snus

Tobacco industry adapts to world of fewer smokers

Source: The Tennessean
Author: Anita Wadhwani

By any name or variety you choose — call it snuff, dip, chew or plug — smokeless tobacco is making a comeback, and Tennessee farmers, factory workers and consumers are playing a major role in the renewed buzz.

Farmers here and in Kentucky who once made a good living off raising burley tobacco for cigarettes have had to eliminate 40 percent of acreage devoted to that crop as demand has declined, while farmers who cultivate the dark tobacco used for chewing have been able to expand their fields by 22 percent in three years.

Now, the massive marketing muscle of the nation’s biggest tobacco companies — Altria Group and its subsidiary Philip Morris USA, which owns the 100-year-old U.S. Smokeless Tobacco Co. factory within view of the state Capitol, and R.J. Reynolds, which runs its smokeless operations out of a Memphis factory — are battling for market dominance.

Together, the two manufacturers already control 90 percent of the American smokeless tobacco sector with brands such as U.S. Smokeless’ Skoal and R.J. Reynolds’ Kodiak.

They’re competing with new fruit- and mint-flavored products (some packaged to look like miniature cigarette packs) to attract a new generation of consumers and entice ex-smokers looking for nicotine- infused alternatives.

Former cigarette smokers like Dave Kenner, 31, a construction worker making a pit stop at a West Nashville convenience store last week, said he switched to Red Seal Wintergreen smokeless because heavily taxed cigarettes cost too much — nearly $300 a month to feed his two-pack-a-day habit.

Round tins of chewing tobacco cost less and still satisfy Kenner’s taste for nicotine.

“It’s more like three bucks a day, I still get the nicotine, and it doesn’t taste half bad,” Kenner said. “My girlfriend isn’t crazy about it, but she likes it better than smoking.”

The decline in U.S. rates of cigarette smoking has led to an unexpected boon for the smokeless tobacco industry, historically centered in downtown Nashville and a surrounding 100-mile radius that encompasses farms and processing facilities between here and Hopkinsville, just over the Kentucky border.

Even as other Tennessee manufacturing jobs have vanished — 71,000 and counting since the recession officially began three years ago — the U.S. Smokeless Tobacco Co. plant on Eighth Avenue has prospered without a layoff since 1988. Plans now call for adding a second and possibly third shift of workers to the assembly line next month.

Once available only in the dark, loose variety that stained teeth and created a socially unappealing need to regularly spew dark streams of saliva, smokeless tobacco is now available in “spit-free” forms.

Those range from small, disposable tea-bag-like “snus” (pronounced “snoose”) products that conceal the brown tobacco within, to toothpicks and strips in flavors such as cherry, grape and wintergreen.

Smokeless brings in billions

It’s no accident that smokeless tobacco has attracted the interest of cigarette makers like Philip Morris USA.

Parent company Altria Group bought U.S. Smokeless (the top smokeless company) for $11.7 billion in 2009.

The company is diversifying its Nashville operations to provide an expanded array of smokeless products in addition to its best-known and decades-old Copenhagen and Skoal brands.

“We weren’t in the smokeless market, but our testing told us we needed to get into the space in a big way,” said Ken Garcia, a spokesman for Richmond, Va.-based Altria.

“It’s a growth industry for us, and we think it will continue to be for local operations.”

Last week, the Fortune 500 company reported a 27 percent increase in fourth-quarter income, even though it’s selling fewer cigarettes.

Revenue from smokeless tobacco brands including longtime Nashville products Copenhagen and Skoal, as well as the newly introduced Marlboro snus marketed at ex-smokers, grew to more than $1.45 billion in smokeless product sales in 2010

The expanding consumer market has translated into growth for the Nashville U.S. Smokeless Tobacco factory complex across the street from the Nashville Farmers’ Market downtown.

More products offered

The factory has been in continuous operation since the early 20th century, said plant manager Wayne Whiting, who worked his way up to management after starting on the factory floor in the mid-1970s at the age of 17.

“When I first started … we ran two products,” he said. “Now we’re running a multitude of products and operate some parts of the plant 22 hours a day.”

The Nashville plant employs 400 people. Automation and increased consumer demand have led to an increase in output from 100 tins a minute to 400, most shipped directly to retailers like Walmart or convenience store chains.

With Altria buying U.S. Smokeless, the Nashville plant has started making new products that mirror the parent company’s best-known cigarette brands, such as Marlboro snus, packaged in a slim, silver-and-blue cardboard box.

Altria boasts a 2,500-member sales force that connects the company to 200,000 stores nationwide. Competition is heating up.

R.J. Reynolds Tobacco Co., the nation’s No. 2 cigarette maker, bought the 200-year-old American Snuff Co. — U.S. Smokeless’ direct competitor — in 2006.

Last year, the company said it would invest $133 million in a new manufacturing facility in Memphis to make its own “snus-like” products linked to its iconic Camel cigarette brand.

Surge helps TN, KY growers

The resurgence of smokeless products has helped farmers in Tennessee and southern Kentucky plug into new markets.

Buddy Bryant, 51, is a fourth-generation tobacco farmer whose 290-acre tobacco operation just outside Adams, Tenn., helps support Bryant’s family of four as well as his brother’s family, the families of two adult nephews and his parents.

Between 2005 and 2009, the number of acres in Tennessee devoted to dark tobacco increased from 6,000 to 7,300, according to the Knoxville-based Center for Tobacco Grower Research, which receives funding from Philip Morris. The production value grew from about $42 million to $57 million.OCF

“The demand for smoking has gone way down, and farmers know what that means,” said Jane Howell Starnes, the director. “We’re seeing more switch completely from burley to dark (tobacco), but it’s still an uncertain future for farmers.”

Farmers operate on a pre-season contract basis with U.S. Smokeless, bringing tobacco to the Hopkinsville, Ky., processing facility. At the plant, the tobacco is sorted, aged and then shipped to either the Nashville plant or one in Lincoln Park, Ill.

Because of a short retail-shelf life, all tobacco shipments are based on orders, said plant manager Danny Kingins, a 27-year employee who also raises dark tobacco on his family farm.

The industry isn’t without controversy.

Anti-tobacco advocates armed with new data that show an increase in the popularity of smokeless tobacco among teenage boys are advocating for tighter regulations and stiffer taxes comparable to those put on cigarettes.

