nicotine

The danger in smokeless tobacco products

Source: www.observer.ug (Uganda, Africa)
Author: Racheal Ninsiima

Tobacco use is the single most preventable cause of death among adults and is a significant factor for several mouth, throat, lung and heart diseases.

It is also a major contributor to morbidity. Globally, the World Health Organisation (WHO) estimates that tobacco causes about 71% of lung cancer, 42% of chronic respiratory diseases, 20% of global tuberculosis incidence and nearly 10% of cardiovascular diseases. But the issue of smokeless products that contain tobacco has for long been ignored.

According to Dr Sheila Ndyanabangi, the tobacco control focal point person at the ministry of Health, schoolchildren are also consuming the products. This is because sometimes the ingredients are written in foreign languages which may not be understood by the consumers.

What is smokeless tobacco?
There are two basic forms of smokeless tobacco: snuff and chewing tobacco. An article ‘smokeless tobacco and how to quit’ on the website www.cancer.org, says snuff is finely ground tobacco packaged in cans and is sold either dry or moist. The nicotine in the snuff is absorbed through the tissues of the mouth as it is placed between the cheek and gum.

Snuff is designed to be both “Smoke-free” and “spit-free” and is marketed as a discreet way to use tobacco. Chewed tobacco comes along as long strands of tobacco leaves that are chewed by the user who thereafter spits out the brown liquid (saliva mixed with tobacco).

Types of smokeless tobacco
Mouth fresheners:
The commonest is Kuber. It is a highly addictive tobacco drug disguised as a mouth freshener and packed in sachets similar to tea leaves. Kuber may be added to tea or simply licked. According to Dr Ndyanabangi, Kuber, rich in nicotine, is widely consumed by secondary school students and taxi drivers.

Results of a research conducted by the Uganda Youth Development Link (UYDEL) in 2011 revealed that Kuber also contains drugs like cocaine and marijuana which may lead to hormonal change, impaired brain development, mental health disorders and heart problems.
Kuber is often chewed with mairungi leaves, sucked or taken with hot water as a beverage resulting in a drowsy feeling. Kuber is sold in shops and supermarkets.

Chocolate:
Many people value chocolate as a delicacy. However, tobacco is one of the sweeteners added to some brands of chocolate, especially dark chocolate. Among the ingredients are: cocoa, sugar, cocoa butter, tobacco, soya lecithin, milk and gluten.

Menthol products:
Dr Ndyanabangi says people ought to be careful with menthol products such as toothpaste, mouthwash and gum; they may also contain tobacco. In some, menthol is used as a sweetener to make them useable and disguise the smell of tobacco. Other products include nicotine lollipops, wafers and water. Currently in the US, tablets are being investigated for any form of tobacco.

Nevertheless, the fact still stands; smokeless tobacco is as lethal as cigars. Dr Prossy Mugyenyi, the manager at the Centre for Tobacco Control in Africa (CTCA), says the tobacco in these smokeless products acts as a receptor and the person keeps demanding more and more.

“Just like a person becomes addicted to smoking and becomes a chain smoker, so do these smokeless products make one addictive to the tar and nicotine in them,” Mugyenyi says.

No safe tobacco
According to Dr Jackson Orem, head of the Uganda Cancer Institute, there is no safe form of tobacco and at least 28 chemicals in smokeless tobacco have been found to cause cancer. Smokeless tobacco products raise the incidence of cancer, especially oral cancers like mouth, tongue and throat.

In addition, Mugyenyi says excessive exposure of one’s body to tobacco increases the risk of heart disease, stroke, teeth loss, gum disease and aneurysm (abnormal widening of a portion of an artery due to weakness in the wall of the blood vessel). However, despite the prevalent risk, Uganda does not have a comprehensive tobacco control law. The WHO Framework Convention on Tobacco Control (FTCT) to which Uganda has been signatory since 2003 is not enforced.

“There is a lot of illicit trade in the tobacco industry and the fines of Shs 20,000 to Shs 30,000 stipulated in the statutory instrument of 2004 to ban smoking in public places are not punitive enough and neither are they being enforced,” Ndyanabangi says.

Tobacco use and baseball

Source: www.quitsmokingforyou.com

Like cigarettes, smokeless tobacco (snuff and chewing tobacco), cause mouth cancer, gum disease, and heart disease. Yet many think that chewing tobacco is safe or less so than smoking. This is not true!

In 1986, the Surgeon normal closed that the use of smokeless tobacco “is not a safe substitute for smoking cigarettes. It can cause cancer and a whole of noncancerous conditions and can lead to nicotine addiction and dependence.” Since 1991, the National Cancer institute (Nci) has officially recommended that the group avoid and desist the use of all tobacco products, including smokeless tobacco. Nci also recognizes that nitrosamines, found in tobacco products, are not safe at any level.
Chewing tobacco and baseball have a long tight affiliation, rooted in the cultural confidence among players and fans that baseball players chew tobacco and it is just part of the grand old game. This mystique is slowing changing with campaigns by ballplayers who have had or have seen friends with mouth cancer caused by chewing tobacco use.

