Smoking is estimated to cause 6.3 million deaths annually worldwide. The use of snuff, differing from smoking, has significantly increased especially among the adolescents. Snuff powder contains 20-fold more nicotine compared to cigarettes, leading to strong nicotine addiction. In addition to cancer development, both smoking and snuff use exert other risks for oral health. Compared with non-smokers, smokers are at a 10-fold risk for the development and progression of periodontal diseases. Snuff causes oral mucosal changes, gingival recessions and root surface caries. Smoking induces systemic low-grade inflammation, which weakens defensive immune responses in oral mucosa, gingiva, gingival crevicular fluid and saliva.