“We’ve seen a big change in demographic for this from being primarily a habit for older men to a habit of younger men,” said Danny McGoldrick, vice president for the Washington-based Campaign for Tobacco Free Kids.

A recent ban on flavored tobacco products by the federal government doesn’t apply to smokeless products.

“The two big boys — Philip Morris and R.J. Reynolds — are making flavors like cherry that appeals to kids. It’s more cool to use,” McGoldrick said.

Altria also is contending with claims that the product causes mouth, tongue and throat cancers among all ages of users. Earlier this month, the company settled a suit against U.S. Tobacco by the family of a 42-year-old North Carolina man who died of mouth cancer and had used smokeless tobacco products since he was 13 years old.

The $5 million settlement is believed to be the first of its kind involving smokeless products.

In 2012, the U.S. Food and Drug Administration is expected to report to the secretary of Health and Human Services on whether the products pose a threat to children and teens.

February, 2011|Oral Cancer News|

RJ Reynolds’ ads urge tobacco pouches for smokers

Source: washingtonexaminer.com
Author: Emery P. Dalesio

R.J. Reynolds Tobacco Co. is targeting people who resolve to quit smoking in the new year with advertisements suggesting they switch to its smokeless tobacco pouches, a move critics say is an attempt to keep people from quitting nicotine.

The ads mark the company’s first campaign aimed at getting smokers to switch to the pouches known as snus, which Reynolds introduced in early 2009, spokesman David Howard said Wednesday.

The carefully worded ads suggest, but don’t say directly, that the pouches are a way to help kick the smoking habit. Under federal law, companies cannot claim that tobacco products work as smoking cessation products. But tobacco companies would love for smokers to think of them that way as cigarette sales fall because of higher taxes, smoking bans and falling social acceptability.

The No. 2 U.S. cigarette maker is advertising in major magazines this month its suggestion for a “2011 Smoke-Free Resolution” in some ads that show the tobacco-filled white pouches dropping from the sky like confetti. The ads promote the company’s Camel snus — small pouches filled with tobacco that users stick between the cheek and gum.

“If you’ve decided to quit tobacco use, we support you. But if you’re looking for smoke-free, spit-free, drama-free tobacco pleasure, Camel Snus is your answer. Logon to the Pleasure Switch Challenge and see how simple switching can be. Camel Snus — it might just change the way you enjoy tobacco,” one ad says.

“At this time, there will some that will be considering the option to maybe quit smoking, but not necessarily quit enjoying tobacco pleasure,” Howard said. “We want to inform them that here is a product that is an option for you to consider.”

The “resolution” ads appeared in wide-circulation magazines including Time, Sports Illustrated and People, Howard said. Two other versions, which specifically address themselves to smokers, appeared in alternative weekly newspapers around the country, he said. Those ads feature the packaged product at the heart of snowflakes or ringed into a holiday wreath.

All three ads also warn: “Smokeless tobacco is addictive.”
An anti-tobacco campaigner said the Reynolds ads aim to reorient smokers to smokeless snus to keep them from being lost as potential customers.

“These ads are trying to take advantage of the fact that around the first of every year many people try to quit smoking altogether. These ads aren’t designed to help people quit, they’re designed to keep people using tobacco,” said Matthew Myers, president of the Campaign for Tobacco-Free Kids.

The Food And Drug Administration, which regulates tobacco advertising, is reviewing the Reynolds ad campaign. The agency is charged under the Tobacco Control Act with deciding if any tobacco ads make false claims.

“The claims made by R.J. Reynolds Tobacco Co.’s advertising and labeling materials are being evaluated by the FDA,” spokesman Jeff Ventura said.

R.J. Reynolds is owned by Reynolds American Inc., based in Winston-Salem, N.C.

About 46 million American adults, or one in five, still smoke and about the same number are former smokers, according to the Centers for Disease Control and Prevention. That’s down from one out of four Americans who smoked in 1995. About 3 percent of American adults use smokeless tobacco.

The CDC says smokeless tobacco contains 28 cancer-causing agents and is not a safe substitute for smoking cigarettes. But a 2007 report from the United Kingdom’s Royal College of Physicians suggests that some smokeless tobacco products are less harmful than cigarettes.

“Since tobacco smoking is driven primarily by addiction to nicotine, but the harm from smoking is caused by other smoke constituents, the rational next-best option is to reduce the harm arising from nicotine use by providing it in a form that does not involve inhaling smoke,” the report said.

January, 2011|Oral Cancer News|

Reynolds targets smokers trying to quit with new snus campaign

Source: www.csnews.com
Author: staff

R.J. Reynolds Tobacco Co. wants cigarette smokers to consider Snus if they are trying to quit.

According to the Winston-Salem Journal, the giant tobacco company has launched a national campaign marketing Camel Snus as a potential New Year’s Resolution solution for smokers. It’s the company’s first campaign aimed specifically at encouraging smokers to switch to Camel Snus, according to David Howard, a Reynolds spokesman.

“A lot of adults make a decision to quit smoking this time of the year,” said Howard in the report. “For those making that attempt, but still wanting the pleasure of tobacco, we’re saying ‘Here’s an option.”

Reynolds has run ads in large-circulation magazines such as Entertainment Weekly, People, Sports Illustrated, Time and US Weekly, as well as free and alternative publications, according to the report.

In the “2011 smoke-free resolution” ad, Reynolds said it supports smokers who have decided to quit using tobacco. “But if you’re looking for smoke-free, spit-free, drama-free tobacco pleasure, Camel Snus is your answer,” the ad’s text reads.

The ads also contain a large warning that “smokeless tobacco is addictive.”

Howard said that the “drama-free” reference is aimed at adults who want to use tobacco products in restaurants, bars and other social outlets where smoking is discouraged or banned.

Reynolds’ print ads are part of a “take the pleasure switch challenge” campaign tied to an age-restricted Camel Snus Web site.

As might have been expected, some anti-smoking groups are upset by the ads.

“The ads are trying to take advantage of people trying to end all uses of tobacco,” said Matt Myers, president of the Campaign for Tobacco-Free Kids. “If a smoker does that, switch to smokeless, they’ll be worse off than if they had quit.”

Snus comes in a small pouch that is placed between the lip and gum. The tobacco is pasteurized, not fermented, and it contains less moisture and salt than moist snuff. It also does not require the consumer to spit.

