------- Moist Snuff Users -------

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Move to Smokeless Tobacco

Cigarette sales in the United States have been declining over the last two decades.

Tobacco companies are looking for alternative tobacco products to bolster their growth and halt the decline. They think they found their salvation product – smokeless, spitless portioned tobacco packets (sachets) - tea-bag like pouches.

Smokeless tobacco has grown in popularity as restrictions on public smoking have increased. Smokeless tobacco product sales have increased more than 30% in the past 10 years. Moist snuff (finely ground tobacco, also called dipping tobacco)products have been growing at 4% to 5% for the past five years as smoking bans make it harder to light up in public places. In 2006 the moist snuff market jumped almost 10% and from 2001 to 2005 the number of adult consumers of smokeless tobacco rose from about 4.7 million to about 6 million. U.S. cigarette sales still far exceed smokeless at more than $70 billion vs. more than $3 billion (Going Smokeless, John Reid Blackwell, Richmond Times Dispatch, 4/9/2007). As a result of the increased consumption of moist snuff there's now a demand for dark fire-cured and air-cured tobacco.

While we will not provide detailed information about our test market for competitive reasons and because it is too early, I can tell you that we are pleased with the strong distribution we have achieved in more than 2,000 retail stores across Indianapolis and the initial response to Taboka from adult consumers who have tried it in the marketplace. Taboka is our first product in an adjacent category (part of PM's adjacency growth strategy) and we expect to bring other new products to market in the future (Remarks by Michael E. Szymanczyk Chairman and CEO Philip Morris USA at Prudential Consumers Conference, Boston, 9/7/2006). Mr. Szymanczyk remarks describing Taboka. Other comments on the test marketing of Taboka: has not released any sales figures, citing competitive reasons. John R. Nelson, Philip Morris' president of operations and technology would only say that the company has learned a lot from the test market. "The smokers who try it find it to be a good tobacco product. Whether that means they are going to switch from cigarettes to this product, we have to wait and see," Nelson said (Going Smokeless, John Reid Blackwell, Richmond Times Dispatch, 4/9/2007).

Thursday, October 5, 2006—Philip Morris International (PMI) has acquired through one of its affiliates Rocker Production AB (Rocker), a privately owned manufacturer of snus. "I am extremely pleased with this acquisition, which provides an entry for PMI into the profitable and growing market for snus in Sweden," said Jos Arkes, area director Nordics, PMI. "The acquisition of Rocker will allow PMI to gain product development and manufacturing expertise in this important market segment, where we are not currently present." Rocker, located in Arvika, Sweden, manufactures and sells the Rocker brand of snus and, according to AC Nielsen figures, accounted for 0.1% of the Swedish snus market during the first half of this year. According to Swedish tax authority data, snus accounts for 52.5 per cent of the total amount of tobacco sold in Sweden and PMI expects snus to have a yearly growth rate of 0.4 per cent, based on current market trends. The acquisition is not expected to have a near-term impact on PMI earnings.

Richmond Post Dispatch 2/11/2007 - Univeristy of Virginia (UVA) receives a $25 million gift from Philip Morris USA (PM). The bulk of which will be used for research into preventing youth smoking and reducing the harm caused by smoking. Michael Szymanczyk, Chairman and CEO of PM indicated he was approached by UVA to support the fund raising campaign. Szymanczyk said that regardless of the economic impact, we cannot ignore the fact that cigarette smoking is addictive and causes severe diseases. As cigarette sales in the U.S. decline, the company is venturing into the growing market for smokeless tobacco products. PM is test-marketing one smokeless product in Indianapolis, IN and is investing $100 million to re-equip a previously shuttered plant in York County, VA. PM also is investing in a $350 million research center (in Downtown Richmond) to help develop new products. (Richmond Post Dispatch 2/11/2007). NOTE: NO MENTION OF THE DANGERS OF TOBACCO ITSELF ONLY SMOKING TOBACCO.. Philip Morris USA is planning to make a smokeless tobacco product called Taboka at its 144,000-square foot plant in York, a Virginia Department of Economic Partnership memo said. The plant, which has been idle since 2004, will reopen later this year. Taboka fits the company's "adjacency strategy," which means the product will be tobacco-related, but not cigarettes (Daily Press by the Associated Press, 2/11/2007).

