The American Heart Association (AHA) said in a policy statement that smokeless tobacco is unsafe to use, and does not help smokers quit cigarettes, ScienceDaily reported Sept. 14.

Investigators reviewed international studies and found evidence that smokeless tobacco — snuff and chewing tobacco —  is addictive and increases the risk of fatal strokes and heart attacks, some cancers, and oral disease. 

Research from Sweden had found that the rate at which Swedish men used smokeless tobacco more than doubled (from 10 to 23 percent) from 1976 and 2002, at the same time that the smoking rate declined from 40 to 15 percent.

However, a longitudinal study done in the United States showed no correlation between use of smokeless tobacco and smoking cessation, and found that smokeless tobacco users were more likely to switch to cigarettes.

In addition, the AHA team concluded that nicotine replacement therapies, such as skin patches and gum, are safer than smokeless tobacco, as they do not increase the risk of heart attack or stroke. 

Because of the health risks associated with the use of smokeless tobacco, the investigators also cited concerns about the marketing of chewing tobacco and snuff for use in public places where cigarette smoking has been outlawed, as well as a rise in the use of smokeless tobacco by teenaged boys.

“Scientists and policy makers need to assess the effect of 'reduced risk' messages related to smokeless tobacco use on public perception, especially among smokers who might be trying to quit,” said the statement’s lead author, Mariann Piano, Ph.D., of the University of Illinois at Chicago.

The policy statement appeared online Sept. 13 in Circulation, the journal of the American Heart Association.