appendix 19 hookah - tobacco-free uteptobaccofree.utep.edu/tobaccoproducts.pdf · cigarettes...

What is a hookah? A hookah is a waterpipe used to smoke specially-flavored tobacco called “shisha”. The tobacco is heated with charcoal and filtered through the water-filled body of the pipe before being inhaled through a hose. Hookah smoking is a social activity, often done in bars or cafés, with a single session lasting up to 60 minutes. The device has been used for centuries in the Middle East and Asia. U.S. brands of shisha include Social Smoke and Fumari. Hookah smoking is NOT safer than smoking cigarettes. Smoking hookah carries many of the same health risks as cigarette smoking: cancer, respiratory illness and lung damage. Hookah smoke may feel smoother and not “burn” when you inhale, but the smoke still contains dangerous toxins such as tar and carbon monoxide. Smoking a hookah is NOT less addictive than smoking a cigarette. Similar to the tobacco in cigarettes, shisha contains nicotine and carries the same risk of getting hooked as any other tobacco product. Hookah smokers can inhale 100 times more smoke during a one hour session than a single cigarette! The water does NOT filter out harmful chemicals. Even after it passes through water, hookah smoke contains high levels of carbon monoxide, heavy metals and cancer-causing toxins making it just as harmful to the body as cigarette smoke. Heating tobacco is NOT healthier than burning it. It doesn’t matter how the smoke is produced, hookah smoke is just as dangerous as cigarette smoke. In fact, hookah smokers puff more often and inhale more deeply, absorbing higher concentrations of the same toxins in cigarette smoke. Herbal shisha is NOT a safe alternative. Herbal shisha may not contain nicotine, but you are still exposed to cancer-causing substances. The charcoal used to heat it produces large amounts of carbon monoxide and tar. Even if you don’t inhale you are still putting yourself at risk. The health risks include gum disease, tooth loss, oral cancer and the effects of secondhand smoke. Sharing mouthpieces not properly washed between uses also exposes you to bacteria and viruses such as hepatitis, mono, flu and herpes. Just being around hookah smoking is dangerous. Charcoal used to burn the tobacco generates high levels of carbon monoxide, an extremely toxic chemical. Even without inhaling directly, those around hookah smoking are exposed to the carbon-monoxide filled smoke.

Hookah

Sources: Knishkowy, B., Amitai, Y. (2005). Water-Pipe (Narghile) Smoking: An Emerging Health Risk Behavior. Pediatrics, 116, 113–119.; WHO Study Group on Tobacco Product Regulation. (2005) Waterpipe Tobacco Smoking: Health Effects, Research Needs, and Recommended Actions by Regulators.

For more information about Tobacco Free Colleges or for assistance in adopting and implementing tobacco-free policies and promoting cessation visit www.tobaccofreecollegesnc.com.

THE BOTTOM LINE: CHOOSE NOT TO SMOKE HOOKAH.

For free help to quit smoking or using tobacco call 1-800-QUIT-NOW or visit www.smokefree.gov.

Developed by Wake Forest School of Medicine (2012)

Photo courtesy of Wake Forest Baptist Health

Appendix 19

What are little cigars and cigarillos? Little cigars are slightly larger than cigarettes, while cigarillos resemble full-sized cigars, but are smaller. Both contain pipe tobacco wrapped in tobacco leaves and come in flavored varieties. They are available with and without a filter and/or tip. Brands include Swisher Sweets, Black & Mild and Optimos.

Little cigars and cigarillos are NOT safer than cigarettes. Little cigars and cigarillos contain many of the same toxic ingredients as cigarettes. Smoking little cigars and cigarillos can increase the risk of mouth, throat and lung cancers, as well as heart disease, gum disease and tooth loss. Little cigars and cigarillos are NOT less addictive than cigarettes. Little cigars and cigarillos have more nicotine than cigarettes, and can be just as addictive. Even if you don’t inhale the smoke, you can absorb the nicotine through the lining of the mouth. Removing the liner does NOT make them less harmful. Taking the liner paper out of the tube of cigarillos (also called hyping or freaking) does not make them less harmful. Even if you don’t inhale you are still putting yourself at risk. Smoking little cigars and cigarillos directly exposes your lips, mouth and throat to smoke and its harmful chemicals. You also still breathe in large amounts of smoke from the lit end of the cigar. Whether or not you inhale, you are still at risk for lung cancer, heart disease, lung disease and oral problems. Just being around smokers is dangerous. Little cigar and cigarillo smoke is very harmful even to non-smokers around them. Secondhand smoke exposure is associated with lung cancer, heart disease and premature death.

Little Cigars & Cigarillos

THE BOTTOM LINE: CHOOSE NOT TO SMOKE.


Sources: National Cancer Institute (1998). Smoking and tobacco control monographs. Monograph 9: Cigars: Health effects and trends, Bethesda, MD. NIH Pub. No. 98-430; U.S. Department of Health and Human Services (2006). The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Rockville, MD: U.S.


