Around 300 million people worldwide use smokeless tobacco. Meta-analyses show this use more than doubles the risk of oral cancer and is associated with leukoplakia in up to 46% of users. This data examines the prevalence, health outcomes, and economic impact of chewing tobacco.
Key Takeaways
- 11.0% of U.S. adults (18+) reported current smokeless tobacco use in 1985
- Leukoplakia is estimated to occur in 9%–46% of smokeless tobacco users, with risk increasing with duration and intensity of use
- Oral submucous fibrosis is reported in about 0.2%–10% of populations exposed to areca nut and related products, with smokeless tobacco commonly co-used and contributing to risk
- Smokeless tobacco use is associated with increased risk of oral cancer (odds ratio 1.2–3.0 reported across studies in a meta-analysis timeframe)
- A 2017 WHO fact sheet reported that smokeless tobacco is used by about 300 million people worldwide
- Japan’s smokeless tobacco market size was reported at about ¥100 billion in 2023 in industry research estimates
- WHO estimated that tobacco use costs countries in the form of healthcare and economic impacts; in a global analysis, smoking-attributable costs were estimated at $1.4 trillion annually
- A U.S. FDA analysis estimated that almost 90% of nicotine in tobacco products comes from the tobacco leaf, with product formulation affecting delivery
- In 2022, the European Union reported that tobacco control policies reduced smoking prevalence; smokeless tobacco use is tracked in Eurobarometer waves with measurable change
- U.S. FDA found that nicotine delivery differs substantially among smokeless products; measured nicotine yields vary by product type in submitted studies
- The federal excise tax rate on smokeless tobacco in the U.S. is $0.80 per tin/package of 25 cans or less (or $0.80 per 25 cans) per Internal Revenue Code definition
- The U.S. federal cigarette excise tax is $1.01 per pack; smokeless tobacco excise is structurally separate under the IRC
- State excise taxes vary; for example, Pennsylvania’s smokeless tobacco excise tax is $0.41 per can/tin (as published in state tax code)
- 10.0% of U.S. adults (18+) reported current smokeless tobacco use in 1988 (men 13.3%, women 6.5%)
- U.S. smokeless tobacco excise tax: $0.80 per can/tin for products defined under IRC Section 5702
U.S. smokeless tobacco use remains common, increasing risks of oral disease and cancer despite possible behavior-based quitting.
Related reading
01 · Category
Cost Analysis11 stats
01
The federal excise tax rate on smokeless tobacco in the U.S. is $0.80per tin/package of 25 cans or less (or $0.80 per 25 cans) per Internal Revenue Code definition
02
The U.S. federal cigarette excise tax is $1.01per pack; smokeless tobacco excise is structurally separate under the IRC
03
State excise taxes vary; for example, Pennsylvania’s smokeless tobacco excise tax is $0.41per can/tin (as published in state tax code)
04
State excise taxes vary; for example, North Carolina’s smokeless tobacco excise tax is $0.10per can/tin or equivalent unit (as stated in state statutes)
05
A 2019 economic study estimated that increases in tobacco prices reduce smokeless tobacco initiation by a measurable percentage (elasticity-based estimate)
06
A 2018 study estimated that a 10% increase in smokeless tobacco prices reduces consumption by several percent in elasticity models
07
A CDC report quantified that smokeless tobacco users incur higher oral health care costs; dental costs are measurable in claims-based analyses
08
In a claims analysis, current smokeless tobacco users had higher odds of dental visits with costs measurable in adjusted models
09
Smokeless tobacco users are more likely to experience oral lesions; cost models quantify increased medical/dental expenditures by several hundred dollars annually
10
In Sweden, snus (a type of smokeless tobacco) is taxed differently; excise and VAT combine to create a measurable price difference vs cigarettes in consumer price data
11
In the U.S., chewing tobacco and snuff retail prices are included in CPI tobacco subcategories; price indices show measurable changes year-to-year
02 · Category
Health Risk Estimates9 stats
01
Leukoplakia is estimated to occur in 9%–46% of smokeless tobacco users, with risk increasing with duration and intensity of use
02
Oral submucous fibrosis is reported in about 0.2%–10% of populations exposed to areca nut and related products, with smokeless tobacco commonly co-used and contributing to risk
03
Smokeless tobacco use is associated with increased risk of oral cancer (odds ratio 1.2–3.0 reported across studies in a meta-analysis timeframe)
04
In a meta-analysis, smokeless tobacco use increased risk of oral cancer by 2.1-fold (relative risk/OR depending on study design)
05
A systematic review reported that smokeless tobacco users have approximately 1.7x higher risk of periodontal disease than non-users
06
Use of smokeless tobacco is associated with higher risk of developing oral lesions, including gingival recession and dental caries (reviewed across clinical studies)
07
Nicotine contributes to dependence; smokeless tobacco products deliver nicotine through the oral mucosa (nicotine pharmacokinetics described across studies)
08
A Cochrane review found that behavioral interventions can reduce smokeless tobacco use, with quit outcomes varying by program intensity (effects summarized quantitatively)
09
Smokeless tobacco use is associated with increased risk of cardiovascular disease; one cohort study reported hazard ratios in the range of ~1.2–1.6 depending on exposure duration
Interpretation
Health Risk Estimates Interpretation
Under the Health Risk Estimates framing, chewing tobacco and other smokeless products show consistently elevated harm, including leukoplakia affecting roughly 9% to 46% of users and periodontal disease occurring about 1.7 times more often than in non-users.
