAGEAL NEOPLASMS
case-control study, 39, 48-50
cohort study, 49-50
ESTMTED E2XkX?RE OF US
RESIDm To NITROSmES
  64
ESTLlzATED RELATWE RISKS
ASSOCL4TED WITH SNUFF USE
FOR ClANCERS OF TljlE ORAL
CAV7TI: PHARYNX, AND
LARYNX, CASECONTROL
DATA FROM VOGLER ETAL.,
Fm ONLY 38
EST~TEDRELAT~RLSKFOR
CMCER OF THEHEADAND
NECK FROM SMOKELESS
TOBACCO USE BY ANATOMIC
SITE, Tm NATIONAL CAN-
CER SUR VEX MALES ONLY 39
EST~TEDRELAT~RLSK OF
OROPHARYNGEU CANCER
ACCORDING To DURATION OF
SNUFF USEANDANAToM7C
SITE, Wm ET AL, 41
ESTWTES OF RELATNE RISKS
OF BLADDER CANC' LN
PERSONS WHO HA VE EVER
USED C%!EW~G TOBACCO
AND SNUFF 53
ETHNIC USE OF SMOKELESS
TOBACCO
of youth, 21-22
Experimental Studies Exposing
Laboratory Animals,
See ANIMAL MODELS

FORMATION OF TOBACCO
SPECUIC NITROSmES 60
FREQUENCY OF SMOKELESS
TOBACCO USE LN PAST YEARi
14

Gastric Neoplasms,
See STOMACH NEOPLASMS
GENERAL PRINCTPLESLN
EVALUATmTG CARCXNOGENIC
RISK OF CHEMC~S OR COM-
PLEX MLX-TURES (INTERNA-
TIONAL AGENCY FOR
RESEARCH ON CANCER, xxi
GINGIVAL AND PERIODONTAL
HEALTH
bone loss, 125
effects of smokeless tobacco, 101,
  103-104, 123
inflammation, 126
studies in Sweden, 126
studies in the United States, 125
GINGIVAL CARCINOMA
case studies, 34, 36, 44, 120
GINGIVAL RECESSION
Advisory Committee report, viii
defined, 123
related to oral leukoplakiai
mucosal pathology, 112
studies in the United States, 125
GINGIVITIS
defined, 123
relation to smokeless tobacco,
  125, 129
studies in the United States, 125
GLYCYRRHIZIC ACID
metabolic consequences, 179

HEAD AND NECK NEOPLASMS
case-control study, 38-39.38-39
HEROIN ADDICTION
THERAPY
model used, 156
HERPES SIMPLEX VIRUS
relation to oral cancer, 86-87, 93
HISTORICAL PERSPECTIVE
chewing tobacco, xvii
consequences of use, xviii-xix
decline of use, 5
early uses, xviii-xix, 5
snuff, xvii-xix
HYPERKERATOSIS
ccrhort study, 117-l 18
defined, 113
relation to snuff use, 125

189


HYPERORTHOKERATOSIS
cohort study, 118
defined, 113
HYPERPARAKERATOSIS
cohort study, 118-l 19
defined, 113
HYPOKALEMIA
nonnicotine metabolic
consequences, 179

INHALED SNUFF
relation to nasal carcinoma, 93

Kidney Neoplasms, See URINARY
TRACT NEOPLASMS

LARYNGEAL NEOPLASMS
/See also THIRD NATIONAL
CANCER STUDY)
case-control study, 37,38, 50-51
Leukoplakia, Oral, See ORAL
LEUKOPLAKIA
LIP NEOPLASMS (See also
ORAL CANCER)
animal models, 84-85
case-control study, 36
labial mucosa, 116-117
Looseleaf, See CHEWING
TOBACCO

MANLT?ACTURLNG TRENDS
QUANTLTLES OF SMORELESS
TOBACCO MANUFACTURED LN
THE UiWTED STATES FROM
1961 To 1985 EXPRESSED LN
JDLLION POUNDS. 8
MEAN FREQUENCY OF SMOKE
LESS TOBACCO USE DURING
LAST 7 DAYS BY ETHNLCITY
BY MALE RESPONDENTS, 23
METABOLIC PATHWAYS OF

NMOR, 74
ME;X&Xl$IC PATHWAYS OF
,A .