June 9, 2007 - Philip Morris USA is introducing a smokeless product under its Marlboro brand name called Marlboro SNUS pouches (Marlboro Snus will be packaged in a Slidepak that holds 12 pouches). Right now PM is test marketing a smokeless, spitless product called Taboka (Tobaccopaks) Original and Taboka Green (the menthol version) in Indianapolis, IN. The field testing of this product will continue. PM indicates that have leasrned a lot from the Taboka test and are applying those learnings tot he Marlboro SNUStest market. Starting in August 2007 Marlboro SNUS will be introduced in the Dallas/Fort Worth area and will come in 4-varieties: rich, mild, mint and spice. PM New Product Fact Sheet.

Philip Morris is planning to sell a smokeless, spit-free tobacco pouch called Marlboro Snus will be manufactured in Virginia at a plant in York County. Company spokesman Steve Callahan says production will start this month ahead of a consumer test launching in the Dallas-Fort Worth area in August.(June 2007, WWBT-TV, Richmond, VA)

Citigroup tobacco analyst Bonnie Herzog believes that the entrance of the new spitless pouches catering to smokers is a positive move. She anticipates "rapid expansion, given what PM has learned from Taboka snus." Herzog also said that using the Marlboro name to sell the product will attract the majority of smokers that will cross over into the smokeless market. (American Wholesale Marketers Association Update)

Reynolds American this summer (2006)is test marketing a similar product that is refrigerated prior to purchase called Camel Snus (snus is the name used in Sweden for moist snuff) in two cities – Austin, TX and Portland, OR. (It is felt that it would be easier marketing the product if it was tied to popular cigarettes that people already recognized.) It comes in three varieties: original, frost and spice and is touted as "another tobacco pleasure" for adults that can be used "anytime, anywhere" (MSNBS Money May 18, 2006, 11:41pm ET). Camel Snus is touted as "another tobacco pleasure" for adults, that can be used "anytime, anywhere. Camel Snus will be manufactured in Sweden in conjunction with British American Tobacco, Inc. (BAT) and kept refrigerated until the tin is sold. (BAT is the largest stockholder in Reynolds American with approximately 42% of shares.

Summary Reynolds American Inc. 2006 Financial Results Daniel M. Delen (joined R.J. Reynolds Tobacco Company as president on January 1, 2007) said "He was pleased with the Camel Snus test market, which is providing valuable learning that will enhance the product's potential." Conwood's performance in 2006 further solidified the company's position as the smokeless-tobacco growth leader, with the company delivering strong gains in volume, market share and profits. In 2006, one of every four cans of moist snuff sold in the United States was manufactured by Conwood. (February 8, 2007)

In about May 2005 BAT introduced two new snus products – one an extension of its Lucky Strike cigarettes and the other of its Peter Stuyvesant cigarettes--in Johannesburg, South Africa and Stockholm, Sweden for consumers. (Anton Rupert, a South African billionaire owns about 28% of BAT.) BAT opened a new facility to research and test new snus products at its Southampton, England laboratories this month.