Jeff Bagwell
Jeff Bagwell, retired first baseman with the Houston Astros and Joe Garagiola, a previous baseball player and commentator, campaign against tobacco use among children and addicted adults. In 1993, when Bagwell was 25-years-old, his dentist discovered leukoplakia, a whitish pre-cancerous sore in his mouth where he continually located chewing tobacco. About 5% of leukoplakias institute into cancer. Fortunately this did not happen to Jeff Bagwell due to the early detection by his dentist.

Rick Bender, The Man Without a Face
In 1988 Rick Bender, a 25 year old minor league baseball player advanced a large sore on the side of his tongue that would not go away for months. He began using ‘spitting tobacco’ when he was 12. After finding his dentist and then a biopsy by a specialist, he was diagnosed with mouth cancer.

Surgeons successfully removed the cancerous cells from Bender’s mouth and throat, taking a chunk of his tongue and the lymph nodes on the right side of his neck in the process. But removing the cancer also caused nerve damage that puny the use of his right arm, his throwing arm, which ended his baseball career. Later an infection occurred to the right side of Bender’s jaw after radiation therapy. As a result, it deteriorated and doctors had to remove his right jaw.

As a follow Rick Bender calls himself “the man without a face” and lectures on the dangers of ‘spitting tobacco’ throughout the nation. Bender visits schools and colleges over the country to dispel what he sees as the myths about chewing tobacco. He also addresses major and minor league baseball players each year at spring training.

Robert Leslie
Sonoma County has it own tragic baseball related, smokeless tobacco, and mouth cancer story. In June of 1998, Robert Leslie died at the young age of 31 from mouth cancer after years of chewing smokeless tobacco. He had been diagnosed four years prior and had bravely counseled youths against the use of smokeless tobacco after that point. Leslie, who was a star pitcher at Rancho Cotate High School, turned to coaching after a brief attempt at playing expert baseball. He was a popular coach at Casa Grande High School. He believed, rightly so, that the cancer had resulted from years of stuffing wads of smokeless tobacco between his gums and lower lip. He advocated against the use of chewing tobacco prior to his death. He is missed.

History Of Tobacco Use and Baseball
Tobacco has a long association with baseball. From the earlier beginnings of baseball in the late 1800′s, baseball players chewed tobacco to keep their mouths moist in dusty dirt parks of that era. Drinking water was thought to make one feel too heavy. Players also used tobacco spit to soften leather gloves and to give the spitball its wild gyrations canada viagra.

Chewing tobacco’s popularity among baseball players rose and fell with the times, most often trading places with cigarettes and cigars. The wrongful confidence that chewing tobacco caused the spread of tuberculosis lead to its reduction in use during the end of the nineteenth century. during the beginning of the twentieth century, it again rose to major use until after Wwii when cigarettes became more popular in the U.S.

During the 1950s, cigarettes reached their most prominence when teams legitimately had sponsored brands. For example, Giant’s fans (New York Giants that is) smoked only Chesterfield Cigarettes to show their team loyalty. during this era, baseball cards were often packaged with cigarettes. As a kid, I remember having my Dad buy Lucky Strikes so I could get the baseball cards.

In 1962, the Surgeon General’s record highlighted the cause and follow between smoking and heart disease and smoking and cancer. Believing that chewing tobacco was a safer product, baseball players took up smokeless tobacco again. Since then, smokeless tobacco has dominated the sport of baseball, from the major leagues down to the high school level. And similar to the targeted cigarette marketing of the 1950s, smokeless tobacco producers have promoted tobacco chewing straight through baseball players, even providing free samples in major and minor league clubhouses.

All tobacco, including smokeless tobacco, contains nicotine, which is addictive. The whole of nicotine absorbed from smokeless tobacco is 3 to 4 times the whole delivered by a cigarette. Nicotine is absorbed more slowly from smokeless tobacco than from cigarettes, but more nicotine per dose is absorbed from smokeless tobacco than from cigarettes. Also, the nicotine stays in the bloodstream for a longer time.

By giving players free samples of chew tobacco, the smokeless tobacco manufacturers were getting players hooked to the addictive drug nicotine in a tobacco goods that contains 28 cancer-causing substances. Even today, I saw a full-page magazine ad from R.J. Reynolds Tobacco Co. With a free coupon for Camel Snus. It was advertised as “Spitfree” and “Sold Cold” in large bold print, while in small print a warning stated, “this goods may cause gum disease and tooth loss.”

Big League Chew, a chewing gum aimed at children, is a goods that uses the deep association between baseball and chewing tobacco. Introduced in 1980, Big League Chew consists of shredded bubble gum, which resembles loose chewing tobacco. It is packaged in an aluminum foil pouch, similar to the containers of chewing tobacco, with the cartoon image of a baseball player on the outside. While candy cigarettes, other symbolic tobacco goods aimed at children, fell out of favor years ago, Big League Chew continues to be popular with kids.

