Nicotine absorption and cardiovascular effects with smokeless tobacco use: Comparison with cigarettes and nicotine gum

TLDR

Because of recent resurgence in its consumption, the effects and health consequences of smokeless tobacco are of considerable public health interest. The study examined nicotine absorption kinetics and cardiovascular effects of smokeless tobacco versus cigarette smoking and nicotine gum in 10 healthy volunteers. The authors measured nicotine levels and heart rate/blood pressure responses following single exposures to oral snuff, chewing tobacco, cigarettes, and nicotine gum. Smokeless tobacco produced twice the nicotine exposure of cigarettes, caused greater overall cardiovascular responses despite some tolerance, whereas nicotine gum yielded lower nicotine levels and milder cardiovascular effects, suggesting that nicotine‑related harms of smoking may also apply to smokeless tobacco. Clinical Pharmacology and Therapeutics (1988) 44, 23–28; doi:10.1038/clpt.1988.107.

Abstract

Because of recent resurgence in its consumption, the effects and health consequences of smokeless tobacco are of considerable public health interest. We studied the extent and time course of absorption of nicotine and cardiovascular effects of smokeless tobacco (oral snuff and chewing tobacco) and compared it with smoking cigarettes and chewing nicotine gum in 10 healthy volunteers. Maximum levels of nicotine were similar but, because of prolonged absorption, overall nicotine exposure was twice as large after single exposures to smokeless tobacco compared with cigarette smoking. All tobacco use increased heart rate and blood pressure, with a tendency toward a greater overall cardiovascular effect despite evidence of development of some tolerance to effects of nicotine with use of smokeless tobacco. Relatively low levels of nicotine and lesser cardiovascular responses were observed with use of nicotine gum. Adverse health consequences of smoking that are nicotine related would be expected to present a similar hazard with the use of smokeless tobacco. Clinical Pharmacology and Therapeutics (1988) 44, 23–28; doi:10.1038/clpt.1988.107