METkOLIC PATmA YS OF
Nvy 73
METABOLISM OF
CONSTITUENTS OF
SMOKELESS TOBACCO
conversion of products, xx-xxi
of NMOR, 74-75
of NNK, 71-73
of NNN, 73-74
MOUTH NEOPLASMS
(See also ORAL CANCER)
case-control study, 36-37.36, 37,
  39,120

MUCOSAL PATHOLOGY
snuff-induced lesions, 114-l 16
studies in Scandanavia, 11 l-l 12
studies in the United States, 107,
  108-109110-112
MUTAGENICITY ASSAYS AND
OTHER SHORT-TERM TESTS
(See also ANIMAL MODELS)
chewing tobacco, 88
snuff, 88
tobacco-specific N-nitrosamines,
  88-89

NASAL NEOPLASMS
posterior nasal space tumors, 48
relation to snuff use, 48
Nass, See ASIAN DATA
NATIONAL BLADDER
CANCER STUDY
relation to smokeless tobacco
  use, 52-53
NATIONAL BLOOD CANCER
STUDY
survey data, 16
NATIONAL HEALTH INTER-
VIEW SURVEY (NHIS)
survey data, 10, 14-15
NATIONAL INSTITUTE ON
DRUG ABUSE (NIDA)
survey data, 13-15
NATIONAL PREVALENCE OF
CURRENT USE OF SNUFF BY
GENDER AGE, AND RACE FOR
1980 THROUGH 1985,ll
NATION& PREVALENCE OF
SMOEELESS TOBACCO USE BY
ADCZT STATUS AND SEX,
INIDA SAMPLE, 1935, 13
NATIONAL PREVXLENCE OF
SMOKES TOBACCO USE:
DATA SOURCES, 9
NATIONAL SURVEY DATA
conclusions, 24-25
Current Population Survey, 12,14
discussion of data, 14-15
National Health Interview
  survey, 10, 14-15
National Institute on Drug
Abuse Household Survey, 13-15
Office on Smoking and Health
Surveys, 7,10,12,14
Simmons Market Research
  Bureau, 10, 12, 14-15

190


NEUROADAPTATION (See also
PHYSICAL DEPENDENCE
POTENTIAL OF NICOTINE,
PHYSIOLOGIC EFFECTS OF
NICOTINE)
defined, 145.
demonstrated, 153
nicotine, 162
NICOTINE (See also PHARMA.

COKINETICS OF NICOTINE,
NICOTINE ADDICTION,
NICOTINE EXPOSURE,
ABUSE LIABILITY, PHAR-
MACODYNAMICS OF NICO-
TINE, PATHOLOGIC
EFFECTS OF NICOTINE, AND
SMOKELESS TOBACCO)
absorption, 141-142, 185
cotinine levels, 143
dependence, 154
distribution, 142
elimination, 142-143
habituating agent, 58
levels, 143
physical dependence, 162-166
self-administration, 159-161
therapeutic effects, 154-155
turnover, 143
NICOTINE ADDICTION /See also

NICOTINE EXPOSURE,
PHYSICAL DEPENDENCE
POTENTIAL OF NICOTINE)
commonalities with other
  addictive substances, 146-147,
  152-157, 184
dose manipulations, 153
encourages other drug use, 184
pattern of use, 152
relation to smokeless tobacco, 58,
  144-147, 152, 185
self-administration, 152-153
social tolerance, 156
therapeutic effects, 154-155
tolerance of use developed, 153
treatment for, 155-156
NICOTINE ADDICTION
TREATMENT
blockade therapy, 156
nicotine gum, 156
pretreatment, 156
substitution, 156
supportive therapy, 156
NICOTINE CHEWING GUM
as substitution, 156
reinforcing properties, 166-167
research needs, 184
self-administration, 167

NICOTINE EXPOSURE
/See also NICOTINE,
NICOTINE ADDICTION)
delivery to the central nervous
system, 147
other physiological effects,
    .
  vm, xxii, xxvi
pharmacokinetics, xxiv, 141-144
peer pressure, 147, 152
reinforcer for animals, 147
relation to addiction, xxiv-xxv,