Luckily, the love affair between baseball and smokeless tobacco seems to be subsiding. In 1993, minor league baseball banned all use of tobacco products among its teams. As follow fewer major leaguers are now coming up from those ranks using tobacco products. Campaigns are manufacture headway discouraging tobacco use and encouraging substitute habits like chewing gum or munching on sunflower seeds. Remember previous Giants employer Dusty Baker, setting an example for young players by stopping tobacco use and chewing sunflower seeds in the dugout?

Still an estimated 7.6 million Americans age 12 and older (3.4 percent) have used smokeless tobacco in the past month, and smokeless tobacco use is most common among young adults ages 18 to 25.

So if you use tobacco, please stop. It is the best thing you can do for your health. There are many tobacco cessation programs and nicotine change treatments. And make sure to have regular cancer screening examinations with your dentist. Early detection is indispensable for preventing mouth cancer.

Exposure to Nicotine and Carcinogens among South Western Alaskan Native Cigarette Smokers and Smokeless Tobacco User

Source: AACR Journals

Background Prevalence of tobacco use, both cigarette smoking and smokeless, including iqmik (homemade smokeless tobacco prepared with dried tobacco leaves mixed with alkaline ash), and tobacco-related cancer is high in Alaska Native people (AN). To investigate possible mechanisms of increased cancer risk we studied levels of nicotine and tobacco-specific nitrosamines (TSNA) in tobacco products and biomarkers of tobacco toxicant exposure in South Western AN people. Methods Participants included 163 cigarette smokers (CS), 76 commercial smokeless tobacco (ST), 20 iqmik, 31 dual CS and ST (DT) and 110 non-tobacco (NT) users. Tobacco use history, samples of tobacco products used and blood and urine samples were collected. Results Nicotine concentrations were highest in cigarette tobacco and TSNAs highest in commercial ST products. AN participants smoked on average 7.8 cigarettes per day (CPD). Nicotine exposure, assessed by several biomarker measures, was highest in iqmik users, and similar in ST and CS. TSNA exposure was highest in ST users, and polycyclic aromatic hydrocarbon exposure highest in CS. Conclusions Despite smoking fewer CPD, AN CS had similar daily intake of nicotine compared to the general US population. Nicotine exposure was greatest from iqmik, likely related to high pH due to preparation with ash suggesting high addiction potential compared to other ST products. TSNA exposure was much higher with ST compared to other product use, possibly contributing to high rates of oral cancer. Impact Our data help understanding high addiction risk of iqmik use and cancer-causing potential of various forms of tobacco use among AN people.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

April, 2012|Oral Cancer News|

Dentists key to quitting ‘smokeless tobacco’

Source: http://www.dentistry.co.uk/

The National Institute for Health and Clinical Excellence (NICE) is recommending a key role for dental professionals in their public health intervention proposals to help stop the use of smokeless tobacco by people of South Asian Origin.

Dentists, dental nurses and dental hygienists may be asked to play a leading role as part of new proposals to stop the use of smokeless tobacco in the UK.

NICE has published a consultation on their proposals, which recommends a key intervention and education role for dental professionals.

It is also recommending more training for dental professionals to help them gain a greater understanding of smokeless tobacco including terminology, symptoms and approaches to successful intervention.

Smokeless tobacco is associated with a number of health problems including nicotine addiction, mouth and oral cancer, periodontal disease, heart attacks and strokes, problems in pregnancy and following childbirth and late diagnosis of dental problems as smokeless tobacco products can often mask pain.

Smokeless tobacco is mainly used by ‘people of South Asian origin’, which includes people with ancestral links to Bangladesh, India, Nepal, Pakistan or Sri Lanka.

The draft guidance recommends that dental professionals take specific actions including:
• Asking patients about their smokeless tobacco use and record the outcome in their patient notes
• Making users aware of the potential health risks and advise them to stop, using a brief intervention
• Referring users who want to quit the habit to tobacco cessation services that use counsellors trained in behavioural support
• Recording the person’s response to any attempts to encourage or help them to stop using smokeless tobacco in the patient notes.

Chief executive of the British Dental Health Foundation, Dr Nigel Carter, said: ‘Smokeless tobacco is a little known area for many health professionals in the UK so the current draft public health guidance is a positive step to bring greater knowledge and understanding.

‘The evidence that does exist indicates that South Asian women – the main users of smokeless tobacco – are approaching four times more likely to suffer from mouth cancer. Quite rightly, dental professionals have been identified as major players to help reduce these risks and prevent the serious health conditions caused by smokeless tobacco.

‘The British Dental Health Foundation supports NICE’s draft proposals and encourages all dental professionals to include the intervention of smokeless tobacco usage as part of their continuing professional development.’

March, 2012|Oral Cancer News|

“Through With Chew 2012”

Source: LeaderAdvisor.com

“Through With Chew 2012” is designed to raise awareness about the variety of new smokeless tobacco products (SLT), dangerous especially to young people, not only because the amount of nicotine absorbed from these products is substantially higher than the amount absorbed from a cigarette, but also because of the aggressive marketing of these new products by the tobacco companies. Some of the latest tobacco industry innovations include tobacco dispensed in oral pouches, dissolvable tobacco (orbs) and the electronic cigarette.

