Louis Eubank, executive director, South Carolina Tobacco-Free Collaborative, is the spokesperson this week. He is no stranger to the Observer Notes and he continues to discuss, promote, and support the collaborative for tobacco communities. This week his talking points are attention-grabbing, including big tobacco industry news, healthy living and a variety of noteworthy trends including smoke-free tobacco.

“Thirty of the 50 largest cities in the U.S. are now smoke-free (according to U.S. News and World Report). That means almost half of Americans are protected from secondhand smoke, compared with 3 percent in 2000. Research shows that smoke-free laws reduce exposure to secondhand smoke, reduce smoking, reduce heart attacks and improve health. Smoke-free laws save lives and contrary to popular perception, do not hurt business. Ten of the 20 largest cities with comprehensive smoke-free laws are in the South,” said Eubank.

In a health roundup by USA TODAY —19 percent of American adults still smoke, but they are smoking less. Smoking among young adults, ages 18 to 24, has dropped from 24 percent to 19 percent since 2005.

Wanna quit smoking? Try gargling with lemonade.

A new study has a different way to quit smoking—gargling with lemonade. The study from the University of Georgia finds that the sugar in lemonade helps self-control and decreases the desire to smoke. Even just gargling—swishing and spitting can help the brain fight off the urge.

The emergence of new smokeless tobacco products

While the number of young people smoking cigarettes has dropped significantly, those who use smokeless tobacco products is on the rise largely because it is cheaper and not taxed as much. Over the past several years, the tobacco industry has created and started marketing new types of smokeless tobacco products that pose a potential threat to public health. This move by the industry is part of its continuing strategy to keep people addicted to tobacco products and encourage youth and young adults to start. These new product lines are also in response to the decrease in cigarette sales during the last decade.

The tobacco industry’s marketing of these novel smokeless tobacco products indicates they are also attempting to counteract tobacco control policies, especially laws prohibiting smoking in public places and workplaces. The industry does this by encouraging the use of dissolvable tobacco products in smoke free environments and encouraging the use of more than one type of tobacco product. During the American Cancer Society Great American Smoke-Out, R.J Reynolds ran an advertisement that encouraged smokers to switch to smokeless tobacco instead of quitting. Some of these new smokeless tobacco products, such as Snus, are available nationwide, while others, such as the dissolvable tobacco products created by R.J. Reynolds and Philip Morris are being test marketed in specific states.

Defining Smokeless Tobacco Products: Novel and Traditional

Traditional

Chew or loose-leaf chewing tobacco is processed tobacco that is placed between one’s cheek and gums. It is sometimes flavored with sugar and comes in a variety of forms. It can be formed into strips that are sold in foil pouches, pressed into a cake or plug, or the leaves can be twisted together to resemble ropes.

Snuff is a finely ground and cured form of tobacco that comes in several forms. Its moist form is typically packaged in cans and often referred to as dip. Some moist snuff comes in pouches that are placed between one’s cheeks, lips or gums. The dry form is powdery and is taken orally and inhaled.

Novel

Ariva is available as a tobacco lozenge with natural, wintergreen or java flavoring. The product Ariva comes in small pellets, looks like candy and has sweet flavoring. It has been marketed as a reduced exposure product in the past. This product is sold nationwide.

Dissolvable tobacco products come in many forms including strips, sticks and orbs. Strips are flat strips of ground tobacco. Sticks are similar to toothpicks and coated in tobacco or made of fine ground tobacco. Orbs are flavored pellets that resemble Tic-Tacs or Pez candy. These products dissolve in one’s mouth, eliminating the need to spit. They are often marketed as substitutes for cigarettes in settings where smoking is prohibited.

Snus is a form of tobacco that comes in a small pouch called a sachet. The product is placed between one’s cheek or teeth and one’s gum and also does not require spitting. Snus can also be placed between toes to supply nicotine. Snus is available nationwide.

In 2008, smokeless tobacco products totaled more than $2 billion in sales. With tobacco product sales steadily increasing, tobacco manufacturers appear to be succeeding in hooking Americans on both new and traditional forms of smokeless tobacco. Tobacco manufactures are employing market tactics that mislead the public into believing that smokeless tobacco is a safer option. They are promoting use of several types of tobacco products at once, called dual use.

Deceptive marketing tactics make novel smokeless tobacco products attractive to kids and easy to hide.

Novel Smokeless tobacco products with sweetened flavors, and cheaper prices and deceptive marketing tactics are cleverly designed and packaged to make them more attractive to youth. Parents should note, they are also easier to conceal both in carry and use than cigarettes and easily concealed. Some novel products are similar in size to M&M’s. A particular danger is that very young children will mistake these tobacco products for candy. It would be easy for a child to eat enough of these and become very sick or die of nicotine poisoning, enhancing the appeal to kids as well as young children potentially increasing their risk of nicotine poisoning from eating them.

The current choice among youth is Snus, which they can discreetly tuck under their lip. Snus curbs the craving as nicotine absorbs into the gums. Kids like it because it is not easily detected and they can stay buzzed 24/7.It turns out that Snus is no longer just for the cheek and lip. The latest craze to capitalize on the nicotine punch of the pouches is to use it not with the mouth but with the feet. There is a growing trend among high school kids of cutting slits between their toes and tucking a pouch there. The nicotine absorbs directly into the blood giving them nicotine high at school or during practice. No one is the wiser.

Chewing tobacco and other forms of smokeless tobacco are more harmful and addictive than you might think. Whether you use chewing tobacco or other types of smokeless tobacco because you like it or because you think smokeless is safer than cigarettes, be forewarned—smokeless tobacco can cause serious health problems. Chewing tobacco is a common type of smokeless tobacco. Smokeless tobacco products consist of tobacco or a tobacco blend that is chewed, sucked on or sniffed, rather than smoked, and it puts more nicotine into your bloodstream than cigarettes do.

The use of any tobacco product has both immediate and long-term effects on your health and overall being. Smokeless tobacco stains and wears down your teeth, causes your gums to recede and produces mouth sores. Bad breath is also a common problem. Over time, the use of smokeless tobacco can cause cancer of the mouth, dental problems, nicotine addiction and a debilitating and deadly cancer of the mouth and throat. Nicotine from smokeless tobacco also raises blood pressure and cholesterol levels, and can increase your risk of having a heart attack.

It is hard to quit using smokeless tobacco. Like cigarettes, smokeless tobacco contains nicotine, a very addictive substance that causes changes in the way you think and act. If you are addicted to nicotine, you crave the “buzz” you get from using smokeless tobacco, and you have to use more and more to get the effect you want. However, many smokeless tobacco users have quit successfully—and so can you. Stop using all tobacco products. Find an oral substitute for smokeless tobacco that you enjoy. This may be sugarless gum, hard candy, beef jerky or sunflower seeds. Your family doctor can help you quit.

Conclusion

There is much to be learned about the use and health risks of novel smokeless tobacco products. However, what is clear is that these products are marketed to youth and young adults, and the tobacco companies are marketing them as products that can be used in smoke free settings. In addition, the increasing availability of these types of smokeless products may have contributed to increased dual use of tobacco products. Dual use has grave implications for public health as it may mean the potential for more people, especially youth, to begin using tobacco products they mistakenly think are safe and fewer people quitting smoking. More research, education and effective oversight by the FDA is needed to ensure that these products do not addict more Americans, cause death and disease and prevent others from quitting tobacco use for good.