Cigar

Cigarillo

Cigarette

Little Cigar



Appendix 20

What are bidis & kreteks?

Bidi Bidis (pronounced “bee-dees”) are small, thin hand-rolled filtered or unfiltered cigarettes imported primarily from India and other Southeast Asian countries that contain shredded tobacco rolled in brown leaves and tied with a string. They come unflavored or in a variety of flavors such as pineapple, chocolate or vanilla. Kretek (Clove cigarette) Kreteks (pronounced “cree-techs”) are cigarettes imported from Indonesia that contain tobacco, ground cloves, clove oil and other additives and can be either filtered or unfiltered. They typically release a sweet smell. Bidis and kreteks are NOT safer than cigarettes. Natural does not make it safer. Bidi and kretek smokers are at risk for cancer, heart disease, heart attack, and lung problems. Unfilitered bidis and kreteks can actually contain more tar, nicotine and carbon monoxide than regular cigarettes. Bidis and kreteks are NOT less addictive than cigarettes. Bidi smoke contains 3 to 5 times more nicotine than a regular cigarette. Bidi and kretek smoking carries the same risk of getting hooked as any other tobacco product. No warning label does NOT mean they are safe. They may not always have a health warning, but it is a misconception to think they are safe. Smoking bidis and kreteks is just as dangerous as smoking regular cigarettes and several states have laws banning their sale and distribution. Research shows that smoking bidis and kreteks can lead to oral cancers, lung cancers, and other health risks similar to the ones experienced by cigarette smokers. The fruit and candy flavorings may appeal to youth. The FDA, the Centers for Disease Control and Prevention, and the American Academy of Pediatrics have all expressed concern that flavorings may be appealing to youth and may increase youth tobacco use.

Bidis & Kreteks

THE BOTTOM LINE: CHOOSE NOT TO SMOKE. For free help to quit smoking or using tobacco call 1-800-QUIT-NOW or visit www.smokefree.gov.

Source: Centers for Disease Control and Prevention (n.d.) Bidis and Kreteks. Retrieved June 7, 2012 from www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/bidis_kreteks/.


Photo courtesy of Ludvig Dave



Appendix 21

What is an electronic cigarette? Electronic cigarettes (or e-cigarettes, e-cigs) are battery operated nicotine delivery devices made to look and feel like regular cigarettes. Or, they can be made to look like an everyday item such as a pen or USB memory stick, for people who want to use them without being noticed. Liquid nicotine and other chemicals in the cartridge are heated and vaporized by an internal battery, then inhaled through the mouthpiece. The act of smoking an e-cigarette is often called “vaping”. The nicotine cartridges come in various nicotine strengths and fruit and candy flavors. Brands include Blu, NJoy, V2 and Smoke Tip. There is NO proof e-cigarettes help people quit smoking. E-cigarettes have not been approved by the FDA as a nicotine replacement therapy and are not recommended to help quit smoking. You can NOT use e-cigarettes anywhere. Many smoke-free venues, including workplaces, airlines, restaurants and bars prohibit the use of e-cigarettes. It is completely legal for an owner or manager of an establishment to ban e-cigarettes. There are NO quality controls on e-cigarettes. While candy flavored cigarettes have been banned by the FDA, e-cigarettes are still produced in candy and fruit flavors such as strawberry, mint, and chocolate. Very limited research has been conducted on the safety of e-cigarettes and the risks posed by them are unknown. There’s no way to know what’s in the product and what you are putting in your body. The fruit and candy flavorings may appeal to youth. The FDA, the Centers for Disease Control and Prevention, and the American Academy of Pediatrics have all expressed concern that e-cigarettes may be appealing to youth and may increase youth tobacco use.

Electronic Cigarettes

THE BOTTOM LINE: CHOOSE NOT TO VAPE.



Sources: U.S. Food and Drug Administration (2009). FDA and Public Health Experts Warn About Electronic Cigarettes; Wollscheid, K. A., & Kremzner, M. E. (2009). Electronic cigarettes: Safety concerns and regulatory issues. American Journal of Health-System Pharmacy, 66(19), 1740-1742.



Appendix 22

Appendix 23

What is snus? Snus (pronounced “snoose”) is a flavored, smokeless tobacco product that does not require spitting. Originally created in Sweden, snus comes in small, teabag-like pouches that are placed between the lip and gums. Snus is available in a variety of flavors and may be highly appealing to youth. Brands include Camel, Marlboro, Skoal and Discreet. Snus was the first smokeless tobacco product to be co-branded (i.e., share the same name) with cigarettes. You CAN’T hide it. You may think you can hide it because snus is spitless, but your mouth will give you away through stained teeth, gum disease and dental cavities. Snus is NOT a safe substitute for cigarettes. There is no safe form of tobacco. Using snus may put you at risk for pancreatic cancer, gum disease and sores on the mouth. Smokeless tobacco is NOT less addictive than cigarettes. Snus contains nicotine and can lead to addiction. In fact, there is some evidence that smokeless tobacco users may also smoke cigarettes. There is NO proof snus can help you quit smoking. There is no scientific evidence that snus is an aid to help you quit smoking. Although snus has been promoted as a potential harm-reduction strategy for cigarette smokers, it has not be shown that smokers switch products and there is some evidence that those who use both cigarettes and snus actually have an increased risk of tobacco-related morbidity and mortality.