Aggressive marketing includes the fact that the five largest tobacco manufacturers spent $547.9 million on SLT advertising and promotions in 2008, up from the previous year by 34 percent (www.cdc.gov). A goal of the education campaign this year is to educate parents, teachers, administrators and coaches about these new products, that the packaging often resembles candy packaging, and that they are actually tobacco-containing products.

Tobacco industry documents themselves indicate that SLT products are aggressively marketed toward youth, and that the industry has a strategy to progressively move youth from candy or fruit flavored products to more robust varieties for the nicotine dependent user (www.tobaccofreekids.org).

Because so many people die per year due to tobacco-related illness, the tobacco companies need to find replacement users for their products. Tobacco use, no matter what form, remains the leading cause of death in this country annually. Just as in cigarettes, the leading cancer-causing agents in SLT are the tobacco-specific nitrosamines, which are formed during the growing, curing, fermenting and aging of tobacco leaves.

They increase the risk of developing cancer of the mouth, throat, esophagus and pancreas (www.cancer.org). This statewide, educational campaign is sponsored by the Montana Tobacco Use Prevention Program (MTUPP) and the local Lake County Health Department’s Tobacco Prevention Program here in Polson.

Smokeless tobacco is also strongly associated with leukoplakia — a precancerous lesion of the soft tissue of the mouth that consists of a white patch or plaque that cannot be scraped off. Smokeless tobacco use can cause recession of the gums, gum disease and tooth decay, and this is largely due to the fact that it contains high amounts of sugar, used as a preservative. If you are a diabetic and a tobacco user, you greatly increase the risk of circulatory problems compounded by the effects of nicotine – constriction of blood vessels and faster heart rate.

Tobacco addiction doesn’t have to be dealt with alone, however. By calling the Montana Tobacco Quit Line at 1-800-QUIT-NOW, you can find out how counselors, nicotine replacement therapy and discounted medications can help you take control of your life. While we’ve known for 50 years that tobacco is killing us – millions of people have quit using, and there are now more ex-users in America than there are tobacco addicts.

“Through With Chew and All that’s New,” Feb. 20-24, is designed to raise awareness about spit tobacco and the variety of other dangerous nicotine-containing products on the market. And, it is not just cancer that these products cause; it is also the damage to your heart and blood vessels that impairs circulation that makes you vulnerable to all manner of dangerous and debilitating ailments.

Be aware of industry targeting, especially to youth, and the destructive power of nicotine addiction that has been harnessed for enormous corporate profits over the past four to five decades.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

February, 2012|Oral Cancer News|

Emerging indications: antioxidants for periodontal disease

Source: http://www.dentistryiq.com
Author: Edward P. Allen, DDS, PhD

Since approximately 10 to 15 percent of adults worldwide suffer from periodontitis at one time or another(1), oral health professionals are constantly challenged with treating patients for existing conditions and helping them prevent future occurrences. Root planing, scaling, and in severe cases, surgical intervention are part of the standard treatment for periodontitis, and antibiotics are used for infection control.

However, in recent years, dental health professionals have honed in on the inflammation that accompanies periodontitis. Research shows that inflammation in the oral tissues—especially that associated with periodontitis—can be a factor in chronic illness such as heart and vascular disease, diabetes, arthritis, Alzheimer’s, pregnancy complications, and a growing list of other conditions.

The real culprit with inflammation is oxidative stress, a disturbance in the balance of oxidants and antioxidants. Oxidative stress is the result of overproduction of free radicals, unstable molecules that attack tissue cells by “stealing” electrons from other molecules.

Although infection is a major trigger for inflammation and oxidative stress, there are numerous other causes, such as poor diet, alcohol consumption and nicotine use or chemical pollutants. In oral tissues oxidative stress can result from dental procedures and from materials used for bleaching, composite fillings, implants, crowns, veneers, and so on.

Antibiotics control the micro-organisms that contribute to periodontitis and other infection, but they do not necessarily address the free radicals and oxidative stress that accompany inflammation.

Innate defense through natural salivary antibiotics and antioxidants
The human body has an innate defense system that combats oral inflammation: saliva. Saliva contains natural antibacterial compounds that defend against bacteria and other micro-organisms. Saliva also contains natural antioxidants that have been shown to neutralize free radicals contributing to oxidative stress and inflammation.

Several recent scientific articles have explored salivary antioxidants and their role in oral health, including periodontal disease, OLP, and even cancer.(2,3,4,5) There is a growing consensus that administration of local therapeutic agents (i.e., antioxidants) to the oral cavity should be considered.(6)

Topical antioxidants for inflammation control
Many dental health professionals have begun to augment the natural salivary antioxidants with topical application of antioxidants. A suite of products, AO ProVantage, from Dallas-based PerioSciences, LLC (www.periosciences.com), contain antioxidants, including phloretin and ferulic acid, that are applied directly to the gums. The products are distributed through professional dental offices and are best used as part of a comprehensive oral hygiene program.