Although Reynolds does not dictate the price of Camel Snus at retail, the price is comparable to a premium pack of cigarettes, which typically sells for $4 to $4.50 in North Carolina.

Reynolds began its first trial of Camel Snus in April 2006, with national distribution commencing in January 2009. The ads do not make any claims of reduced health risks with a potential switch.

Some anti-smoking advocates are encouraging the U.S. Food and Drug Administration to allow the advertising of smokeless tobacco as less harmful than cigarettes if such claims can be proven through research. But other anti-tobacco advocates oppose marketing smokeless products under cigarettes’ brand names because of those brands’ appeal to youth, according to the Winston-Salem Journal report.

December, 2010|Oral Cancer News|

Burgeoning market for smokeless tobacco products

Source: www.acsh.org
Author: staff

Now for some more good news on the harm reduction front: While cigarette sales have fallen by 17 percent since 2005 due to robust health campaigns and steeper taxes, smokeless tobacco products sales have grown by an annual rate of approximately 7 percent, reports The Chicago Tribune. The increase in sales of smokeless tobacco products can be partially attributed to their invisibility. For addicted smokers stuck in a smoke-free office environment all day long, these products relieve them of their nicotine craving.

Economic factors have also been responsible for the rise in smokeless tobacco sales since a can of premium Swedish snus can run not much more than half the cost of a pack of Marlboro cigarettes in places where state, county and city excise taxes are high.

Perhaps the most intriguing element to this story is that the use of smokeless tobacco products is increasing even though advertisers aren’t allowed to market them as a safer alternative to cigarettes. “I wonder how these people get the message,” ponders ACSH’s Dr. Elizabeth Whelan.

Even though medical experts agree that quitting tobacco altogether is the ideal scenario, scientists admit that smokeless tobacco products are much less harmful than cigarettes.

But the potential benefit of these products, says ACSH’s Dr. Gilbert Ross, is often overshadowed by anti-tobacco camps that focus on the possibility of increased risks of oral cancer from smokeless tobacco products. Dr. Ross notes that this risk “is essentially nil in the kinds of highly purified snus products found on the market today. These people must be confusing that with chewing tobacco used in years gone by.”

While others like Dr. Frank Leone, director of the University of Pennsylvania Medical Center’s Comprehensive Smoking Treatment Program, argue that smoke-free cigarette alternatives will only prolong a smoker’s addiction to nicotine, Dr. Ross counters that “there is a far greater net beneficial effect seen from the people who use snus instead of cigarettes as a means of effectively quitting smoking.”

Source: American Council on Science and Health, Facts and Fears

December, 2010|Oral Cancer News|

Snus smokeless tobacco: Less harmful than cigarettes, but not safe.

Source: WebMD

By: Daniel J. DeNoon

If you use snus, do you win or lose?

Snus — alternately pronounced snoose or snooze — is a smokeless, flavored tobacco product very different from snuff. When placed between cheek and gum, it doesn’t make you spit.

Even its critics admit that snus is less harmful than other forms of smokeless tobacco. And it is far less harmful than cigarette smoking.

So is snus a good thing?

It would be a good thing if everyone who smoked cigarettes or dipped snuff switched to snus instead. It would be a good thing if snus were a way station on the road to quitting all forms of tobacco. It would even be a good thing if kids who would have become smokers became snus users instead.

But despite all of that, mounting evidence suggests snus isn’t a good thing — and may be far worse than they appear.

Snus: Less Harmful, But Not Safe

Cigarettes are the world’s most efficient nicotine delivery device. They are also the most deadly. Many of the most dangerous byproducts of cigarettes are created during the burning process.

Smokeless tobacco products obviously don’t burn. But smokeless tobacco is a major cause of oral cancer, pancreatic cancer, and esophageal cancer.

Much of this risk comes from cancer-causing chemicals called nitrosamines and polycyclic aromatic hydrocarbons (PAH). And snuff products actually deliver more cancer-causing nitrosamines than cigarettes do.

But nitrosamine content is far lower in snus than in snuff, says Stephen S. Hecht, PhD, professor of cancer prevention at the University of Minnesota.

“Snus are made with a special process to help control nitrosamine levels,” Hecht tells WebMD.

There’s a catch, of course. Carcinogen levels in snus may be lower — but they are not low.

“Nitrosamine levels in snus are still 100 times greater than levels of nitrosamines in foods like nitrite-preserved meats,” Hecht says. “This is not a harmless product.”

And there’s evidence that these nitrosamines — or something else in snus — are causing cancer. In Sweden and Norway, where snus originated, snus users have a significantly higher risk of pancreatic cancer.

Snus are also linked to mouth sores, dental cavities, heart attack, stroke, and diabetes risk. And they do deliver nicotine — an addictive drug.

Snus: Harm Reduction or Multiplication?

OK, so snus isn’t without harm. But if it’s so much safer than cigarettes, wouldn’t it be good for smokers to switch to snus?

In Scandinavia, there’s some evidence that snus contributed to a decline in smoking. Whether that happens in the U.S. depends on young people, says Michael Eriksen, ScD, director of the Institute of Public Health at Georgia State University and former director of the CDC Office on Smoking and Health.

“If we see that existing smokers are the primary users of snus and go from smoking to snus, that would be a public health success story,” Eriksen tells WebMD. “But if kids start out on snus and then grow into smoking, that is going to be a disaster.”

It’s a huge public health experiment — and the results already are plain to see, says Terry Pechacek, PhD, associate director for science at the CDC’s Office on Smoking and Health.

Pechacek notes that more than a fourth of white, male high school students report having used smokeless tobacco products in the last month. Overall, nearly 7% of all U.S. high school students already use smokeless tobacco.

And they are not using snus instead of cigarettes.

“The overwhelming pattern is to smoke cigarettes along with smokeless tobacco — and two-thirds of this is among young adults,” Pechacek tells WebMD. “Over half of teens using smokeless tobacco are also using cigarettes. … It is of great public health concern.”

This isn’t an accident, says Michael Steinberg, MD, MPH, director of the tobacco dependence program at the University of Medicine and Dentistry of New Jersey.

Steinberg notes that in 2006, major U.S. cigarette companies bought the major smokeless tobacco brands. And the two major brands of snus? They’re from leading cigarette makers Altria/Philip Morris (Marlboro Snus) and RJ Reynolds (Camel Snus).