U.S. Smokeless Tobacco Co. (in 2001 U.S. Tobacco Company changes its name to U.S. Smokeless Tobacco Company - UST) Revel since August 2001 – a small paper packet of moist ground tobacco with flavors like mint, wintergreen and cinnamon about the size of a piece of gum – “a chicklet”). Revel was tested marketed for the 1st 6-months in Topeka, KA and Youngstown, OH. This month (July 2006) UST will come out with a similar product to Revel called Skoal Dry Tobacco Packs and will be test marketed in Louisville, KY and in Austin, TX going head-to-head with Camel Snus. Skoal Dry comes in three flavors: regular, menthol and cinnamon and will sell for $3.50 - $4. a pack or about the same as a pack of premium cigarettes. Each can will contain about 20 tobacco pouches. (Tobacco Journal International August 3, 2006) The Skoal Dry web site indicates this product is exclusively for adult smokers who still want to enjoy real satisfaction without the restrictions of smoking. Other tags: No Spit No Smoke No Boundaries, A suprisingly refreshing experience, Skoal Dry is discreet so others wouldn't notice you're enjoying it. (Packets are suppose to be smaller than with Revel).

The launch of Skoal Dry will likely spell the end of the five-year experiment with Revel, said Murray Kessler, UST’s president and chief operating officer. Skoal Dry uses a bigger pouch than Revel and uses a new technology to coat each bit of tobacco with additional flavor. With Revel, the company faced the twin hurdles of introducing an unfamiliar product and doing it with a name that had no familiarity to consumers. It was found, that nine out of 10 smokers who tried smokeless still rejected the product. Mr. Kessler still thinks that Skoal Dry is the wave of the future. (UST could end test of Revel brand by year's end, Tobacco Journal International (TJI) Newsletter June 22, 2006)

Swedish Match (SM)is a unique company with its range of market-leading brands in the product areas of snuff and chewing tobacco, cigars and pipe tobacco -- tobacco's niche products -- as well as matches and lighters. SM is the leading global manufacturer of matches and the third-largest manufacturer of disposable lighters. SM is the leading producer of snuff products in Sweden and now has a presence in the U.S. – Swedish Match North America located in Richmond, VA. and produces loose leaf and moist snuff tobacco in Owensboro, KY. (Pinkerton Tobacco Company of Owensboro had produced Red Man since 1904 - the leading brand of chewing tobacco in the United States. In 1985, Pinkerton was acquired by a Swedish corporation and (after further corporate reshuffling) the Red Man brand now falls under the umbrella of the Swedish Match company.) This company has been marketing moist snuff products (Timber Wolf, Longhorn, Renegade portions) in the states since 2001. Swedish Match North America, Inc., offers two primary moist smokeless brands. Timber Wolf is said to be a high-quality alternative to premium-priced moist snuff brands and a leader in the price-value segment. Timber Wolf accounts for 20 percent of price-value brand sales (AC Nielsen YTD 2005). According to Swedish Match, Longhorn is one of the fastest-growing moist snuff brands in the marketplace. It is positioned as a high-quality product with premium branding at an “everyday low price” and is available in six flavors/cuts. MYRTLE BEACH, S.C. 2/23/2007 -- The Hooters Pro Cup Series is pleased to announce that Longhorn, a leading value-priced moist snuff brand manufactured by Richmond, Va. based Swedish Match, will return to the series as the "Official Tobacco Product" for the 2007 season (by Paul Warner, WhoWon.com).

Swedish Match North America, Richmond, Va., has announced that as a result of solid market performance in Washington, D.C. and New York City, it has introduced reduced-harm tobacco products for cigarette smokers in both Chicago and Minneapolis. General and Exalt, both premium brands of Swedish snus (oral moist snuff), can be found in local tobacconists throughout these metropolitan areas (Tobacco Retailer, October, 2004).

STOCKHOLM (AFX, 11/29/2006) - Swedish Match AB hiked its 2006 growth forecast for the US moist snuff market, to 9-10 pct from 8 pct, the news agency Direkt report citing a company spokesman.