In the early 1990s, compounds of phloretin and ferulic acid were clinically proven to counteract free radicals that caused damage in skin cells. More recently, scientists at Texas A&M University Baylor College of Dentistry have shown that specific concentrations and combinations of phloretin and ferulic acid are highly effective at neutralizing free radicals in oral cells that are caused by nicotine, alcohol, and hydrogen peroxide—some of the most common toxins introduced to the oral cavity. Additional studies indicate that combinations of phloretin and ferulic acid may actually promote cell proliferation and healing in oral cells.(7)

Treating periodontal disease will continue to depend on antibiotics for micro-organisms. And now, augmenting natural salivary antioxidants with topical antioxidants on oral tissues shows promise in reducing free radicals, oxidative stress and oral inflammation. In the fight against periodontitis and other oral inflammation, topical antioxidants are taking their place next to antibiotics.

References:
1. Brown, L.J., and Loe, H. Prevalence, extent, severity and progression of periodontal disease. Periodontology 2000; 2, 57-71.

2. Sculley DV, et al. Salivary antioxidants and periodontal disease status, Proceedings of the Nutrition Society 2002; 6:137-143.

3. Battino M, et al. The antioxidant capacity of saliva. Journal of Clinical Periodontology 2002; 29:189-194.

4. Miricescu D, et al. The antioxidant potential of saliva: Clinical significance in oral diseases. Therapeutics, Pharmacology and Clinical Toxicology 2011; 15 2:1-5.

5. Gupta A, et al. Lipid peroxidation and antioxidant status in head and neck squamous cell carcinoma patients. Oxidative Medicine and Cellular Longevity, April-June 2009.

6. Hershkovich O, et al. Age-related changes in salivary antioxidant profile: Possible implications for oral cancer. The Journals of Gerontology 2007; 62A 4:361-366.

7. San Miguel SM, et al. Bioactive antioxidant mixtures promote proliferation and migration on human oral fibroblasts. Archives of Oral Biology 2011; doi:10.1015/jarchoralbil.2011.01.001.

January, 2012|Oral Cancer News|

E-Cigarette Controversy

Source: The New York Times

If you want a truly frustrating job in public health, try getting people to stop smoking. Even when researchers combine counseling and encouragement with nicotine patches and gum, few smokers quit.

Recently, though, experimenters in Italy had more success by doing less. A team led by Riccardo Polosa of the University of Catania recruited 40 hard-core smokers — ones who had turned down a free spot in a smoking-cessation program — and simply gave them a gadget already available in stores for $50. This electronic cigarette, or e-cigarette, contains a small reservoir of liquid nicotine solution that is vaporized to form an aerosol mist.

The user “vapes,” or puffs on the vapor, to get a hit of the addictive nicotine (and the familiar sensation of bringing a cigarette to one’s mouth) without the noxious substances found in cigarette smoke.

After six months, more than half the subjects in Dr. Polosa’s experiment had cut their regular cigarette consumption by at least 50 percent. Nearly a quarter had stopped altogether. Though this was just a small pilot study, the results fit with other encouraging evidence and bolster hopes that these e-cigarettes could be the most effective tool yet for reducing the global death toll from smoking.

But there’s a powerful group working against this innovation — and it’s not Big Tobacco. It’s a coalition of government officials and antismoking groups who have been warning about the dangers of e-cigarettes and trying to ban their sale.

The controversy is part of a long-running philosophical debate about public health policy, but with an odd role reversal. In the past, conservatives have leaned toward “abstinence only” policies for dealing with problems like teenage pregnancy and heroin addiction, while liberals have been open to “harm reduction” strategies like encouraging birth control and dispensing methadone.

When it comes to nicotine, though, the abstinence forces tend to be more liberal, including Democratic officials at the state and national level who have been trying to stop the sale of e-cigarettes and ban their use in smoke-free places. They’ve argued that smokers who want an alternative source of nicotine should use only thoroughly tested products like Nicorette gum and prescription patches — and use them only briefly, as a way to get off nicotine altogether.

The Food and Drug Administration tried to stop the sale of e-cigarettes by treating them as a “drug delivery device” that could not be marketed until its safety and efficacy could be demonstrated in clinical trials. The agency was backed by the American Cancer Society, the American Heart Association, Action on Smoking and Health, and the Center for Tobacco-Free Kids.

The prohibitionists lost that battle last year, when the F.D.A. was overruled in court, but they’ve continued the fight by publicizing the supposed perils of e-cigarettes. They argue that the devices, like smokeless tobacco, reduce the incentive for people to quit nicotine and could also be a “gateway” for young people and nonsmokers to become nicotine addicts. And they cite an F.D.A. warning that several chemicals in the vapor of e-cigarettes may be “harmful” and “toxic.” But the agency has never presented evidence that the trace amounts actually cause any harm, and it has neglected to mention that similar traces of these chemicals have been found in other F.D.A.-approved products, including nicotine patches and gum. The agency’s methodology and warnings have been lambasted in scientific journals by Dr. Polosa and other researchers, including Brad Rodu, a professor of medicine at the University of Louisville in Kentucky.

