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Most people chew or suck (dip) the tobacco in their mouth and spit out the tobacco juices that build up, although spitless smokeless tobacco has also been developed

Public Health 77 : 425431 McDuffie H, Klassen D, Dossman J

Effects of in utero tobacco exposure, age of smoking initiation, and environmental pollution on the risk of chronic obstructive pulmonary disease in adulthood: a large scale prospective cohort study

However, they opted for vaping due to limited health risks

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Effect of tobacco smoking cessation on C-reactive protein levels in a cohort of low-dose computed tomography screening participants