GREENSBORO, N.C., Oct. 25, 2006 /PRNewswire-FirstCall/ -- Lorillard Tobacco Company today announced that it has entered into an agreement with Swedish Match North America to jointly develop and market a select line of smokeless tobacco products in the United States. The parties anticipate that an initial product offering may be launched on some basis of geographic distribution in the not too distant future. Swedish Match North America Inc. is the third leading manufacturer of moist snuff in the United States, with such well-known brands as TimberWolf and Longhorn moist snuff, and is a leading manufacturer of Other Tobacco Products, such as Red Man chewing tobacco, Half & Half pipe tobacco, and White Owl and Garcia Y Vega cigars. Swedish Match North America Inc. is a US subsidiary corporation of Swedish Match AB, a Swedish corporation. Swedish Match shares are listed on Stockholmsborsen (SWMA). Lorillard Tobacco Company is the third largest manufacturer of cigarettes in the United States, including the Newport brand, the best selling menthol cigarette in the country, and the Maverick, Old Gold, Kent and True brands. Lorillard is a wholly owned subsidiary of Loews Corporation (NYSE: LTR; CG). Source: Lorillard Tobacco SOURCE Lorillard Tobacco Company

Blue Whale, based in King of Prussia, Pennsylvania, will introduce a fourth new product - a smokeless tobacco substitute without a pouch made of black tea and nicotine extract - in August 2006. Blue Whale's TV and print ads feature a woman's manicured hand lifting a can of Blue Whale from a man's rear jeans pocket. The company will also advertise on radio, and offer free samples. The U.S. Food and Drug Administration has no jurisdiction over tobacco products, but Blue Whale does not contain tobacco and could be considered a food product. The company says the regulator has told it that agency approval was not required for its smokeless tobacco substitute. But Matthew Myers, president of the Campaign for Tobacco-Free Kids, predicted that the FDA would eventually ban Blue Whale.

Test marketing is most likely just a formality, and then these snus-like products will be sold in retail stores nationwide. Convenience store owners are anxiously waiting for the new tobacco product to arrive on their shelves. For the last few years they have experienced ever-dwindling margins on cigarettes and the number of cigarette smokers decreasing.

Comments Star Scientific Inc.,based in Chester, VA

August 9, 2006 - There was heightened activity in this market segment recently as test markets for several smokeless tobacco products were launched in Austin, Texas and Indianapolis, Indiana. However, those products (Camel Snus, Skoal Dry and Taboka), like a number of others, are pouches of smokeless tobacco that must be inserted into and then removed from the mouth after use. Both Ariva(R - introduced in 2003) and Stonewall Hard Snuff(R - introduced in 2001) Star products are distinctly different, however: as the only completely dissolvable smokeless tobacco products in the marketplace, there is neither residue nor spitting involved with either product. Stonewall is a larger version of Ariva, so it may appeal to heavier smokers. Like Ariva it is flavored with wintergreen.

Chester, VA Business Wire - Aug 9, 2006 - Star Scientific Reports on Second Quarter 2006 Results An independent analysis of Star's smokeless tobacco products recently validated the extremely low TSNA levels in Ariva(R) and Stonewall Hard Snuff(R). That analysis tested TNSA levels in a variety of smokeless tobacco products available both in the United States and in Sweden and was conducted by a researcher at the University of Minnesota, who presented the results in June 2006 at a conference at the National Institutes of Health (NIH). The TSNA levels in Ariva(R) and Stonewall Hard Snuff(R), as reported there, are .19 and .28 micrograms per gram, more than three times lower than the next-lowest TSNA product level of .99 micrograms per gram, found in Revel pouches. The Ariva(R) and Stonewall Hard Snuff(R) TSNA levels, as reported in this analysis, also are 25 times lower than those found in the Skoal Long Cut product, and 30 times lower than those found in the Copenhagen Long Cut product. Star believes that these figures speak for themselves, and that continued expansion of Ariva(R) and Stonewall Hard Snuff(R) distribution and consumer acceptance can ultimately make an important impact on the risk associated with conventional tobacco use. One component of the company's efforts to meet these goals includes continued development and test marketing of a new flavor of Stonewall Hard Snuff(R), during third quarter 2006, that will be known as "Natural". Monday, 3/19/2007 - Star revealed that, in addition to its efforts to promote its dissolvable tobacco brands, Ariva and Stonewall Hard Snuff, it would focus on developing new flavors for both the brands, providing better choice to tobacco users in selecting either smoking or using the transitional moist snuff (TradingMarkets.com).

