Smokeless tobacco: health hazard on the rise

There are an estimated 22 million users of smokeless tobacco in the United States, 3 million of them under age 21. We surveyed physicians and patients to determine whether the health hazard of smokeless tobacco was recognized and whether preventive measures were being implemented. Although more than 80% of physicians were aware that the use of smokeless tobacco is rising and potentially harmful, only 25% inquired regularly about the habit, only 58% recorded the patient's answer, and only 11% routinely performed a digital oral examination. Patients were less well informed; only 30% believed that smokeless tobacco was potentially harmful, and 93% always placed the tobacco in the same area of their mouth. Although physicians tended to be more informed than patients, preventive measures were not being instituted. There is a need for patient education programs.