   144-157
XICOT~E SELF-ADMINISTRATION
PATTERIS. 161
NMOR /See also
ABBREVIATIONS)
metabolism in rats, 74-75
N-NITROSAMINES
(See also CARCINOGENS)
exposure in nontobacco
  products, 64, 64
in snuff, 60
in tobacco leaves, 59
metabolized by tissue, 70-75
nonvolatile, 60, 62
tobacco-specific, 60, 63
volatile, 60. 61
N-NflROSAMINES lN SMOKELESS
TOBACCO, 59
NNK (See also
ABBREVIATIONS)
metabolism in rats, 71-73
NNN (See also
ABBREVIATIONS)
metabolism in rats, 73-74
relation to buccal mucosa, 73
relation to lingual mucosa, 73
NONCANCEROUS CONDITIONS
(See also PRECANCEROUS
CONDITIONS)
relation to smokeless tobacco,
  100105
NONVOLATILE NITROSAWES
IN SMOIfELESS TOBACCO
(PPB), 62

OFFICE ON SMOKING AND
HEALTH (OSH)
survey data, 7, 10, 12, 14

ORAL CANCER (See also ORAL
LEUKOPLAKIA, ORAL SOFT
TISSUES, LIP NEOPLASMS,
MOUTH NEOPLASMS,
CHEEK NEOPLASMS, AND
TONGUE NEOPLASMS)

case studies, 34-41

191


ORAL CANCER-Cont.
epidemiologic studies, 33-55
in rats, 72, 79, 84-86, 88-89
ORAL LEUKOPLAKIA
causation, vii
defined, 113
prospective study, 118
relation to smokeless tobacco, viii,
  xxiii-xxiv, 107, 110-112, 121
studies in Scandanavia, 11 l-l 12
studies in the United States, 107,
  lot?-10!9, 110-112
ORAL SOFT TISSUES
clinical reports of lesions, 114-117
cohort studies, 117-119
definitions, 113-l 14
oral lesions, 119-120
transformation, 113-123

PANCREATIC NEOPLASMS
chewing tobacco use, 54-55
PARANASAL SINUS
NEOPLASMS
relation to snuff use, 48
PATHOLOGIC EFFECTS OF
NICOTINE AND SMOKELESS
TOBACCO
coronary and peripheral vascular
  disease, 177-178
hypertension, 178
nonnicotine metabolic
  consequences, 179
peptic ulcer disease, 178
pregnancy risks, 178-179
PERIODONTAL TISSUE
DEGENERATION (See also
MUCOSAL PATHOLOGY,
GINGIVAL AND
PERIODONTAL HEALTH)
and teenagers, 110
PERMIsslLE LlMIll!3 FOR
INDIVWUAL N-NITROSAMINES
AV CONSlIlX!TR PRODUCTS, 65
PHARMACODYNAMICS OF
NICOTINE
Liking Scale, 158
Morphine Benzadrine Group
  Scale, 158
research needs, 184
self-administration
implications, 162
PHARMACOKINETICS OF
NICOTINE
absorption, 141-142
cotinine blood levels, 143

PHARMACOKINETICS OF
NICOTINE-Cant .
distribution, 142
elimination, 142-143
levels in smokeless tobacco, 141
nicotine blood levels, 143
time course of turnover, 143
PHARYNGEAL NEOPLASMS
case-control study, 37,38, 39-40
cohort study, 41-42
PHYSICAL DEPENDENCE
POTENTIAL OF NICOTINE
(See also NEUROADAPTATION)
defined, 145,162
determination, 153-154
evidence for physical dependence,
  157-166
evidence of withdrawal
  symptoms, 164-166
implications of physical
  dependence, 166
reinforcement with nicotine
  gum, 167
studies conducted, 157, 162-163
tobacco withdrawal, 163-164
PHYSIOLOGIC EFFECTS OF
NICOTINE /See also NEURO-
ADAPTATION, PHYSICAL
DEPENDENCE POTENTIAL
OF NICOTINE)
cardiovascular system, 175-l 76
central nervous system, 147,176,
  183
differentiation possible, 162
endocrine system, 176
pleasant effects produced, 162,
  176
PLAQUE
defined, 128
use of smokeless tobacco, 130
Plug, See CHEWING TOBACCO
Polonium2Ia (21OPo),
See CARCINOGENS
Polynuclear Aromatic
Hydrocarbons (PAHI,
See CARCINOGENS
POSTERIOR NASAL SPACE
TUMORS
relation to liquid snuff, 48
PRECANCEROUS CONDITIONS
(See also NONCANCEROUS
CONDITIONS)
Advisory Committee Report, xxi
defined, 113
relation to leukoplakia, 119
relation to smokeless tobacco, xxi