Chester-based maker of the smokeless product suggests pending patent suit a factor Jump to full article: Richmond (VA) Times-Dispatch, 2004-12-21 Author: JOHN REID BLACKWELL / TIMES-DISPATCH STAFF WRITER Intro: Cigarette maker R.J. Reynolds Tobacco Co. has stopped test-marketing an alternative tobacco product manufactured by a Virginia company. Chester-based Star Scientific Inc. said yesterday that it was notified by Reynolds last week that its test market of Star's "hard snuff" smokeless tobacco product was "deemed unsuccessful" and has been terminated. Star, a maker of discount cigarettes and smokeless tobacco, signed an agreement in April 2001 with Brown & Williamson Tobacco Corp., then based in Louisville, Ky., to test-market the product, a spitless tobacco lozenge advertised as an alternative to cigarettes. B&W began selling the product in Louisville last year, initially under the brand name Interval, a Star spokeswoman said.

HIGHEST PRIORITY - Keeping Kids from Using Tobacco Products

Our highest priority has to be keeping children from beginning to use tobacco products. Except for Sweden snus (moist snuff) is outlawed by the European Union mainly because it was deemed an attraction to children, who would become easily hooked and move on to cigarettes. (Other countries where smokeless tobacco products are banned including moist snuff are New Zealand, Australia, Hong Kong, Japan, Switzerland and Israel (S Chapman, Public health advocacy and tobacco control: making smoking history, Oxford: Blackwell 2007). As Dr. Richard Carmona, 17th Surgeon General of the United States has stated, "Young people may be especially attracted to smokeless tobacco if they perceive it to be safer than cigarettes. The evidence is clear that the use of smokeless tobacco is a gateway to cigarettes." "Smokless tobacco is a threat to our nation's public health, especially to the health of our children," - U.S. Representative Jan Schakowsky, June 3, 2003.

Kids are well aware of what is happening.. they’ve been told over and over again how bad tobacco smoking can be - it kills. Now – you have public health officials telling people how safe this alternative is and you can still get the same amounts of nicotine (perhaps even more) and much lesser chance of developing a disease. Nicotine addict – studies show after a few cigarettes – the average person starts being addicted to nicotine. Smokeless tobacco delivers a high amount of nicotine. Patricia Richter of the CDC’s Office on Smoking and Health. ‘‘The amount of nicotine absorbed per dose from using smokeless tobacco is greater than the amount of nicotine absorbed from smoking one cigarette.’’ An average dose of nicotine for snuff is 3.6mg, for chewing tobacco 4.6mg and 1.8mg for cigarettes (ACS). Many fear that by endorsing smokeless tobacco as an alterative to tobacco smoking will draw in lots of new customers – the youth of America.

We’re afraid this generation of youngsters will not be able to reach their full potential – their crutch will always be nicotine addiction. In addition, tobacco is considered to be as gateway drug which may lead to alcohol, marijuana and illegal drug use. One study found that snuff consumers consume more alcohol that those that smoke cigarettes (Wickholm S et al., Community Dent Oral Epidemiol. 31(4): 265-274, 2003). Another study found that the nicotine in smokeless tobacco reduces an individuals ability to perform complex tasks that require hand and body movements to adjust to new visual feedback. Don’t you want your child to reach their full potential instead of relying on abused drug to satisfy their addiction the rest of their lives??

