The following may be concluded about nicotine and smokeless tobacco use: Systemic absorption and levels of nicotine are similar in users of smokeless tobacco and cigarette smokers. Data from the few studies performed to date suggest that smokeless tobacco users develop a dependency similar to that for cigarette smokers. Effective treatment strategies to help smokeless tobacco users quit need to be developed. Smokeless tobacco use in young people also poses a concern for later development of dependence on cigarettes. The health hazards known to be caused by cigarette smoking and suspected to be related to chronic nicotine exposure are expected to be a hazard of habitual use of smokeless tobacco. A major concern in young males is accelerated coronary artery disease. Information about the potential health hazards of nicotine, as well as oral pathology, may be incorporated into educational programs to help discourage the use of smokeless tobacco, with a resultant decrease in the associated cancer risk.