“Snus is being co-marketed with cigarettes,” Steinberg tells WebMD. “The companies are not shy in saying, ‘When you can’t smoke, use snus.’ But when you can smoke, it is clear they want you to smoke cigarettes. They make more money from cigarettes sales than anything else on the planet.”

Steinberg also notes that U.S. snus deliver less nicotine than do cigarettes.

“So if people try to get nicotine from snus, they will not get what they are used to. They will go through nicotine withdrawal and so will not use snus alone,” Steinberg says. “My conclusion is that companies do not want to replace cigarettes with snus.”

Snus: An Aid to Quitting Cigarettes?

Data from Sweden show that snus users don’t always progress to cigarette use, and that it’s possible to use snus to reduce dependence on cigarettes.

One Swedish study, for example, found that there were more ex-smokers using snus that there were ex-snus users using cigarettes.

However, Steinberg notes that this study fails to account for significant anti-smoking efforts taking place in Sweden at the same time, such as indoor health programs and government assistance to smoking cessation programs.

“Other countries, such as Norway, have not seen the same outcomes in terms of health benefits of snus as in Sweden,” he says.

Steinberg points to studies showing that snus isn’t any more helpful than nicotine replacement products such as nicotine gum and nicotine nasal spray.

“The real question is who do you buy your nicotine from?” GSU’s Erickson says. “Do you buy it from a tobacco company that can put anything on the market with no testing … or do you buy it from pharmaceutical companies that have to demonstrate the safety and effectiveness of their products as a drug and demonstrate they actually work?”

It’s right there in a big black box on the home page of the Camel Snus web site: “WARNING: Smokeless tobacco is addictive.”

Snus users get hooked on nicotine. This means that if users try to quit, they will go through the unpleasant sick feeling known as withdrawal. Many will find it very difficult, if not impossible, to stop using nicotine in one form or another.

“Those who sell nicotine would like to keep people hooked on nicotine forever. That is a question, whether lifetime nicotine addiction is acceptable,” Erikson says. “There are 50 million people in the U.S. who are regular nicotine users. The sooner we can get them from relying on smoked nicotine to not-smoked nicotine the better. The sooner we can get them all off nicotine entirely, the better.”

All of the experts who spoke with WebMD agree: Snus clearly aren’t as deadly as cigarettes, but they pose a significant risk to your health.

“The bottom line is there is no safe form of tobacco use,” Pechacek says.

November, 2010|Oral Cancer News|

Refurbished York plant churning out Marlboro Snus, a new smokeless tobacco product

Source: www.dailypress.com
Author: Jon Cawley

From outside the non-descript facility on Merrimac Trail nothing indicates it’s home to Marlboro Snus, a spit-less, smokeless tobacco product that company officials say is gaining significant market traction.

Inside, processed tobacco is finely ground, cooked, flavored, pouched and packaged by automated machinery in sanitary “clean rooms.” High-speed robots can produce 150 Snus packages — each containing six individual pouches of tobacco — per minute, officials said during a recent plant tour.

The York manufacturing center is the only place making Snus (pronounced snoose). The tobacco product has been in limited production since late 2007 but began nationwide distribution in March. That marks a big turnaround for the once-idle York County plant that underwent a $100 million renovation and expansion beginning in 2006 and now employs 17 salaried and 30 hourly workers along with 54 contractors.

During renovations, Philip Morris USA gutted the facility, located across from Anheuser Busch’s Williamsburg-area brewery. It had been closed for about three years since the company discontinued production of an electrically heated smoking device.

The facility was expanded by 33,000 square feet to 139,000 square feet and fitted with high-tech machinery specific to making and packaging Snus. That construction was partly funded by a $650,000 state and county grant, said Ed Tucker, a director with the U.S. Smokeless Tobacco Manufacturing Co.

Tucker said Snus and its packaging are discreet and designed to appeal to consumers as smoking restrictions continue to tighten. He said that because Snus is cooked instead of fermented, bacteria is removed and less saliva is produced during consumption making it ingestible. Traditional smokeless tobacco, typically called chew or dip, can’t be swallowed and has to be spit out.

In just under three years, Snus has carved out a 3 percent share of the smokeless tobacco market and company officials said they anticipate further growth although there are no plans to expand the York facility again or pursue international distribution.

Snus is “clearly one of the dominate players,” said David Sutton, a spokesman with Altria Client Services, the parent company of Philip Morris USA and the U.S. Smokeless Tobacco Manufacturing Co. that recently took over ownership of the York plant.

“To go from basically nothing to 3 percent in two to three years — that’s significant,” Sutton said.

And the tobacco company isn’t the only one benefitting, as York County gets a sizable bite as well. The facility’s machinery and tools taxes topped $266,000 in 2010. Real estate taxes for 2010, on the facility currently valued at about $11.4 million, comprise another $75,000, according to Commissioner of the Revenue data.

October, 2010|Oral Cancer News|

Snus increases miscarriage risk drastically

Source: The Swedish Wire
Author: Johan Nylander

Women who use snuff tobacco face 60% higher miscarriage risk.

A Swedish study by the Karolinska Institute and Uppsala University warned that women who uses snus are 60 percent more likely to misscarry than average.

“Stillbirth is probably one of the worst things that can happen to parents who are expecting a baby. That also snus increases the risk of this underlines the importance of being complete tobacco-free when you are pregnant”, Anna-Karin Wikström at the Uppsala University Hospital Women’s clinic told newspaper Upsala Nya Tidning.

Snus, a moist powder tobacco product that you consume by placing it under the lip, is said to be much less dangerous than smoking. But to take up snus in order to quit smoking may be contra productive. A woman who smokes just a few cigarettes a day has 40 percent higher risk of miscarriage.

“Taking the help of snus to quit smoking is a bad option to protect children”, said Anna-Karin Wikström.

The study, that was launched more than ten years ago, involved almost 570,000 women.

The small, teabag-like pouches, also called moist snuff, are used by nearly one million Swedes. Placed under the user’s lip, they quickly deliver a nicotine rush to the blood and a strong salt and herbs flavour in the mouth. While cigarette sales have tumbled by 50 percent in Sweden over the past 30 years, snus is on the up, with sales rising from some 2,500 tonnes a year in the 1970s to almost 7,500 tonnes in 2008.

Sweden is the only EU member state where sales are permitted.

