New ways
to ingest nicotine -- and fight it
By Josephine Marcotty
Star-Tribune
October 25, 2007
The choices for smokers used to
be so simple. There were cigarettes. And there were
cigars. Maybe an occasional pipe.
But as the tobacco industry attempts to adapt to smoking
bans, it is developing dozens of new ways for the body
to absorb nicotine -- from hookahs to snus to lozenges
to smokeless nicotine delivery systems. And, in a clear
attempt to attract younger users, they come in more
flavors than you can find at a Ben & Jerry's ice cream
store.
Public health and anti-tobacco experts are perplexed
about all those new products. Some might be a safer
alternative to cigarettes and could help smokers quit.
On the other hand, they know almost nothing about how
many carcinogens they harbor, how they're marketed, who
uses them and why.
That new terrain in the world of tobacco was sketched
Thursday by Dorothy Hatsukami, a tobacco researcher at
the University of Minnesota, for some of the
approximately 3,000 anti-tobacco experts from around the
world who are in Minneapolis this week for the National
Conference on Tobacco or Health.
"Is it a gateway drug to cigarette smoking?" she said.
"Does it help them quit smoking? We don't know."
For the first time, the National Cancer Institute has
developed an experimental fast-track research process so
scientists and public health officials can keep up with
those new products and devise their own public programs
to counter them. They said they do not want a repeat of
the public health debacle that occurred with the
introduction of low-tar cigarettes. They were marketed
as a healthier alternative, but turned out to be just as
dangerous as the full-strength variety.
Some of the new products are smokeless. There are snus
-- little pouches of tobacco that users put in their
cheeks -- and lozenges. There are also new variations on
ancient ways to smoke. Hookahs, for example, are an
ongoing trend with teenagers and young adults.
There are now hookah bars in some 33 states, said
marketing expert Barry Matthews, and they are usually
found around college campuses.
"But what's in the smoke," he said. And how does it
compare to cigarette smoking?
Even though some users believe that flavored tobacco
pulled through water is cleaner, the little analysis
that has been done doesn't show that, he said. Hookah
tobacco has more nicotine and vastly more tar than a
cigarette, Matthews said. In addition to the diseases
normally associated with tobacco, hookah smoking carries
the added risk of infectious disease from sharing the
mouthpiece, he said.
One of the most startling new trends in tobacco use has
been the sharp increase in small cigars, such as
Winchester and Swisher.
They're becoming more popular because cigars are taxed
at much lower rates, making them much less expensive.
Manufacturers are now making them -- and marketing them
-- a lot like cigarettes, but in dozens of flavors. In
2006 there were 4.5 billion sold in the United States,
the highest number ever, she said. And while that pales
in comparison to the hundreds of billions of cigarettes
that are sold, it's an alarming trend, she said.
Anti-tobacco organizers have asked the federal
government to more precisely define cigarettes and
cigars. If it agrees and clearly delineates the
difference between them, then the small-cigar market
could disappear, she said.
The newest tobacco products to arrive in the United
States are snus, often described as spitless tobacco.
Snus alarm health advocates because the tobacco
companies market them as a replacement for cigarettes in
places where people can't smoke. Camel SNUS, which are
now being test marketed in a few U.S. cities, come with
the tag line "pleasure for whenever."
Research shows that they have fewer carcinogens than
other sorts of tobacco products but just as much
nicotine, Hatsukami said. They could help people quit
smoking or it could just keep smokers addicted.
Anti-tobacco researchers are on it, however, with the
new, fast-track grant-making system at the National
Cancer Institute. Normally, it can take a year or more
before the federal government approves a research grant
and many more months before the studies are completed.
But now, even as the tobacco manufacturers are
test-marketing snus in Indianapolis, Portland, Oregon,
and on the Internet, their anti-tobacco counterparts are
shadowing them -- and presenting what they find at
conferences such as the one this week in Minneapolis.
They have even adopted an attitude about this program
that sounds more like warfare than staid scientific
research. They call it "rapid mobilization."