Unfortunately, most of the publicity focused only on the health hazards associated with cigarette smoking. While the number of cigarette smokers in the United States has continually decreased over recent years, the number of smokeless tobacco users has steadily increased. Since the 1970s, a 15-fold increase in smokeless tobacco has been noted in adolescents aged 17 to 19. Each year, approximately 1.3 million Americans quit smoking. It is estimated that about 5.5 million people use smokeless tobacco daily and another 6 million use it at least weekly.
Young men are at highest risk for using tobacco products but the incidence in women is increasing.
Smokeless tobacco use is highest in the Southeast region, followed by the Central Plains and Western states. Its use is lowest in the Northeast region of the United States. Bowel tone and activity increases along with saliva and bronchial secretions. Stimulation of the central nervous system may cause tremors in the inexperienced user, or even convulsions with high doses. Stimulation is followed with a phase that depresses the respiratory muscles.