The European Court of Justice ruled on (December 2004) Tuesday that an EU ban on the sale of snus - Swedish snuff tobacco - should remain in force. Noting the risk that young people would become addicted to nicotine if they begin to use snus, the Court said that its decision was motivated by a desire to protect the health of European citizens. A lethal dose of nicotine, a neurotoxin used as a insecticide, is contained in as little of three cigarettes – only a fraction of the nicotine contained in a cigarette is actually released into the smoke. There are stories about how people have fallen asleep with the pouch left inside their mouth. – higher amounts of nicotine in pouch then cigarettes. In Sweden, an average SNUS user did so for 13 hours a day, and some nicotine-addicted users even kept a pouch under their lip when they went to sleep, so they would not wake up a 4:00am with a craving (Dr. Gunilla Bolinder, director of education at Stockholm's Karolinska University Hospital, SNUS gets the thumbs-down News-24 1/31/2007).

No federal regulations in place - tobacco products remain virtually unregulated in the United States. Without federal regulations for our kids sake – we must say no to SNUS. A bill giving the FDA the authority to regulate tobacco products failed to pass congress in 2004. An identical FDA legislation was reintroduced in March 2005 and is still pending. The proposed FDA legislation would regulate the sale, marketing and manufacture of all tobacco products. It would also prohibit all flavorings in cigarettes except menthol. As Matthew Myers, Campaign for Tobacco Free Kids, points out – “with the absence of FDA authority over tobacco products – the tobacco companies are free to market their new smokeless tobacco products in ways to encourage kids to start using tobacco and discourage smokers from quitting tobacco entirely. If Senate Bill 666 (DeWine-Kennedy Bill)had already been enacted to regulate tobacco products it would ensure that the marketing of each smokeless product did not discourage current tobacco users from quitting or encourage new users to start. On Thursday (2/15/2007) congressional lawmakers renewed (reintroduced legislation)a push for federal regulation of tobacco, a step they say is needed to deter children from lighting up and to get smokers to quit (The News & Observer 2/16/2007). On Tuesday (2/27/2007), the Senate Health, Education, Labor and Pensions Committee is scheduled to hold a hearing on the legislation, opening a new battle in the tobacco wars. The legislation, aimed at combating youth smoking, would give the FDA authority to restrict tobacco manufacturing, sales and marketing. (FOR YOUTH ALL TOBACCO PRODUCTS NOT JUST CIGARETTES) An op-ed piece by Dr. Alan Blum (Director of the University of Alabama's Center for the Study of Tobacco and Society) argued that the legislation would give No. 1 cigarette-maker Philip Morris "a virtual monopoly" in the current cigarette market and continue to furnish special protection for the company. "The fact that Philip Morris is supporting the bill is strong evidence it's not good for the public health," said Stanton Glantz, director of the Center for Tobacco Control Research and Education at the University of California at San Francisco. "It needs to be fixed to the point that PM doesn't support it," Glantz said (Tobacco Control Bill Gets Hearing by Peter Hardin, Richmond Times-Dispatch 2/26/2007).

In Sweden snus is regulated as a food product. Sanitation requirements in Swedish snus factories are the same as those used in food production. All additives are approved as food additives. (Although snus is not a food, in Sweden it is currently governed by the food legislation. This means that the ingredients used in snus must be approved according to the food legislation and the same stringent hygiene demands as for the manufacture of foodstuffs is imposed, and adhered to.)

Even Chris Proctor, Head of Science and Regulation for British American Tobacco has stated, “We’re also responding to public health stakeholders who told us they believe snus, properly regulated, can contribute to reducing the impact of tobacco on public health. We hope more stakeholders, including governments, will agree.” Hyland et al. (Addictive Behaviors 31:1190-1200, 2006) have concluded that only under strict regulations the increase in low-nitrosamine smokeless tobacco use could reduce overall smoking prevalence yielding potentially substantial health benefits.
Kids would just love this feature, e.g., with Skoal Dry discreet so others wouldn't notice you're enjoying it.
Well - at the present time we have no federal regulations on tobacco products in the USA.

