Smokeless cigarettes

One of the first requested potential uses of phosphate fibers was as the support body in smokeless cigarettes. There was no doubt that the product would have behaved well and would have been safe. Most of us associated with the product were not really too pleased that the fibers might be used in cigarettes of any kind. We were not displeased when the cigarette company decided not to market the cigarettes. To associate our product with yet another recognized hazard was not the kind of press we were seeking even if the product was safe and the effort noble. 

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The predominant form of smokeless tobacco in Uzbekistan is nasway, which is a mixture of dried tobacco leaves, slaked lime, ash from tree bark, and flavoring and coloring agents water is added and the mixture is rolled into balls. In 2002,41% of Uzbek men said they used cigarettes and 38% said they had used nasway less than 1% of the women used nasway. 

While gender roles and norms in some parts of the world have discouraged women from smoking, smokeless tobacco is more acceptable in some regions (e.g., Africa, India), and waterpipes in others (Middle East). Smokeless tobacco is responsible for four million deaths per year worldwide half of these are among women this is predicted to increase to 10 million deaths per year by 2030 (Christotides 2003). In contrast to India, women in the United States are much more likely to smoke cigarettes than to use smokeless tobacco. 

For all regions of India, 2.4% of women smoke and 12% chew tobacco. In Goa, 19% of women smoke, mostly bidis (4-13% in various districts) cigarette smoking was negligible. In many areas smokeless tobacco use was more common for women (27% in Goa, 35% in Kerala virtually no women smoked in Pune district in Mahrashtra, half of the women used smokeless tobacco and 39% used mishri. 

Jacob P, 3rd, Yu L, Shulgin AT, Benowitz NL (1999) Minor tobacco alkaloids as biomarkers for tobacco use comparison of users of cigarettes, smokeless tobacco, cigars, and pipes. Am J Public Health 89(5) 731-736... 

Since the late 1980s, there has been a proliferation of new potential reduced-exposure products (PREPs), promoted by the industry with the claims of reduced harm, in all the four categories that were summarized earlier (Stratton et al. 2001 Hatsukami et al. 2002, 2005). These include (a) modified tobacco products, such as several denicotinized brands and reduced TSNA emission cigarettes (b) chewing gum impregnated with tobacco (c) smokeless tobacco products with claimed reduced nitrosamine levels and (d) cigarette-like products (carbon-heated smoking devices). 

While cigarette sales in the USA declined 18%, from 21 billion packs in 2000 to 17.4 billion packs in 2007, during the same time period sales of other products, such as moist snuff, increased by 1.10 billion cigarette pack equivalents (Connolly and Alpert 2008). In the USA, the most common smokeless tobacco (ST) products are chewing tobacco (loose leaf, plug, and twist), moist snuff, and dry snuff. Many other forms of smokeless tobacco that are used globally were described in an lARC monograph (lARC 2007). All ST products contain nicotine and other tobacco alkaloids that are inherent to tobacco leaf. 

Alpert HR (2008) Manipulation of free nicotine and its dosing to target high risk groups. Paper presented at the cigarette industry s entry into the smokeless tobacco market. Harvard School of Public Health, Boston, MA, July 10, 2008... 

PhUip Morris et al. (1998) Comments before the Massachusetts Department of Public Health on proposed amendments to regulations entitled cigarette and smokeless tobacco products Reports of added constituents and nicotine ratings. October 2 1998. Massachusetts Department of Public Health. Boston, Massachusetts... 

As shown in Fig. 1, the speed of nicotine uptake in venous blood following several forms of nicotine delivery varies widely, from that of the very slow pattern of nicotine appearance in the blood (several hours to peak level) produced by current transdermal nicotine medications to the explosive rise produced by tobacco smoke inhalation. Nicotine gum, lozenge, tablet, and vapor inhaler can provide more rapid delivery of nicotine than the patch, but the speed and amount obtained are constrained by use patterns. Smokeless tobacco products deliver their nicotine more rapidly than nicotine gum and with less physical effort, but are still slower than cigarettes in their nicotine dehvery. 

The long-term use patterns of various nicotine-containing products differ by dose and form. Clearly, dependent users of cigarettes and smokeless tobacco often use these products for years prior to making a quit attempt, and often take years to successfully quit. In contrast, users of medicinal nicotine tend to use the products for a much shorter duration. For example, one study found that among 805 households that purchased lucotine gum, 2.3% of new purchase incidents led to continuous monthly purchase of gum for >6 months. For nicotine patches (2050 households). 

Nicotine Psychopharmacology Research was Pivotal in FDA s Conclusions that Cigarettes and Smokeless Tobacco are Addicting... 

Food and Drug Administration (1996) Regulations restricting the sale and distribution of cigarettes and smokeless tobacco to protect children and adolescents final rule. Fed Regist 61 44396 5318... 

A-Nitrosodiethanolamine has been detected in cigarette smoke at concentrations of 24-36 ng per cigarette, in smoking tobacco at concentrations up to 420 pg/kg, and in smokeless tobacco products (chewing tobacco, snuff) at concentrations up to 6800 pg/kg (Bruimemann Hoffrnaim, 1981 Bmnnemann et ah, 1982-1983 lARC, 1985). The presence of /V-nitrosodiethanolamine in tobacco and tobacco smoke was attributed, at least in part, to a maleic hydrazide-diethanolamine herbicidal combination commonly applied to tobacco to prevent sucker growth and levels of 7V-nitrosodiethanolamine have declined (< 100 ppb) in some tobaccos since the herbicide was phased out (Brunnemann Hoffmaim, 1991)... 

In the past decade. Ecstasy use has exploded. In fact, although overall illicit drug use by teens markedly decreased in the past several years — including use of marijuana, inhalants, hallucinogens, LSD, cocaine, crack, heroin, tranquilizers, alcohol, cigarettes, and smokeless tobacco — Ecstasy use continued to rise, unabated (Figure 5.1). 

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