Writing in Harm Reduction Journal this year, Dr. Rodu concludes that the F.D.A.’s results “are highly unlikely to have any possible significance to users” because it detected chemicals at “about one million times lower concentrations than are conceivably related to human health.” His conclusion is shared by Michael Siegel, a professor at the Boston University School of Public Health.

“It boggles my mind why there is a bias against e-cigarettes among antismoking groups,” Dr. Siegel said. He added that it made no sense to fret about hypothetical risks from minuscule levels of several chemicals in e-cigarettes when the alternative is known to be deadly: cigarettes containing thousands of chemicals, including dozens of carcinogens and hundreds of toxins.

Both sides in the debate agree that e-cigarettes should be studied more thoroughly and subjected to tighter regulation, including quality-control standards and a ban on sales to minors. But the harm-reduction side, which includes the American Association of Public Health Physicians and the American Council on Science and Health, sees no reason to prevent adults from using e-cigarettes. In Britain, the Royal College of Physicians has denounced “irrational and immoral” regulations inhibiting the introduction of safer nicotine-delivery devices.

“Nicotine itself is not especially hazardous,” the British medical society concluded in 2007. “If nicotine could be provided in a form that is acceptable and effective as a cigarette substitute, millions of lives could be saved.”

The number of Americans trying e-cigarettes quadrupled from 2009 to 2010, according to the Centers for Disease Control. Its survey last year found that 1.2 percent of adults, or close to three million people, reported using them in the previous month.

“E-cigarettes could replace much or most of cigarette consumption in the U.S. in the next decade,” said William T. Godshall, the executive director of Smokefree Pennsylvania. His group has previously campaigned for higher cigarette taxes, smoke-free public places and graphic warnings on cigarette packs, but he now finds himself at odds with many of his former allies over the question of e-cigarettes.

“There is no evidence that e-cigarettes have ever harmed anyone, or that youths or nonsmokers have begun using the products,” Mr. Godshall said. On a scale of harm from 1 to 100, where nicotine gums and lozenges are 1 and cigarettes are 100, he estimated that e-cigarettes are no higher than 2.

If millions of people switch from smoking to vaping, it would be a challenge to conventional wisdom about the antismoking movement. The decline in smoking is commonly attributed to paternalistic and prohibitionist social policies, and it’s ritually invoked as a justification for crackdowns on other products — trans fats, salt, soft drinks, Quarter Pounders.

But the sharpest decline in smoking rates in the United States occurred in the decades before 1990, when public health experts concentrated on simply educating people about the risks. The decline has been slower the past two decades despite increasingly elaborate smoking-cessation programs and increasingly coercive tactics: punitive taxes; limits on marketing and advertising; smoking bans in offices, restaurants and just about every other kind of public space.

Some 50 million Americans continue to smoke, and it’s not because they’re too stupid to realize it’s dangerous. They go on smoking in part because of a fact that the prohibitionists are loath to recognize: Nicotine is a drug with benefits. It has been linked by researchers (and smokers) to reduced anxiety and stress, lower weight, faster reaction time and improved concentration.

“It’s time to be honest with the 50 million Americans, and hundreds of millions around the world, who use tobacco,” Dr. Rodu writes. “The benefits they get from tobacco are very real, not imaginary or just the periodic elimination of withdrawal.

“It’s time to abandon the myth that tobacco is devoid of benefits, and to focus on how we can help smokers continue to derive those benefits with a safer delivery system.”

As a former addict myself — I smoked long ago, and was hooked on Nicorette gum for a few years — I can appreciate why the prohibitionists fear nicotine’s appeal. I agree that abstinence is the best policy. Yet it’s obviously not working for lots of people. No one knows exactly what long-term benefits they’d gain from e-cigarettes, but we can say one thing with confidence: Every time they light up a tobacco cigarette, they’d be better off vaping.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

November, 2011|Oral Cancer News|

Monitoring Tobacco-Specific N-Nitrosamines and Nicotine in Novel Marlboro and Camel Smokeless Tobacco Products: Findings From Round 1 of the New Product Watch

Source: OxfordJournals.org

Abstract

Introduction: Information on chemical composition of the new oral “spitless” smokeless tobacco products is scarce, and it is not clear whether there is some variability as a function of purchase place or time due to either unintended or intended manufacturing variations or other conditions.

Methods: We analyzed tobacco-specific N-nitrosamines (TSNA) and nicotine in Marlboro Snus, Camel Snus, and dissolvable Camel products Orbs, Sticks, and Strips that were purchased in various regions of the country during the summer of 2010.

Results: A total of 117 samples were received from different states representing six regions of the country. Levels of unprotonated nicotine in Marlboro Snus and Camel Snus varied significantly by regions, with the differences between the highest and the lowest average regional levels being relatively small in Marlboro Snus (∼1.3-fold) and large in Camel Snus (∼3-fold). Some regional variations in TSNA levels were also observed. Overall, Camel Snus had significantly higher TSNA levels than Marlboro Snus, and Camel Strips had the lowest TSNA levels among all novel products analyzed here. The amount of unprotonated nicotine in the dissolvable Camel products was comparable to the levels found in Marlboro Snus.

