occasional chewing tobacco use WHO EMRO Smokeless Tobacco

It is a major risk factor for oral cancer as well as cancers of other organs such as lung, stomach, pancreas, kidney, bladder, colon and uterine cervix

Nicotine itself and tobacco-specific N-nitrosamines are actively involved in the formation of reactive oxygen species (ROS) in the mouth 22,23

However, these effects are generally temporary and reduce as users adapt to the correct chewing technique

Krassas GE, Wiersinga W

This type of tobacco, also known as "twist," is made by tightly braiding and twisting tobacco leaves into a rope-like form

Amerigo Vespucci, an Italian explorer,discovered chewing tobacco in 1499 during his travels to the New World