Tobacco Companies Claim Targeting Current Smokers

Philip Morris in the Taboka Fact Sheet states at least three times that this product is for adult smokers interested in smokeless tobacco alternatives to smoking. But is this true – they provide information for parents to convince your child not to smoke yet have promotions to buy one and get one free making it easier for kids to afford to buy cigarettes. Their international record especially in developing countries is disgraceful, e.g., Philip Morris recently made headlines in the Ukraine after releasing a billboard featuring a pregnant woman or how about Philip Morris concerts in Niger where kids as young as 10 were given free cigarettes. In Indonesia, Dji Sam Soe, Philip Morris-owned Sampoerna's flagship best-selling brand, has twice the amount of nicotine and three times the amount of tar of a conventional cigarette.

We all know that Reynolds American doesn’t even care if they knowingly market indirectly to kids. They have been masking the regular tobacco flavor and scent in favor of flavored cigarettes ranging from watermelon (“Beech Breezer”) to berry (“Bayou Blast”) to pineapple and coconut (“Kauai Kolada”) to make it even more appealing for youngsters to take the initial puff and keep smoking until he or she gets hooked. Reynolds has been aggressively targeting the youth and young adult market with several recent marketing campaigns that seek to link smoking with alcohol use, gambling and rebellious behavior. The report details how R.J. Reynolds recently sold alcohol- flavored cigarettes as limited edition brands of an ongoing line of flavored cigarettes called Camel Exotic Blends. Included were packs of cigarettes with names such as Screwdriver Slots, SnakeEyes Scotch and Blackjack Gin. Take a look at one of our modules – Prevent Tobacco Advertising to Our Youth - and you decide whether or not cigarette makers are targeting our Future - the Youth of America. Results of recent surveys indicate that the flavored cigarettes are especially popular among smokers under the age of 25. The studies showed that 20 percent of smokers ages 17 to 19 smoked flavored cigarettes in the past 30 days while only 6 percent of smokers over the age of 25 did. Each day more than 5,000 kids under 18 try their first cigarette, and more than 2,000 become established daily smokers. Anti-smoking advocates are concerned that flavored cigarettes will appeal to the under-18 demographic, which tobacco companies have long targeted with marketing campaigns including images of hip-hop culture, women, and the now retired "Joe Camel." Under the 1998 Master Settlement Agreement with the states, tobacco companies were prohibited from using cartoon images. Since that time, marketing of candy-flavored cigarettes has surged. Although legislation has been introduced in Congress in an effort to regulate the tobacco industry, so far no bills have survived the legislative process. In March 2005, a new bill that if enacted, will immediately prohibit candy and fruit-flavoring in cigarettes and give the Food and Drug Administration (FDA) power to regulate the industry. (American Lung Association, Tobacco Policy Trend Alert, July 26, 2005).

October 11, 2006 – Attorney General of California Bill Lockyer today announced he and the Attorneys General of 38 other jurisdictions have entered a settlement with R.J. Reynolds Tobacco Company (RJR) that ends RJR’s sale in the United States of its candy, fruit and alcohol-flavored cigarettes. “In marketing these products to our youth, RJR violated the agreement it made with the states back in 1998 to stop targeting kids,” said Lockyer. “Hopefully, this settlement will keep RJR from breaking its word again and ensure the company acts responsibly to help protect children from starting a deadly habit.” Under the settlement, RJR agreed to a ban in the United States of its flavored Camel, Kool and Salem cigarettes. The agreement also imposes significant marketing restrictions that make it virtually impossible for RJR to market a flavored cigarette to youth in the future. The curbs apply to any cigarettes manufactured by RJR in the future that have a characterizing flavor other than tobacco or menthol.

The brand styles of flavored cigarettes sold by Reynolds that are banned by the Agreement are: Camel Exotic Blends: Mandarin Mint, Dark Mint, Crema, Izmir Stinger, Twist, Cinnzabar, Mandalay Lime, Aegean Spice, Bayou Blast, Beach Breezer, Margarita Mixer, Midnight Madness, Back Alley Blend, Kauai Kolada, Twista Lime, Winter MochaMint, Warm Winter Toffee, Blackjack Gin, Screwdriver Slots and SnakeEyes Scotch; Salem Silver: Dark Currents, Fire & Ice, Deep Freeze and Cool Myst; and Kool Smooth Fusions: Mintrigue, Mocha Taboo, Midnight Berry and Caribbean Chill.