Snus


Sources: Foulds, J., & Furberg, H. (2008). Is low nicotine Marlboro snus really snus? Harm Reduction Journal, 5(9), 1-5; Campaign for Tobacco Free Kids (2006). The United States isn’t Sweden.; Mejia, A. B., Ling, P. M., & Glantz, S. A. (2010). Quantifying the effects of promoting smokeless tobacco as a harm reduction strategy in the USA. Tobacco Control, 19, 297–305; Wetter, D. W., Kenford, S. L., Welsch, S. K., Smith, S. S., Fouladi, R. T., Fiore, M. C., & Baker, T. B. (2004). Prevalence and predictors of transitions in smoking behavior among college students. Health Psychology, 23(2), 168-177.

THE BOTTOM LINE: CHOOSE NOT TO USE SNUS.




Photos courtesy of Wake Forest Baptist Health

What are dissolvables? Dissolvables are new flavored smokeless tobacco products made from finely ground tobacco that are designed to dissolve in the mouth within 30 minutes. The products come as pellets (Orbs) that resemble mints, a twisted stick that looks like a toothpick (Sticks) and a film strip for the tongue (Strips) similar to breath strips. Brands include Camel Sticks, Strips and Orbs, Marlboro Sticks, Skoal Sticks, Ariva and Stonewall Lozenges. While the Ariva and Stonewall products are available nationwide, the Camel products are being test marketed in Charlotte, NC and Denver, CO; and the Marlboro and Skoal products are being test marketed in Kansas. You CAN’T hide it. You may think you can use these products without being noticed, but your mouth will give you away through stained teeth, gum disease and dental cavities. Dissolvables are NOT a safe substitute for cigarettes. There is no safe form of tobacco. Using dissolvables may put you at risk for oral cancer. Smokeless tobacco is NOT less addictive than cigarettes. Smokeless tobacco products, including dissolvables, contain nicotine and can lead to addiction. In most cases, the products deliver a level of nicotine equal to or higher than smoking a cigarette. There is NO proof dissolvables can help you quit smoking. There is no scientific evidence that smokeless tobacco products can help you quit smoking. All forms of tobacco are harmful- there is no safe level of tobacco use.

Dissolvables

THE BOTTOM LINE: CHOOSE NOT TO USE TOBACCO.


Source: U.S. Food and Drug Administration (2012). TPSAC Report on Dissolvable Tobacco Products. Accessed on February 28, 2012 from http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/TobaccoProductsScientificAdvisoryCommittee/UCM290182.pdf.



Appendix 24

What are little cigars and cigarillos? Little cigars are slightly larger than cigarettes, while cigarillos resemble full-sized cigars, but are smaller. Both contain pipe tobacco wrapped in tobacco leaves and come in flavored varieties. They are available with and without a filter and/or tip. Brands include Swisher Sweets, Black & Mild and Optimos.

Little cigars and cigarillos are NOT safer than cigarettes. Little cigars and cigarillos contain many of the same toxic ingredients as cigarettes. Smoking little cigars and cigarillos can increase the risk of mouth, throat and lung cancers, as well as heart disease, gum disease and tooth loss. Little cigars and cigarillos are NOT less addictive than cigarettes. Little cigars and cigarillos have more nicotine than cigarettes, and can be just as addictive. Even if you don’t inhale the smoke, you can absorb the nicotine through the lining of the mouth. Removing the liner does NOT make them less harmful. Taking the liner paper out of the tube of cigarillos (also called hyping or freaking) does not make them less harmful. Even if you don’t inhale you are still putting yourself at risk. Smoking little cigars and cigarillos directly exposes your lips, mouth and throat to smoke and its harmful chemicals. You also still breathe in large amounts of smoke from the lit end of the cigar. Whether or not you inhale, you are still at risk for lung cancer, heart disease, lung disease and oral problems. Just being around smokers is dangerous. Little cigar and cigarillo smoke is very harmful even to non-smokers around them. Secondhand smoke exposure is associated with lung cancer, heart disease and premature death.

Little Cigars & Cigarillos

THE BOTTOM LINE: CHOOSE NOT TO SMOKE.


Sources: National Cancer Institute (1998). Smoking and tobacco control monographs. Monograph 9: Cigars: Health effects and trends, Bethesda, MD. NIH Pub. No. 98-430; U.S. Department of Health and Human Services (2006). The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Rockville, MD: U.S.


Cigar

Cigarillo

Cigarette

Little Cigar



Appendix 20

appendix 19 hookah - tobacco-free uteptobaccofree.utep.edu/tobaccoproducts.pdf · cigarettes...

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