192


PRECANCEROUS LESION
defined, 113
oral lesions, 119
PREVXLENCE OFSMOKELESS
TOBACCO USE BY CENSUS
REGION, 1985,16
PREVALENCE OF USE OF SMOKE
LESS TylBACCO AMONG YOUTH
BYGENDERANDGRADE
LOCAL SUR KEYS USING STAN-
DARDIZED QUESTIONS, 21-22
PREVALENCE OF USE OF SMOKE
LESS TOBACCO AMONG YOUTH
BY GENDER AND GRADE..
REGIONAL AND STATE LEVEL
SURVEYS REPORTED SINCE
1980,1&19
PREVALENCE OFSNUFFAND
CHEWING TOBACCO USE BY
ADULTM4LESlN10
GEOGRAPHIC AREAS 17
PREVALENCE OF SNUFF USE
AMONG COLLEGE STUDENTS
18 YEARS OF AGE OR OLDER
BY GENDER AND YEAR, 12
PREVALENCE OF THE USE OF
SNUFFAND CHEWmG TOBACCO
AMONG MALES BY AGE, 1970
NHLsAND1985cpssURVEY$ll

Quids, See ASIAN DATA

RECENCY OF SMOKELESS
TOBACCO USE BY SEXAND
AGE GROUP, 13
RELATmRfSK OFORAL CANCER
FROMBETEL QUID W7TLjlAND
W!IT.HOUT To&1CCO (WITH95
PERCENT CONFIDENCE
-), 43
RELATNERLSKS OF
ESOPHAGEAL CANCER lN
PERSONS ExposED To CHEW-
&VG TOBACCO AND SXX'i'?~
.!XlWXR Y OF M)UR CASE
CONTROL STUDHi! 49
Renal Neoplasms, See URINARY
TRACT NEOPLASMS
RESEARCH NEEDS
carcinogenesis, 93-94
nicotine exposure, 184-185
oral health effects 131-132
prevalence/trends of use, 25
standardizing methods, 25

SALIVA ANALYSIS
of snuff dippers, 64
SALIVARY GLANDS
effects of smokeless tobacco,
  lOl-l&3, 126-128
SCHEME LLNKLNG NICOTLNE TO
FORMATION OF THE
PROMUTAGENIC DNA ADDUCT
O%METHYLGUANINE, 72
SELECTED STUDY Sm
FOR THE NONC'CEROUS
ORAL HEALTH EFFECTS FROM
THE USE OF SMOKELESS
TOBACCO, lm105
SIALADENITIS
defined, 123
relation to smokeless tobacco, 127
relation to snuff dippers, 127
SIMMONS MARKET
RESEARCH BUREAU
survey data, 10, 12, 14-15
SMOKELESS TOBACCO (See also
CHEWING TOBACCO, SNUFF)
carcinogenesis associated with,
  33-93
chemical constituents, 58-69
cohort studies, 41-42
commonalities with other
  addictive substances, 146-147,
  152-157
conclusions, 24-25, 92-93,
  130-131, 182-183
effect on oral leukoplakia/
mucosal pathology, 107-l 12
epidemiologic studies and case
reports of oral cancer, 33-44
epidemiologic studies of other
  cancers, 47-55
evidence for abuse and
dependence, 166-167
experimental studies exposing
laboratory animals, 78-79
experimental studies of abuse
and dependence, 157-166
metabolism of constituents, 70-75
nicotine addiction, 144-146
nicotine exposure, xxiv, 141-185
noncancerous and precancerous
oral health effects, xxiii-xxiv,
  99-130
pharmacokinetics of nicotine,
  141-144
physiologic and pathologic
effects, 175-l 79
prevalence and trends of use.
xxii, 4-24