September, 2010|Oral Cancer News|

A tough one to chew on: smokeless tobacco and teens

Source: Medscape Today
Author: Mary E. Muscari, PhD, CPNP, APRN-BC, CFNS

Introduction

One would think that the mere image of a bulgy cheek spewing brown, foul-smelling goo would be more than enough to turn anyone, especially appearance-conscious teens, off of using smokeless tobacco (ST). But then, these media-savvy adolescents probably have discovered snus, a smoke- and spit-free tobacco. According to a recent article in Reuters,[1] the use of ST is on the rise among US teens, reversing a downward trend in tobacco product use by adolescents. The Reuters article cites comments made by Terry Pechacek, PhD, Associate Director for Science, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), in a report to a US Congressional Panel. Among his comments is the suggestion that ST-using Major League Baseball® (MLB) players may be influencing young men to take up the cancer-causing habit. In his report, Dr. Pechacek noted that “the recent increases in ST use by adolescent boys and young adult men and the increasing dual use of cigarettes and ST products may portend a leveling off or even a reversal in the decline in smoking, the perpetuation of nicotine dependence, and continuing high levels of tobacco-related disease and death in the country.”[2] Given this grim outlook, healthcare professionals need to kick up their fight against teen tobacco use by increasing their focus on smokeless forms of tobacco.

Smokeless Tobacco

ST (also known as spit, plug dip, chaw, rack, spits, grizz, and tasties) comes in 2 forms: chew and snuff. Chewing tobacco is available in loose-leaf, twist, and plug forms, whereas snuff comes in moist, dry, and sachet forms.[2,3]

  1. Snuff: Available in dry or moist forms, snuff isfinely ground or shredded tobacco leaves that are packaged in tins or teabag-like pouches. A pinch of snuff is placed between the lower lip and gum or cheek and gum. Users typically spit out the tobacco juices, but those who swallow the juices become more addicted. Dry forms of snuff can be sniffed into the nose; using snuff is also called dipping.[2,3]
  2. Chew (chaw): A wad of chewing tobacco is placed inside the cheek and held there, sometimes for hours, and users spit out the tobacco juices. Chew is made fromloose tobacco leaves that are sweetened and packaged in pouches.
  3. Plug: Chewing tobacco is pressed into a brick, usually with the help of molasses or another sweet syrup. Users cut off or bite off a piece of the plug and hold it between the cheek and gum, spitting out the tobacco juices.
  4. Twist: Twist is flavored chew, braided and twisted into rope-like strands. It is held between the cheek and gum, and users spit out the tobacco juices.
  5. Snus: The relatively new snus(pronounced “snoos”) is a smokeless, spitless tobacco product that originated in Sweden. Snus comes in a pouch that is placed between the upper lip and gum for about a half-hour before discarding.
  6. Dissolvable tobacco products: Pieces of compressed powdered tobacco, similar to small hard candies, dissolve in the mouth and require no spitting of tobacco juices. Instead, they melt like breath mints. Sometimes called “tobacco lozenges,” these products are sold in shiny plastic cases and are not to be confused with the nicotine lozenges used for smoking cessation. Dissolvable tobacco products include[4]:
    • Orbs: similar to popular tiny breath mints;
    • Sticks: similar to toothpicks; and
    • Strips: similar to mouthwash breath strips.

According to the National Cancer Institute, ST contains at least 28 carcinogens in varying concentrations. The most harmful are the tobacco-specific nitrosamines, which are formed during the growing, curing, fermenting, and aging of tobacco. Tobacco-specific nitrosamines have been detected in some ST products at higher levels than levels of other types of nitrosamines, which are allowed in foods, such as bacon and beer. Other carcinogens include N-nitrosamino acids, volatile N-nitrosamines, benzo(a)pyrene, volatile aldehydes, formaldehyde, acetaldehyde, crotonaldehyde, hydrazine, arsenic, nickel, cadmium, benzopyrene, and polonium-210. Similar to smoked tobacco, ST contains nicotine, which is addictive, and the amount of nicotine absorbed from ST is 3 to 4 times greater than the amount delivered by a cigarette. Nicotine is absorbed more slowly from ST than from cigarettes; however, more nicotine per dose is absorbed from ST than from cigarettes, and the nicotine stays in the bloodstream for a longer time.[5]

Prevalence of Smokeless Tobacco Use in Teens

In 1970, men aged 65 years or older were almost 6 times as likely as those aged 18 to 24 years to use ST regularly, but by 1991, young men were 50% more likely than the oldest men to be regular users.[6] The 2009 Youth Risk Behavior Surveillance Survey[7] (YRBSS), which summarized results from public and private schools with students in at least 1 of grades 9-12 in the 50 US states and the District of Columbia, found that 8.9% of students had used ST (eg, chewing tobacco, snuff, or dip) on at least 1 day during the 30 days before the survey. The YRBSS also found that use was higher among boys (15.0%) than girls (2.2%) and higher among white persons (11.9%) than black (3.3%) and Hispanic persons (5.1%).[7]

ST has long been a staple in the rural United States, and it remains a problem among rural youth. The table demonstrates that in many states with large rural areas, prevalence of ST use among youth was higher than the national average.[8] Compared with urban children, rural children in the US are more likely to be poor, be white, and have less educated parents. Rural children also engage in more smoking, drinking, and drug use than their urban counterparts.[9]

Table. 2009 YRBSS Results on Smokeless Tobacco in US Rural Regionsa

State Prevalence Percentage
National 8.9
Alabama 12.4
Alaska 13.6
Arkansas 12.4
Colorado 10.7
Idaho 9.4
Louisiana 9.6
Kentucky 14.2
Montana 14.6
North Dakota 15.3
Oklahoma 10.5
South Carolina 10.4
South Dakota 14.6
Tennessee 12.2
West Virginia 14.4
Wyoming 16.2

a Used chewing tobacco, snuff, or dip on at least 1 day during the 30 days before the survey.

To describe substance use among Pennsylvania rural youth, Aronson and colleagues[10] identified changes and trends from 2001 through 2005 and compared these trends with use among urban youth. They found that ST use was more prevalent among rural youth than urban youth, although a significant shift toward increased ST use among urban 10th-grade boys occurred in 2005. They also found that:

  1. ST use by rural Pennsylvania youth far exceeded use reported at the national level.
  2. In the 12th grade, approximately 25% of rural boys used ST, compared with no more than 15% of urban boys.
  3. Nearly 12% of rural 12th grade girls used ST in 2005.
  4. Prevalence doubled for rural girls in 6th through 8th grades in both 2003 and 2005.
  5. At nearly every time point and in every grade, lifetime ST use increased for rural girls and boys.

