The use of smokeless tobacco is well known to induce wrinkled changes in the oral mucosa at the site where the quid is placed.The changes are usually discreet with a colour similar to the surrounding oral mucous membrances or whitish-yellowish to brown.The changes seem to be reversible.Gingival recessions may also be seen in suers of smokerless tobacco at the site where the quid is placed.

    The relationship between the use of oral smokeless tobacco and cancer development has been amply discussed.Snuff use as practiced in Scandinavia carry none or very low risks for development of oral cancer.Differences in habits and between products around the world are probably important when evaluating the harmful effects of oral smokeless tobacco,so that a general statement on this subject cannot be made.However,many forms of oral smokeless tobacco in common use in Asia,the Middle East,and North Africa are carcinogenic.

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