193


SMOKELESS TOBACCO-Cant .
product characteristics, 5
research needs, 25, 93-94,
  131-132, 184-185
transformation of oral soft
  tissue, 113-120
trends in production and sales,
  5, 7

trends in self-reported use, 7, 10,

12-17, 20, 24
SMOKELESS mBACC0 AND h!EAD
AND NECK CANCER BY ANA-
RMfICSITE, CASECONTROL
DATA FROM VtNCX!h'TAh?D
MARCtlETZA, - ONLU, 38
SMO- lloBACC0 AND
MOUTH CANCER CASE
CONTROL DATA FROM
MOOREETAL+ 36
SMO- TylBACCO AND
MOUTH CANCER, CASE
CONTROL DATA FROM
PEACOCKETAL, 37
SNUFF (See also SMOKELESS
TOBACCO, BIOASSAY8
ANIMAL MODELS)
case-control studies, 37, 40
characteristics. 5
dry,7
historical uses, xviii-xix
levels of carcinogens, 60, 64-66
moist, 7
relation to cancer, 41, 53-55
saliva analysis, 64
SNUFF-DIPPERS CARCINOMA
defined, 113
exposure to nitrosamines, 64
oral lesions, 120
reports, 35
Scandinavian study, 111
SQUAMOUS CELL CARCINOMA
case studies, 34-36
clinical study, 117
defined, 114
oral lesions, 119-120
snuff and ear neoplasms, 47
STAINING (DENTAL)
defined, 129
STATE AND LOCAL SURVEY
DATA
adolescent use, 17, 20, 24-25
adult use, 16-17
STOMACH NEOPLASMS
relation to smokeless tobacco,
  51-52

Substitution Therapy, See
NICOTINE ADDICTION
TREATMENT
SUMMRY OF DATA: LIABILJTY
OF NICOTmTE AS mBACC0
SMOKE OR lNTRAVENOUS
lh?JECTION$159
StJUX4RYOFREFOR~IN
WZICHNICOT~ WAS AVAII
ABLE uNoERINTR.AvENom
DRUG SELF+tDMIhZXUATION
PROC%!DiXE!$14&151
S-Y OFSELJXTZD CASE
REpoRT$106
Supportive Therapy, See
NICOTINE ADDICTION
TREATMENT
Surgeon General's Advisory
Committee on the Health
Consequences of Using Smokeless
`Ibbacco, See ADVISORY
COMMITTEE TO THE SUR-
GEON GENERAL, REPORT

TEETH
dental caries, 129-130
effect of smokeless tobacco,

128-130

other hard tissue effects, 130
THERAPEUTIC EFFECTS OF
NICOTINE
as an anoretic, 154
mood regulator, 154
performance of cognitive tasks,
  154
self-medication, 155
work enhancement, 154
THIRD NATIONAL CANCER
STUDY (TNCS)
bladder cancer, 54
laryngeal neoplasms, 50-51
other cancer sites, 55
stomach neoplasms, 52
TOBACCO SNIFFING
rare practice, xvii
TOBACCMPEC~IC
N-NITR-B liV SMOKE
LhXJ TOBACCO fPPB), 63
mBA CCO-SPECXFIC
N-NITRO-Bmm'
US. BRANI& 1985,66
TOBACCO WITHDRAWAL
(See also PHYSICAL DEPEN-
DENCE OF NICOTINE)
evidence of symptoms, 164-166

194


TOBACCO WITHDRAWAL-
Cont.
study findings, 165
symptoms, 163-164
University of Minnesota
  studies, 164-166
`TONGUE NEOPLASMS (See also
ORAL CANCER, MOUTH
N-EOPLASMS)
case-control study, 36,120
TRENDS IN PRODUCTION
ANDSALES
categories of products, 7
temporal trends, 7
United States Department of
Agriculture (USDA) reports, 5
TRENDS IN SELF-REPORTED
USE: SURVEY DATA
national survey data, 7, 10, 12-15
state and local survey data,
  15-1'7, 20, 24
Twist, See CHEWING TOBACCO

URINARY TRACTNEOPLASMS
castxontrol studies, 52-54
relationship to smokeless
tobacco, 52-54

USEOFSMO-llylBAccOm
THE UNITEB SZ4TEs BY

VAlpIATIONs~ T- USEDm
DEI?!ONS PROKiDED EylR
GINGMTISAND GINGWXL RE
C%ssIONBYS~~ CITED, 124
VMU4TIONS~ TERbis USEDAND
D,W!MIONS PROKWED EylR

USED BY STuDrn CITED,
108109
VERRUCOUS CARCINOMA
defined, 114
dysplastic lesions, 13 1
voLAlzLEm-m
MfOKI.hZSS mBACc0 IPPBJ,
61

WORLD HEALTH
ORGANIZATION (WHO)
Chnmittee on Drug Dependence,
  145
defines oral leukoplakia, 107
differing diagnoses, 123

195