03 · Category
Health Outcomes5 stats
01
In the U.S., smokeless tobacco users accounted for 1.7% of all tobacco-attributable deaths in 2018 (smokeless tobacco component of CDC’s smoking-attributable death framework)
02
In the U.S., smokeless tobacco use is associated with elevated risk of oral cancer mortality; pooled relative risk estimates reported in the Global Burden of Disease Oral Cancer assessment
03
Global Burden of Disease: smokeless tobacco is a quantified risk factor contributing to oral cavity cancer burden globally (risk factor included with measurable attributable fractions in GBD risk assessment)
04
Oral cancer attributed risk: smokeless tobacco included as a risk factor in GBD risk factor causation models for oral cavity cancers
05
Nicotine dependence among smokeless tobacco users is supported by ICD-11 classification of tobacco dependence; dependence criteria include strong craving and withdrawal in users
More related reading
04 · Category
Pharmacology4 stats
01
Chewing tobacco/nicotine products deliver nicotine primarily through the oral mucosa; pharmacokinetic evidence shows rapid systemic nicotine absorption after oral use
02
Smokeless tobacco nicotine absorption is measurable within minutes after placement in the mouth (pharmacokinetic studies report time-to-peak nicotine concentrations on the order of minutes)
03
Swedish snus nicotine pouches marketed as tobacco-free (or with tobacco) still achieve measurable nicotine plasma levels after use (pharmacokinetic study outcomes reported as time courses and Cmax)
04
In a controlled study, nicotine plasma concentration rises with use of snus; reported pharmacokinetic parameters include Cmax and time-to-Cmax for users
05 · Category
Market Size3 stats
01
A 2017 WHO fact sheet reported that smokeless tobacco is used by about 300 million people worldwide
02
Japan’s smokeless tobacco market size was reported at about ¥100 billion in 2023 in industry research estimates
03
WHO estimated that tobacco use costs countries in the form of healthcare and economic impacts; in a global analysis, smoking-attributable costs were estimated at $1.4 trillion annually
Interpretation
Market Size Interpretation
Market size signals remain substantial and global, with the WHO estimating smokeless tobacco use at about 300 million people worldwide and Japan valuing its smokeless tobacco market at roughly ¥100 billion in 2023.
06 · Category
Industry Overview8 stats
01
A U.S. FDA analysis estimated that almost 90% of nicotine in tobacco products comes from the tobacco leaf, with product formulation affecting delivery
02
In 2022, the European Union reported that tobacco control policies reduced smoking prevalence; smokeless tobacco use is tracked in Eurobarometer waves with measurable change
03
U.S. FDA found that nicotine delivery differs substantially among smokeless products; measured nicotine yields vary by product type in submitted studies
04
U.S. smokeless tobacco excise tax: $0.80per can/tin for products defined under IRC Section 5702
05
Australia: chewing tobacco is classified as other tobacco products for taxation purposes with an excise mechanism based on a specific rate per kilogram (as specified in the Australian tax law schedule)
06
United Kingdom: smokeless tobacco (including chewing tobacco and snuff) is taxed via excise duty rates specified in the UK tobacco products regulations (rate schedule published for the relevant duty year)
07
11.0% of U.S. adults (18+) reported current smokeless tobacco use in 1985
08
10.0% of U.S. adults (18+) reported current smokeless tobacco use in 1988 (men 13.3%, women 6.5%)
Interpretation
Industry Overview Interpretation
Across key jurisdictions, chewing and other smokeless tobacco are treated as a distinct industrial and policy category, with the U.S. FDA estimating that nearly 90% of nicotine comes from the tobacco leaf and excise taxes ranging from $0.80 per can or tin in the U.S. to rate-based regimes in the EU, Australia, and the UK.
report visual · Breakdown
U.S. excise tax vs. selected state rates (smokeless tobacco)
Smokeless tobacco faces differing excise taxes across jurisdictions, ranging from the federal rate to lower or higher state-specific rates.
10%
A 2018 study estimated that a 10% increase in smokeless tobacco prices reduces consumption by several percent in elastic
90%
A U.S. FDA analysis estimated that almost 90% of nicotine in tobacco products comes from the tobacco leaf, with product
source-verifiedacademic.oup.com · fda.gov2018
Reference
Cite This Report
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APA
Sophie Moreland. (2026, February 13). Chewing Tobacco Statistics. Gitnux. https://gitnux.org/chewing-tobacco-statistics
MLA
Sophie Moreland. "Chewing Tobacco Statistics." Gitnux, 13 Feb 2026, https://gitnux.org/chewing-tobacco-statistics.
Chicago
Sophie Moreland. 2026. "Chewing Tobacco Statistics." Gitnux. https://gitnux.org/chewing-tobacco-statistics.
Sources & references
40 datasets cited across this report · attribution is report-level
+17 additional datasets cited (not shown individually)