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Wednesday, June 15, 2011

Beware Of Cigarettes In Sheep's Clothing


You've gotta give the cigarettes industry credit: It's innovative and persistent. Unfortunately, it's devious, too.

With the success of public health efforts to discourage smoking cigarettes, discount cigarettes manufacturers � always eager to hook new customers � are developing smokeless and spitless products that can provide addicts with their nicotine fix even where smoking cigarettes is banned.

The latest group of novel discount cigarettes 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 cigarettes, they dissolve in the mouth within a few minutes. They come in sweet "Mellow" and minty "Fresh."

Sticks: Nicotine-laced cigarettes online 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 cigarettes.

Snus: A spitless modification of chew, snuff and other smokeless cigarettes. Snus (pronounced "snoose") comes in small teabag-like pouches to be placed between the lip and gum. The harsh flavor of buy cigarettes is masked by flavors like "Frost," "Mellow," "Winterchill" and "Peppermint."

Sound enticing, don't they? The cheap cigarettes companies sure hope so.

What's the harm?

While these products don't produce the cancer-causing smoke cigarettes that online 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 cheap 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 cigarettes 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 cigarettes products may prove to be their "gateway effect," the craving they create for cigarettes.

The Campaign for cigarettes-Free Kids has warned that "smokeless cigarettes use during youth can lead to a lifetime of addiction to smokeless cigarettes or, frequently, to cigarettes, as the nicotine addiction created by smokeless use ultimately leads to habitual smoking cigarettes."

The group cited a 2010 study that found that adolescent boys who use smokeless cigarettes products have a higher risk of becoming cigarette smokers within four years.

The Campaign also fears that the novel cigarettes products will lead to increased cigarettes 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 cigarettes products.

"Products designed or marketed to be used in places where smoking cigarettes is not allowed may defeat public health efforts to reduce smoking cigarettes rates," he said in a 2010 report. "The overall health of the public could be harmed if the introduction of novel cigarettes products encourages cigarettes use among people who would otherwise be unlikely to use a cigarettes product or delays cessation among persons who would otherwise quit using cigarettes 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 cigarettes industry to change the products or pull them from the shelves.

Until we know more about their impacts on individual and public health, novel cigarettes 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 cigarettes products, and we support efforts to determine how these new products affect health and health behaviors.

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