Melanie Reynolds, Public Health | Posted: Wednesday, June 15, 2011 12:00 am
You’ve gotta give the tobacco industry credit: It’s innovative and persistent. Unfortunately, it’s devious, too.
With the success of public health efforts to discourage smoking, tobacco manufacturers — always eager to hook new customers — are developing smokeless and spitless products that can provide addicts with their nicotine fix even where smoking is banned.
The latest group of novel tobacco products isn’t yet readily available in Montana, but you may have seen them advertised in popular magazines. Disturbingly, they come in forms, flavors and packages that are hard to distinguish from candy or breath fresheners. Here are some of the products that may be coming soon to a convenience store near you:
Orbs: Small pellets that look a lot like breath mints. Made from finely milled tobacco, they dissolve in the mouth within a few minutes. They come in sweet “Mellow” and minty “Fresh.”
Sticks: Nicotine-laced tobacco sticks about the size of a toothpick. They dissolve in the mouth in about five to 20 minutes and deliver almost three times as much nicotine as a cigarette.
Strips: Look and feel like dissolvable breath strips but are made of tobacco.
Snus: A spitless modification of chew, snuff and other smokeless tobacco. Snus (pronounced “snoose”) comes in small teabag-like pouches to be placed between the lip and gum. The harsh flavor of tobacco is masked by flavors like “Frost,” “Mellow,” “Winterchill” and “Peppermint.”
Sound enticing, don’t they? The tobacco companies sure hope so.
What’s the harm?
While these products don’t produce the cancer-causing smoke that cigarettes do, that doesn’t mean they’re harmless. Many are so new that their full impacts on health have yet to be scientifically established.
Still, all of them contain nicotine, the highly addictive substance that makes cigarettes so hard to quit. By itself, nicotine can raise cholesterol rates, increase blood pressure, and accelerate or aggravate heart disease. It also can cause reproductive disorders.
Because the nicotine in these products is in a form more rapidly absorbed in the mouth, it may be even more toxic than the nicotine contained in cigarettes. A researcher with the Harvard School of Public Health has estimated that the nicotine in 10 to 17 orbs could kill an infant. Obviously, they create a serious threat of accidental poisoning among children.
“Nicotine is a highly addictive drug,” the Harvard official told The New York Times, “and to make it look like a piece of candy is recklessly playing with the health of children.”
Physicians with the Center for Tobacco Products at the U.S. Food and Drug Administration have also expressed concern that “the candy-like appearance, added flavors, and easily concealable size of many of these products may be particularly appealing to children and adolescents.”
Potential gateway drug
Perhaps the biggest threat from these novel tobacco products may prove to be their “gateway effect,” the craving they create for cigarettes.
The Campaign for Tobacco-Free Kids has warned that “smokeless tobacco use during youth can lead to a lifetime of addiction to smokeless tobacco or, frequently, to cigarettes, as the nicotine addiction created by smokeless use ultimately leads to habitual smoking.”
The group cited a 2010 study that found that adolescent boys who use smokeless tobacco products have a higher risk of becoming cigarette smokers within four years.
The Campaign also fears that the novel tobacco products will lead to increased tobacco use in current smokers, relapse in former smokers and initiation in those who never smoked, as well as “dual use” of both cigarettes and smokeless products.
The U.S. Surgeon General, too, has expressed concern about the new tobacco products.
“Products designed or marketed to be used in places where smoking is not allowed may defeat public health efforts to reduce smoking rates,” he said in a 2010 report. “The overall health of the public could be harmed if the introduction of novel tobacco products encourages tobacco use among people who would otherwise be unlikely to use a tobacco product or delays cessation among persons who would otherwise quit using tobacco altogether.”
A dangerous gamble
Because of their novel configuration, packaging and flavoring, Congress has asked the Food and Drug Administration to fast-track its research into these dissolvable products. Depending on the outcome of the review, the FDA could require the tobacco industry to change the products or pull them from the shelves.
Until we know more about their impacts on individual and public health, novel tobacco products seem like a dangerous gamble, especially among young people who are the most vulnerable to nicotine addiction.
We in public health recommend avoiding all tobacco products, and we support efforts to determine how these new products affect health and health behaviors.
If you already use tobacco products, the healthiest choice is to quit. Help is available from the toll-free Montana Tobacco Quit Line, 1-800-QUIT-NOW. To learn more about the services offered by the quit line, visit http://tobaccofree.mt.gov/quitlinefactsheet
.shtml.
More information about tobacco use prevention and cessation is also available on the health department website atwww.lewisandclarkhealth.org. Click on Community and Family Health in the left navigation menu.
Melanie Reynolds is the health officer at the Lewis and Clark City-County Health Department. The mission of the Health Department is to improve and protect the health of all Lewis and Clark County residents.