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In 2006, pouch-type tobacco products were marketed in the United States.
This type of tobacco is positioned along the gum line, and the user may swallow the juices, making chewing and spitting unnecessary.
Premalignant lesions and carcinoma in situ (CIS) may be permanently cured after excision or biopsy.
The term smokeless tobacco, also known as dip, plug, chew, or spit tobacco, refers to both chewing tobacco (coarse cut) and snuff (fine cut).
In the United States, clean indoor air acts and cigarette excise tax increases have resulted in a coincidental increase in smokeless tobacco use.
Two distinct grading systems are used to classify lesion stage by degree of clinical thickening.
Tobacco-related lesions (smokeless tobacco–related and nicotine stomatitis) comprised 4.7% of all lesions found in 17,235 people examined as part of the Third National Health and Nutrition Examination Survey.
Smokeless tobacco users had one of the highest odds of having a lesion present (odds ratio, 3.9).
These include plug, gutkha, khiwam, khaini, iq’milk, zarda, naswar, nass, chimo, toombak, shamma, gudhaku, gul, mishri, maras, and moist snus.
The use of smokeless tobacco is associated with a spectrum of oral cavity lesions, including leukoplakia, speckled leukoplakia, erythroplasia, tobacco-associated keratosis, carcinoma in situ (CIS), verrucous carcinoma, and invasive squamous cell carcinoma (SCC).Oral leukoplakia (white plaques) is a common physical finding in 40-50% of people who use smokeless tobacco.Oral leukoplakia is a premalignant lesion, with the risk of malignant transformation to oral cancer varying in relation to the product used.Indirect pharyngoscopy and laryngoscopy may be performed to help visualize lesions of the throat, base of the tongue, and larynx.