Conclusions: Our study demonstrates some regional variations in the levels of nicotine and TSNA in Marlboro and Camel novel smokeless tobacco products. Continued monitoring of this category of products is needed as the existing products are being test marketed and modified, and new products are being introduced. This information is particularly important given its relevance to Food and Drug Administration regulation of tobacco products.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

October, 2011|Oral Cancer News|

Kentucky Cancer Center Urges Smokers to Switch to Smoke-Free Tobacco. But is it Really a Better Option?

Source: Yourlife.USAtoday.com

In the smoker-heavy state of Kentucky, a cancer center is suggesting something that most health experts won’t and the tobacco industry can’t: If you really want to quit, switch to smoke-free tobacco.

The James Graham Brown Cancer Center and the University of Louisville are aiming their “Switch and Quit” campaign at the city of Owensboro. It uses print, radio, billboard and other advertising to urge smokers to swap their cigarettes for smokeless tobacco and other products that do not deliver nicotine by smoke.

Supporters say smokers who switch are more likely to give up cigarettes than those who use other methods such as nicotine patches, and that smokeless tobacco carries less risk of disease than cigarettes do.

“We need something that works better than what we have,” said Dr. Donald Miller, an oncologist and director of the James Graham Brown Cancer Center, which supports the effort along with the University of Louisville. “This is as reasonable a scientific hypothesis as anybody has come up with and it needs to be tried.”

The campaign runs counter to the prevailing opinion of the public health community, which holds that there is no safe way to use tobacco. Federal researchers, however, have begun to at least consider the idea that smokers might be better off going smokeless.

The National Cancer Institute at the National Institutes of Health says on its website that the use of all tobacco products “should be strongly discouraged,” and that there is “no scientific evidence that using smokeless tobacco can help a person quit smoking.” But this year it approved funding for a study that might provide some of that very evidence.

“Switch and Quit” is directed by Brad Rodu, a professor of medicine at the University of Louisville. He analyzed the 2000 National Health Interview Survey and found that male smokers who switched to smokeless tobacco were more likely to quit smoking than those who used nicotine patches or gum.

“Americans are largely misinformed about the relative risks. … They think smokeless tobacco is just as dangerous,” Rodu said. “This level of misinformation is an enormous barrier to actually accomplishing tobacco-harm reduction because if people believe that the products have equal risk, there’s not a real incentive.”

The program is funded through Rodu’s research money, which includes grants from the tobacco industry. Grants through the University of Louisville are unrestricted, which the program says “ensures the scientific independence and integrity of research projects and activities.”

“There’s absolutely no influence whatsoever,” Rodu said. “I decide, along with my colleagues, how we use the money, for what projects, and this is entirely the case. I would not have a situation where there was some control over the kind of projects I undertake.”

Tobacco companies want to market more smokeless tobacco and other cigarette alternatives to make up for falling cigarette sales. Some have introduced “snus” — small pouches like tea bags that users stick between the cheek and gum — and dissolvable tobacco — finely milled tobacco shaped into orbs, sticks and strips.

But they’re barred by federal law from explicitly marketing them as less risky than cigarettes — at least for now. That means the “Switch and Quit” program can do something the tobacco industry itself cannot: claim that smokeless tobacco has a health benefit when compared to smoking.

The program says smoking kills about 220 adults a year in and around Owensboro. The state of Kentucky, a leading tobacco grower, has the nation’s highest smoking and lung cancer rates.

Owensboro and the surrounding area consume about 3 million cigarettes a week, according to the program. That amounts to well over a pack for every man, woman and child in the community of about 115,000 people.

Owensboro resident Vernon Goode had smoked for about 10 years before he recently traded his Marlboros for dissolvable tobacco tablets. The campaign didn’t inspire him to quit, but he said he thought it was a good idea.

“I was just wanting to quit because, you know, I could feel it in my lungs,” Goode said. “I’ll smoke a cigarette every once in a while, but not very often. I want to quit altogether and I’m just using this right here as I guess what you’d call a stepping stone.”

The Owensboro program has raised concerns among some in the public health community who say organizers are claiming smokeless tobacco is a healthier alternative to smoking without approval from the Food and Drug Administration.

A 2009 law gives the FDA authority to evaluate health risks of tobacco products and approve those that could be marketed as safer than what’s currently for sale. None have been given the OK yet. The FDA also plans to regulate electronic cigarettes, battery-powered plastic and metal devices that heat a liquid nicotine solution in a disposable cartridge, creating vapor that users inhale.

Matthew Myers, president of the Campaign for Tobacco-Free Kids, called the program “a giant experiment with the people of Owensboro without rules or guidance designed to protect individuals from experimental medicine.”

Smokeless tobacco isn’t a safe alternative to cigarettes, according to the Centers for Disease Control and Prevention. Health warnings on the products required by the FDA state the same thing.

However, some studies, including a 2007 report from the Royal College of Physicians in London titled “Harm Reduction in Nicotine Addiction,” suggest that some smokeless tobacco products are about 90 percent less harmful than cigarettes.