Health Hazards of Smokeless Tobacco

The health hazards of ST vary as widely as the types of products and the manner in which they are used. Variations in health risks are possible for persons using both cigarettes and ST compared with those using ST alone. Potential hazards include[3,11]:

  • Nicotine dependence: The nicotine in ST is absorbed directly into the bloodstream and is addicting. Withdrawal often creates the same symptoms as those seen in heavy smokers who attempt to quit. Some manufacturers of ST products have altered the nicotine content and pH, added flavors, and packaged moist snuff in sachets as starter products that gradually move novice users on to higher levels of nicotine as their tolerance increases;
  • Cancer: ST can contribute to oral cancers, as well as cancer of the esophagus and pancreas;
  • Leukoplakia: ST increases the risk for leukoplakia (precancerous lesions);
  • Heart disease: ST contains nicotine, which can contribute to cardiovascular disease and hypertension; and
  • Dental problems: ST can contribute to gingivitis and dental caries.

The Allure of Smokeless Tobacco

ST has been around for a long time. So why are more teens discovering it now? Increased interest in ST may have several causes[3,12]:

  1. Teens may still view ST as relatively harmless compared with cigarettes.
  2. Adolescent girls may use ST to try to lose weight.
  3. With increasing smoking restrictions, ST gives people a way to get nicotine without having to go out in the cold or having to wait until they are out of the no-smoking zone.
  4. Recent mergers and acquisitions resulted in the production and sales of ST moving from companies that do not manufacture cigarettes to companies that do manufacture them.
  5. New forms and flavors of ST are more appealing to youth. A quick Internet search revealed such flavors as apple, butternut, peach, tequila, black wild cherry, “fresh,” and “mellow.” Some of the new snus containers are downright adorable.
  6. Smokeless products are heavily promoted.
  7. Smokeless products are used by youth role models, including MLB players and rodeo stars.

Whereas rodeo stars are more likely to influence rural children, baseball players have a much broader influence, and it is the association between MLB and ST that concerns Dr. Pechacek. Chew is probably as much a symbol of baseball as hot dogs, and its use dates back to the mid-1800s. Players initially used it to keep their mouths moist and gloves soft (by spitting into them). ST use began to decline with the increased use of cigarettes in the 1950s, but players reversed that trend and went back to ST when they learned about the dangers of cigarettes. In 1990, MLB warned players of the dangers of ST and began efforts to help players quit. Since that time, many players have educated young baseball players on the dangers of ST.[13]

Implications for Healthcare Providers

Healthcare providers need to be as aggressive with ST as they are with cigarettes, in both research and practice. Research must focus on the specific types of ST to firmly establish correlations with health problems, particularly in pediatric users, to understand the short- and long-term effects. Research should also guide the development of evidence-based prevention and cessation programs. Practitioners should work together with dental professionals to incorporate possible ST use into assessment, prevention, and intervention.

Primary prevention. Healthy People 2010 objective 27-3 is “Reduce the initiation of tobacco use among children and adolescents.” Objective 27-4.a is “Increase the average age of first use of tobacco products by adolescents (from an average of age 12 to an average of age 14 years) and young adults (from age 15 to age 17 years).”[14]These are average ages of initiation; children younger than 12 years often use tobacco products, especially ST. The first thing practitioners must do is to take this objective to a lower age level, preferably beginning with the early school-age years. Primary care providers need to incorporate ST prevention into anticipatory guidance counseling and to instruct parents to talk with their children about ST products and to role-model positive health behaviors by not using ST — or any form of tobacco.

Secondary prevention. All healthcare providers should ask clients, regardless of age, about the use of ST. This is especially true in inpatient facilities, where clients may be using these products while hospitalized. Of course, healthcare providers should also encourage — and help — clients to quit. Quitting is not easy, even for adolescents, because of nicotine dependence. Withdrawal symptoms (dizziness, depression, frustration, impatience, anger, anxiety, irritability, trouble sleeping, difficulty concentrating, restlessness, headaches, tiredness, and increased appetite) are unpleasant. Users may benefit from cessation support groups, such as Nicotine Anonymous or local groups available through the American Cancer Society or those listed in the phone book. Appropriate nicotine replacement treatments may be beneficial; however, these are not approved by the US Food and Drug Administration (FDA) for ST cessation. Smoking cessation medications (such as Bupropion [Zyban®]) are not FDA-approved for children younger than 18 years.[15,16]

On a broader level, healthcare providers can assist schools and state agencies by providing group education on ST. Several federal agencies are available to provide support, including the CDC’s Smoking and Tobacco Use Media Campaign Resource Center.[17] Finally, healthcare providers can become involved in advocacy by supporting legislation that minimizes ST advertising and exposure to minors. Healthcare providers cannot allow the fight against tobacco to be chewed up and spit in the gutter.

Web Resources

Campaign for Tobacco Free Kids

Smokeless Tobacco Fact Sheets

Spit Tobacco: A Guide for Quitting by the National Institute of Dental and Craniofacial Research

Tips for Teens: The Truth About Tobacco

World Health Organization’s Tobacco Free Initiative

July, 2010|Oral Cancer News|

The global market for snus and snuff is estimated to be in excess of 1.4 billion cans, and growing. Scandinavia and the US are by far the world’s largest markets for snus and snuff. Scandinavia is a pasteurized snus market, while the US market is dominated by the fermented moist snuff.

Source: The Swedish Match
Author: Staff

The Scandinavian snus market is comprised of a broad range of brands and product varieties, with pouch products being the most popular and continuing to grow in importance. The largest market in Scandinavia is Sweden, the largest snus market in the world measured in per capita consumption. Norway was the fastest growing market but Travel Retail and the Swedish market also experienced volume growth in 2009.

Snus, traditionally a Swedish product, is increasingly being recognized globally as an exciting new market category. This is evidenced by the big tobacco players testing Swedish style snus in chosen markets. During 2009, one of Swedish Match competitors rolled-out snus nationally in the US. Still a very small category in the US, Swedish style snus is considered to have a long term growth potential. Swedish Match is continuing its efforts to assess and develop the market for Swedish style snus in the US market through the marketing of brands such as General.

