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Smokeless tobacco has 28 cancer-causing agents.1 Exposure to tobacco juice causes cancer of the esophagus, pharynx, larynx, stomach, and pancreas. Spit tobacco causes leukoplakia, a disease of the mouth characterized by white patches and oral lesions on the cheeks, gums, and/or tongue.6 Chewing tobacco more than doubles the risk of heart attack.7 Smokeless tobacco products may increase the risk of fatal heart attacks and strokes.8 Smokeless tobacco use by men causes reduced sperm count and a


Punch and Chew, 1886

Chew Punch Plug Tobacco. National Tobacco Works, Louisville, Ky. Created by Giles Lithography Co. in 1886 as a color lithograph. Black and white man in pugilistic pose, Punchinello clown and dog wearing hat and collar on wall. via Print Collection