Although Patrick W. Graves has never been a quitter, he staunchly advocates that others should consider doing just that.

At least for a day.

Graves, Naval Hospital Bremerton Tobacco Cessation Facilitator and NHB’s Health Promotion and Wellness team were at Naval Base Kitsap Bangor Liberty Center to actively promote the Great American Spit Out, February 22, 2024.

“Tobacco chewing is dangerous and has definite health risks,” said Graves. “When a person puts chewing tobacco into their mouth, they are instantly exposed to significant dangers such as oral cancer, pancreatic cancer, esophagus cancer, stomach cancer and colon cancer. A dip of chew has 28 cancer-causing carcinogens.”

According to Graves, chewing tobacco is a super concentrated form of nicotine, equal to 3.5 packs of cigarettes. “That makes it all the more addictive,” he said.

Citing compiled DoD statistics, Graves notes that chewing tobacco is used by 19 percent of 18- to 24-year-old military males, approximately twice the national average. That’s approximately one in five personnel.

Graves attests that as a whole, Navy and Marine Corps personnel tend to be better informed than the general public about the inherent dangers of tobacco usage. But getting the information out is only half the struggle. It’s up to the individual and their action and behavior.

“We might know more but due to our demographics, but we also tend to smoke and dip 35 to 50 percent more than our civilian counterparts,” said Graves. “It’s always been a cultural thing in the service. But that notion is gradually changing. The ironic thing about using chewing tobacco is that it’s such a contradictory habit to a person putting in the effort to maintain their readiness, training, physical fitness and be on the top of their game. Dipping and chewing negates that and takes away from all the gains.”



Graves insists that the culture of using tobacco products amongst service members is gradually changing. Yet the progress is slow, even more so with those who use chewing tobacco products.

“Can’t smoke in the field. Can’t smoke in a submarine. There’s just a lot of environments in the military where smoking is not permitted. Or tolerated,” explained Graves. “Even though chewing tobacco is actually more harmful that smoking, it provides that addictive nicotine to any user whether on shore or at sea.”

“Tobacco companies know that with restrictions on smoking, they actively market their other products like chewing tobacco to younger audiences,” continued Graves. “There’s even a new product out which contains straight nicotine in a pouch without any tobacco. The user can put it between their upper lip and gum. Think about that. The addictive chemical of a cigarette that causes cancer is being sold to people to put in their mouth. It’s worrisome. We don’t have any data yet on just how toxic the pouches are to someone’s health, but already there are tobacco cessation experts who advise against using the product.”

The consequences of smokeless tobacco to a user’s health and wellbeing are not ideal. Saliva mixed with tobacco can permanently stain teeth and cause halitosis – chronic bad breath – as well as gingivitis and gum disease. The particles and chemicals in tobacco can wear away teeth surface, destroy tooth enamel and make users more prone to tooth decay.

Smokeless tobacco also extends beyond someone’s oral cavity. Nicotine prompts cardiovascular stress by constricting blood vessels and increasing blood pressure which put added stress on the heart, which in turn can impact a user’s athletic performance and endurance levels.

For those who insist on using, Graves recommends every dipper should conduct self-assessments to check themselves on a monthly basis for early signs of cancer.

Face and neck: do both sides look the same? Gently press along the jawbone to feel for any lumps.

Lips and gums: Pull down the lower lip to check for any white or red patches - or sores- which bleed easily. Pay special attention to the area where chewing tobacco is positioned. Is there any change in color? Any rough areas? Squeeze lips and cheek to feel for any bumps or soreness.

Roof of the mouth: Tilt head back and open wide. Any discoloration, sores, bumps or swelling?

Bottom of the mouth: Brace one finger on the roof and with the other move around the mouth bottom feeling for swelling, sores, sensitivity.

Tongue: Stick the tongue out. Grab it with a paper towel. Move it from one side to the other. Look for any bumps or color changes.

If anyone sees any such ailments, contact your physician immediately.

Graves encourages anyone who is thinking of quitting cigarettes or chewing/smokeless tobacco to contact their primary care doctor, unit/ship/boat corpsman, NHB’s Tobacco Cessation Facilitator office at r (360) 475-4818,