Moreover, through the 2009 joint venture with Philip Morris International, Swedish Match will pursue growth opportunities outside Scandinavia and the US. While still undeveloped, these marketsprovide future growth opportunities.

Within the European Union, sales of snus have been banned since 1992. Sweden was exempted from the sales ban for the Swedish market when it became an EU member in 1995.

The traditional US moist snuff market has achieved sustained volume growth over the past decade. The US snuff market is comprised primarily of loose varieties in a relatively small number of cuts and flavors. However, the pouch snuff segment has been rapidly growing as consumer view pouches as convenient and easy to use. The market is composed of a premium segment and valuepriced segments which are equivalent in size in volume terms. The value priced segments have grown significantly over the past decade, while the premium segment has experienced modest declines in volume. Many of the new consumers entering the snus and snuff categories are former cigarette smokers.

Snus Scandinavia

Main brands

The largest brands on the Scandinavian market are General, Ettan, Grovsnus, Göteborgs Rapé, Catch and Kronan. The General brand is the best selling snus brand in both Sweden and Norway.

During 2009, the Group launched a number of new products, primarily as line extensions or product improvements of existing brands, (the most notable being for General) or under new brands. In October, the Group launched The Lab Series 01 and 02 based on a new formula recipe, a new pouch format, a unique design, and modern graphics. Developed after extensive consumer research, these new products are now available in Norway and parts of Sweden.

In Scandinavia, growth of the share of white-portion snus continued, and Swedish Match during the year upgraded its General White Portion product, now with the upscale star formation packaging technique in both Sweden and Norway. Kronan, the Group’s value priced brand in this region, is the number one brand in that segment in Sweden. In addition to its traditional snus products, Swedish Match also offers the number one brand in the non-tobacco smokefree segment, Onico, providing consumers a high quality nicotine free alternative. On the Norwegian market, the Group has continued to grow with such strong traditional brands as General, Göteborgs Rapé, Catch, and Röda Lacket.

Market development

In 2009, consumption in the Scandinavian snus market is estimated by Swedish Match to have amounted to 250 million cans and to have grown 5 percent from 2008 levels. It is estimated that approximately 25 percent1) of men in Sweden use snus on a regular basis, while in Norway the percentage of men using the product is lower, but growing. The number of men using snus has beenrelatively stable in Sweden and growing in Norway, while the number of women using snus on a regular basis is increasing. Swedish Match is the leading manufacturer of snus, with a volume share in Sweden of approximately 86 percent in October – November 2009.2) In Norway, Swedish Match has a volume share of 74 percent.2) The Swedish market is by far the largest market in Scandinavia, with approximately one million consumers of which approximately 20 percent are women. The Swedish market is estimated to have grown by 5 percent in 2009, following two years of market declines. The Norwegian market has grown by double digits in recent years, and in 2009 is estimated to have grown by more than 10 percent. The Travel Retail market, which is comprised primarily of duty paid and duty free shops at airports and on ferries, is estimated to have grown modestly in 2009, after several years of very rapid growth.

Over the past several years, consumers have moved from traditional loose product to pouch snus, which now accounts for about two thirds of volumes in Scandinavia.2)

Tobacco excise taxes in Sweden, based on weight, are a significant proportion of the retail price of a can of snus. During 2009 there were no excise tax increases in Sweden, which meant that no significant hoarding or destocking occurred during the year. During 2008, the weight based tax on snus increased by 90 SEK per kilo, following an increase in 2007 of 123 SEK per kilo, double the level in 2006. In Norway the excise tax increased by 13 percent during 2009.

Point of sales and merchandising

The most important sales channels for snus in Scandinavia are supermarkets, convenience stores, and gasoline stations. Snus is also sold in tobacconists, bars, restaurants, and in Travel Retail outlets which include airports and ferries. The sales price is set by the retailers, with the result that prices can vary widely. Snus is merchandised from coolers to help ensure freshness and quality. During 2009, Swedish Match continued its efforts with its consumer website for the Swedish market. By logging on to:www.swedishmatch.com/konsument, Swedish consumers can easily explore the Swedish Match product range.

Competitors

The largest competitor in Scandinavia is British American Tobacco (BAT), which acquired the snus business of Scandinavian Tobacco Group (STG) including Fiedler & Lundgren (F&L) in 2008. In October– November 2009, BAT (F&L) had a market volume share of approximately 10 percent in Sweden.2) Other competitors on the Scandinavian market include Japan Tobacco Inc. and Imperial Tobacco Group. Imperial Tobacco Group is the largest competitor in Norway, with a market share of approximately 21 percent.2) In Sweden, most competitive brands are positioned in the lowpriced segment, while in Norway most competitive brands are premium priced.

Moist snuff US

Main brands

The largest brands of moist snuff for Swedish Match on the US market are Timber Wolf, Longhorn, and Red Man, launched in 2007 and rolled out nationally in 2008. The Red Man brand for moist snuff draws on the heritage and values of Red Man chewing tobacco, the best selling brand of chewing tobacco in the US.2) The Timber Wolf brand is available in a wide variety of cuts and flavors, and includes Timber Wolf Packs, part of the rapidly growing pouch segment in the US. In 2009, pouches were added to the Longhorn portfolio, making them the first pouches available in the everyday low price segment.

Market development

The US is the world’s largest moist snuff market, with consumption in 2009 estimated by Swedish Match to be approximately 1.2 billion cans. During the past five years, can volume in the moist snuff market has grown at the rate of approximately 6 percent annually, slowing to a market growth rate of 1.6 percent in volume terms in 2009.2) This growth comes primarily from new consumers, including cigarette smokers, who recognize the advantages of this smokefree product in a country where smoking restrictions continue to intensify. Moist snuff is sold throughout the US, and volumes are particularly strong in the Southeast, Southwest, and mid-Atlantic states.

The fastest growth in the US moist snuff market is in the value priced and pouch segments. In 2009, the value priced segments accounted for nearly 50 percent of total category volume. The Swedish Match portfolio is almost exclusively in the value priced segments, with both traditional loose and pouch products. The pouch category grew by approximately 20 percent in 2009, continuing its rapid growth of recent years. The pouch category now accounts for close to 10 percent of the cans of moist snuff sold in the US.2)

During the first half of 2009, competitors significantly reduced list prices on their premium products, while modifying their use of promotional support for these products. List prices for value priced products increased during the middle of the year, largely offsetting an increase in the federal excise tax on moist snuff. List prices for premium products did not change following the excise tax increase. As a result, the gap in the list price between premium and low priced products narrowed considerably between the beginning of the year and the middle of the year. In addition, tax adjustments in some states altered the relative pricing landscape in those states. Despite the turbulence of relative pricing, the value priced segments continued to significantly outperform the market as a whole, up by approximately 7 percent.

