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Written by Patrick Fratellone, MD & Frank Spinelli, MD - Photo by Stephanie Espinosa   
Wednesday, 01 August 2007

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I’m dating a guy who uses smokeless tobacco. I want him to quit, but he tells me that it’s less harmful than smoking and he could quit any time. What are the health consequences for chewing tobacco? Also, am I at risk just for kissing him?

Justin Santa Barbara, CA

Smokeless tobacco, also known as chewing tobacco, spitting tobacco, spit, dip and chaw, has been around for a long time. In addition to bleeding and/or receding gums, chewing tobacco has the same health hazards as smoking tobacco: an increase in blood pressure and heart rate, and, of course, even more important, cancer. More than 30,000 Americans are diagnosed with mouth, lip and throat cancer each year. I wouldn’t want your new friend to be one of the 10,000 who die from it each year. As secondhand smoke is a health hazard to the nonsmoker, so is chewing tobacco to the non-chewer. And, yes, by kissing him, you are putting yourself at risk—of catching his bad breath, among other things! —PF

LUCKY LEAKER

My boyfriend begins leaking almost as soon as he becomes erect. I, on the other hand, don’t leak at all. Is leaking pre-come something I can learn? If so, how? We’ve tried bringing me to the brink of orgasm and backing off multiple times, but still nada.

Gerry Poughkeepsie, NY

Pre-ejaculatory fluid, or Cowper’s fluid, also known as pre-come, is the clear fluid issued from a man’s penis when he is sexually aroused. Cowper’s fluid is a normal response to arousal, unlike premature ejaculation, the most common form of male sexual dysfunction. Pre-come can be exciting for the other partner, unlike premature ejaculation, which can have devastating long-term effects on relationships. Here are my suggestions for you, provided that you are in a safe, monogamous relationship where you have no concerns about spreading STDs: Once your partner begins secreting pre-come, I would have him try (or you try) spreading his pre-come over the top, or glans, of your penis in a circular fashion. Continue using his pre-come as you begin stroking your penis. This exercise is called the spread, slide and circle technique. This arousal could cause you to produce your own pre-come. The technique you mentioned is often referred to as edging. Edging is when you stroke your penis to near climax but stop before ejaculating. In some cases, this will produce pre-come. In either case, I believe that you and your partner will have fun with the spread, slide and circle technique with incredible and satisfying results. —PF


RISKY BUSINESS

I’ve topped a few HIV-positive men in the past without using a condom because I heard it was less risky. Am I more, less or equally at risk topping someone who is HIV positive with a condom than topping them without a condom?

Billy M. New York, NY

The question of risk is certainly less for the guy topping, but the important word in that sentence is “risk.” Do not be fooled into gambling with your life because someone told you there was a lesser chance of contracting HIV by topping. I have diagnosed many men who have topped another man once and contracted HIV. It only takes one time, and your life will be changed forever. Remember, HIV is transmitted through blood and bodily fluids, such as semen—and yes, men who bottom without condoms are more likely to contract HIV—however, it is important to know that you can get HIV through topping and through performing oral sex. Anal intercourse involves friction, and the lining of the anal cavity can bleed. Blood can enter a small abrasion that results from intercourse on the insertive partner’s penis. More important, uncircumcised men have been found to be at higher risk for contracting HIV though insertive anal sex then circumcised men. HIV is a chronic —and sometimes still fatal—disease, and hopefully one day we will be able to cure it. But the only way to ensure your safety is through proper use of condoms. Dr. Alfred Kinsey reported that the male orgasm lasts approximately four seconds. Don’t value those seconds over the rest of your life. —FS

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written by andrew on August 17, 2007

wouldn?t want your new friend to be one of the 10,000 who die from it each year. As secondhand smoke is a health hazard to the nonsmoker, so is chewing tobacco to the non-chewer. And, yes, by kissing him, you are putting yourself at risk?of catching his bad breath, among other things...really apprecaible...
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written by Christian Peper on May 09, 2008

By Christian Peper

After reading an inaccurate statement on ?Health Q&A? I felt the need to respond. There is no increased risk of cancer for kissing a person who chews tobacco unless the tobacco itself is actually in the person?s mouth and open mouth ?French? kissing is involved.

Chewing tobacco or oral ?snuff? is a very poor drug for those who engage in receptive oral sex (like gays and some straight women) because it has been proven that oral tobacco creates very small cuts in the users mouth and these small cuts can make it easier to receive the HIV virus through.

Those that insist on chewing tobacco that are the receptive partner (the one sucking) should insist on condoms to protect themselves until they are able to quit their addiction.



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