Smokeless Tobacco and Heartburn
A number of studies have implicated cigarette smoking as an etiological factor for acid reflux and heartburn. Nicotine relaxes the lower esophageal sphincter favoring acid reflux. Furthermore, smoking reduces saliva production. Saliva is rich in bicarbonates and help neutralize acid. Chewing tobacco is a type of smokeless tobacco commonly used in Houston, TX. Unlike smoking, chewing tobacco delivers a constant dose of nicotine into the blood stream. Constant nicotine action on the lower esophageal sphincter may further exacerbate acid reflux and heartburn compared to cigarette smoking. Acid reflux pathogenesis, however, is more complicated than lower esophageal sphincter pressure. Nicotine may affect gastric fundus relaxation and motility leading to either reduction or exacerbation of acid reflux. There are limited studies in the literature examining the effect of chewing tobacco on acid reflux. One study published in the Scandinavian Journal of Gastroenterology and published in 2017 shows a reduction in GERD related symptoms in daily users of Snus. Snus is a form of smokeless tobacco product commonly produced and used in Sweden.
So, does chewing tobacco cause heartburn?
The answer is not clear. Tobacco products of any kind have deleterious effects on your health beyond heartburn and acid reflux. The combination of tobacco use and acid reflux increases the incidence of Barrett’s esophagus and esophageal cancer. Smoking and tobacco chewing cessation are strongly recommended by Houston Heartburn and Reflux Center. If you are a smoker or if you chew tobacco and you are currently experiencing heartburn, we recommend evaluation by an experienced reflux specialist.