“The worst that you can say about smokeless tobacco is that it’s the lesser of two evils,” said Dr. Randall Thomas, an oncologist with the Owensboro Medical Health System. The health system, the community’s largest employer, is going smoke-free in 2013 and is offering Rodu’s program as one of a variety of quit-smoking tools for its employees.

“I don’t think we have any problem in telling a person that drinks a six-pack a day that if they could cut it back to two beers a day or two drinks a day that their health risks are greatly reduced,” Thomas said. “Finding a way to let people have their nicotine that carries less risk, it’s the realistic solution.”

The Owensboro program doesn’t suggest pharmaceutical nicotine replacement gum or patches. That’s because they are regulated to provide very small doses of nicotine and are recommended for only a short period of time, while smokeless tobacco can be used as long as a smoker needs, Rodu said.

Myers, of the Campaign for Tobacco-Free Kids, said more research is needed before anyone should suggest that the nation’s 46 million smokers would be better off using smokeless tobacco. In the meantime, he said, there are a host of FDA-approved products that can help people give up smoking.

“There’s a right way and a wrong way to determine whether smokeless tobacco can and should be marketed as a way to help people quit,” Myers said.

The National Cancer Institute approved funding earlier this year for a nationwide 1,250-person study to look at whether being given a snus product changes the habits of smokers who are not motivated to quit.

The tobacco industry sees smokeless tobacco as its future, said Matthew J. Carpenter, a psychology professor at the Medical University of South Carolina who is conducting the yearlong study.

Carpenter said the snus study will examine what smokers do when given smokeless tobacco. He won’t look at the health effects, or advise smokers to use the snus to quit.

“They are probably safer than conventional cigarettes, if for no other reason than you’re not burning anything, you’re not smoking anything, you’re not inhaling any smoke,” he said.

“If you compare it to conventional cigarettes, they’re probably a little bit better. If you compare it to quitting, they’re absolutely worse.”

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

October, 2011|Oral Cancer News|

Students can’t commit to quitting

Source: www.gcsunade.com
Author: Lindsay Peterson

A Georgia College student steps outside, pauses and inhales, filling his lungs with acetone, ammonia, arsenic, benzene, butane, formaldehyde, lead and turpentine – just 8 of the more than 50 carcinogens found in the average cigarette.

According to the Centers for Disease Control and Prevention, of the 46 million smokers in the U.S., college students are among the highest percentage of smokers. Almost 22 percent of adults ages 18-24 smoke, according to 2009 CDC data.

Their professors are not far behind them in their smoking addiction. According to the CDC data, almost 22 percent of people ages 45-64 are smokers. In 2009, the CDC found that adults in the Southeast were among the most prevalent smokers in the United States.

While there are no hard statistics for the percentage of students and staff that smoke at GC, it is not uncommon to see a familiar gathering of smokers sitting outside any of the dorms.

Lauren Luker, junior mass communication major, started smoking in order to get a break at her job as a server.

“You couldn’t have a break unless it was a smoke break,” Luker said.

Now, eight years later, Luker is worried about the health of her lungs and is planning on quitting after several previous failed attempts.

However, quitting such an addictive habit is not always easy, as Luker knows.

According to the National Institute on Drug Abuse, nicotine is as addictive as heroin and cocaine. Fortunately for GC students and staff who are interested in kicking their habit, there is a smoking cessation program held by GC three times a year.

Amy Whatley, the assistant director of the Wellness Programs, leads these free smoking cessation classes.

“(The classes) are held once every fall, spring and summer,” Whatley said.

However, this free program is not very popular among students.

“We’ve only had one student complete (the smoking cessation program) in the last three years,” Whatley said.

While the smoking cessation program is not very popular among GC students, the FDA is beginning a new advertising campaign that has been popular in other countries, such as Australia and Canada.

According to the FDA, as of September 2012, all packages of cigarettes must show graphic images of the effects of smoking and bold text warning of the dangers of smoking.

The graphics range from a man smoking through a hole in his throat to a mouth riddled with sores and rotting teeth – the cruel effects of oral cancer.

According to the American Cancer Society, other countries have had a great success rate with this controversial method. A positive correlation has been shown between people becoming more aware of the harmful effects of smoking and choosing to quit.

The hope is that after being confronted with the grim side effects, such as oral cancer or death, smokers will be more motivated to cut down on their smoking habit or quit altogether.

Currently, smoking is responsible for 20 percent of deaths in the U.S., and is the leading cause of preventable death.

But the human body is resilient and begins to heal itself just minutes after the last cigarette is smoked.

According to the American Cancer Society, just 20 minutes after quitting smoking, blood pressure is noticeably reduced.

Twelve hours after a person quits smoking, the carbon monoxide level in their blood drops to normal.

At nine months, the smoker’s fatigue and shortness of breath decreases.

One year after quitting, an ex-smoker’s risk of heart disease is half that of a smoker.

Ten years after quitting, the death rate for lung cancer is approximately half that of a continuing smoker.

Although university denizens find themselves among the most prone demographics of smokers, they can breathe more easily knowing that GC provides help for those who need it.

August, 2011|Oral Cancer News|