In June, the Food and Drug Administration was given regulatory authority over the US tobacco industry. Regulations will cover products, in terms of labeling, advertising, and product sampling, and will generally be in full effect from mid-year 2010.

Snuff is a dynamic category, with new products, new brands, and line extensions constantly offering consumers a wide variety of choices. For the full year 2009, Swedish Match market share by volume was 12.9 percent, up from 12.4 percent in 2008.2) Red Man averaged 1.7 percent of the market in 2009, up from 1.3 percent in 2008. The Longhorn brand also experienced significant share gains, with volume share averaging 5.1 percent in 2009, up from 4.6 percent in 2008.2)

Point of sales and merchandising

The main distribution channels are convenience stores and gas stations, discount tobacco outlets, supermarkets, as well as the Internet. The product is merchandised through point of sale displays, and supported by both in-store and adult lifestyle related activities.

Competitors

The largest competitors on the market are Altria (UST), with a market share by volume of 55 percent for 2009, and Reynolds American (Conwood), with a market share of 31 percent.2)

Snus US

Market development

Swedish Match, as well as other competitors, continued efforts to assess and develop a market for pasteurized snus in the US market. Still a very small category in the US, Swedish style snus is considered to have a long term growth potential. Consumption in 2009 estimated by Swedish Match to be more than 15 million cans, more than four times larger than 2008. The category has received extensive media attention during the year, as one of the largest moist snuff competitors began rolling out their snus product nationwide.

The main Swedish Match brand for snus in the US is General, available in selected tobacconists. During the year, following successful trials, the General brand was expanded into more outlets and was available in more than 600 stores at year end.

Point of sales and merchandising

The Swedish Match main snus distribution channels are high end and specialty cigar and tobacco stores, as well as the Internet – places where consumers are able to spend more time to learn about snus and the Swedish snus experience. Snus may also be sold in selected convenience stores and gas stations, discount tobacco outlets, and supermarkets. The product is merchandised through point of sale displays in coolers. By logging on to www.generalsnus.com, consumers can find information about Swedish Match products.

Competitors

The largest competitors on the market are Reynolds American and Altria.

Snus outside of Scandinavia and the US

With the establishment of a joint venture company with Philip Morris International, Swedish Match now has more opportunities to produce snus for markets outside of Scandinavia and the US. The joint venturecompany, 50 percent owned by Swedish Match, will source its products from Swedish Match, and sell them through the PMI sales and distribution network. The joint venture company will thereby have both state of the art products and outstanding distribution capabilities.

During 2009 the joint venture company entered into the research phase, and field research is expected to take place in some test markets during 2010. In September Swedish Match ceased to manufacture dry nasal snuff with the sale of its South African pipe tobacco and accessories business to PMI.

Production and distribution

In Sweden, production of snus takes place in Gothenburg and Kungälv. The Kungälv facility opened in 2003, and is currently being expanded. This state of the art unit specializes in pouch products including the Swedish Match proprietary white-portion technology.

In the US, production of moist snuff takes place in Owensboro, Kentucky. The Owensboro factory, in addition to moist snuff, produces chewing tobacco and pipe tobacco. Swedish Match has developed a flexible production platform at the plant which allows resources to be employed where needed. This flexible setup means that the Group can efficiently adapt to production changes as increases in snuff production offset declines in chewing and pipe tobacco. Prior to September 2009, Swedish Match produced nasal snuff in Boksburg, South Africa.

Distribution for all tobacco products in Sweden, including products from other manufacturers, is shipped from the Group’s distribution facilities in Stockholm and Gothenburg. A significant portion of purchase orders are processed through its webshop and supplementary electronic purchase systems. Products are most often delivered on a weekly basis to avoid retail out of stock situations.

In the US, Swedish Match ships products daily to wholesaler and selected retailer locations throughout the country direct from its production facilities and through both owned and third-party warehouses.

July, 2010|Oral Cancer News|

Quantifying the effects of promoting smokeless tobacco as a harm reduction strategy in the USA

Source: http://tobaccocontrol.bmj.com
Authors: Adrienne B Mejia et al.

Background:
Snus (a form of smokeless tobacco) is less dangerous than cigarettes. Some health professionals argue that snus should be promoted as a component of a harm reduction strategy, while others oppose this approach. Major US tobacco companies (RJ Reynolds and Philip Morris) are marketing snus products as cigarette brand line extensions. The population effects of smokeless tobacco promotion will depend on the combined effects of changes in individual risk with population changes in tobacco use patterns.

Objective:
To quantitatively evaluate the health impact of smokeless tobacco promotion as part of a harm reduction strategy in the US.

Methods:
A Monte Carlo simulation of a decision tree model of tobacco initiation and use was used to estimate the health effects associated with five different patterns of increased smokeless tobacco use.

Results:
With cigarette smoking having a health effect of 100, the base case scenario (based on current US prevalence rates) yields a total health effect of 24.2 (5% to 95% interval 21.7 to 26.5) and the aggressive smokeless promotion (less cigarette use and increased smokeless, health-concerned smokers switching to snus, smokers in smokefree environments switching to snus) was associated with a health effect of 30.4 (5% to 95% interval 25.9 to 35.2). The anticipated health effects for additional scenarios with lower rates of smokeless uptake also overlapped with the base case.

Conclusions:
Promoting smokeless tobacco as a safer alternative to cigarettes is unlikely to result in substantial health benefits at a population level.

Authors: Adrienne B Mejia1, Pamela M Ling2, Stanton A Glantz3

Authors’ affiliations:
1Center for Tobacco Control Research and Education, University of California, San Francisco, USA
2Division of General Internal Medicine, Department of Medicine, Center for Tobacco Control Research and Education, University of California, San Francisco, USA
3Division of Cardiology and the Philip R Lee Institute for Health Policy Studies, Department of Medicine, Center for Tobacco Control Research and Education, University of California, San Francisco, USA