Regarding the Surgeon General's 2006 Report (released June 27, 2006) on the dangers of second-hand smoke (involuntary smoking) R.J. Reynolds Tobacco said in a statement on its Web site, "It seems unlikely that second-hand smoke presents any significant harm to otherwise healthy nonsmoking adults; and, given the extensive smoking bans and restrictions that have already been enacted, nonsmokers can easily avoid exposure to second-hand smoke."

You can expect more of the same with smokeless, spitless tobacco pouches. We know tobacco product advertising and promotion are important causes of tobacco use among children.

A direct mail campaign by Leo Burnett, part of the Publicis Groupe, features Taboka coupons offering a $2 discount. WASHINGTON, D.C. -- Sen. Susan Collins, R-Maine, has introduced legislation to help crack down on illegal sales of tobacco to children by banning the shipment of cigarettes and other tobacco products through the U.S. mail. The postal code already makes it illegal to mail alcoholic beverages and guns. Specifically, the bill would add cigarettes and smokeless tobacco to the United States Postal Service's list of restricted, nonmailable products (seacoastonliner.com, 8/7/2006).

Revel, the UST product promotion reads “Discreet Smoke-Free Tobacco Satisfaction” - reminding users you can enjoy Revel anywhere you go – to work, to a theatre, a restaurant, the airport or wherever and you can enjoy tobacco privately – in public. It comes in at least three refreshing flavors like mint, wintergreen and cinnamon.

Camel Snus tag will be - “pleasure for wherever whenever.”
Mitch Zeller, a health policy consultant who was director of the Office of Tobacco Programs at the FDA during the Clinton Administration, said the web site for Camel Snus "seems aimed at young adult males to get them to start using products." The site says Reynolds found Snus in Sweden, "home of the world's best meatballs, massage and blondes." Kylie Meiner, the tobacco prevention coordinator for Multnomah County where one of the two test sites for Camel Snus is located is convinced that the marketing is aimed at young people. One direct mail item she received read “Camel Snus – be the 1st on your block to try it” (Portland Tribune, 11/20/2006). Cathryn Cushing, a specialist with the Oregon's Tobacco Prevention and Education Program, "I see it as a young adult marketing strategy, and we have a lot of hip young adults in this city," Cushing said. And "if it appeals to a 22-year-old, I think you can assume it will appeal to a 16-year-old. Because what do 16-year-olds want to be? Twenty-two" (The Oregonian, 1/7/2007). Comment from Metroblogging User - Portland, OR: There are only two drawbacks. First, it doesn't take a genius to see what a boon snus would be to underage users. Heck, you could sit in class with some in your mouth, and no one would be the wiser. At least when I was in high school, you had the telltale clumps of 'chaw' in the water fountains to betray the tobacco user, or at least the worn white rings in the back pocket of your jeans. You could probably hide this stuff from teachers and parents pretty easily. Second, although smokeless tobacco saves you from some of the risk of heart disease and lung cancer, plenty of smokeless tobacco users out there have developed cancer of the mouth or throat, and have had large chunks of their jaws and tongues removed as a result. But that's a hard image to sell to sixteen-year-olds, who are pretty sure that they're immortal ("You Snus, You Lose" posted by PAgent at 1:50pm on January 8, 2007).

Swedish Match has attractive young men and women offering customers in bars and smoke shops a free taste of tobacco. These promoters hope that smokers who don’t want to forced outside to smoke to puff will try snuff (that comes in various flavors) instead. One person who was approached at a New York City bar was offered a free tin even after telling the model he had quit smoking weeks before. Swedish Match and UST have Internet web sites where these products can be ordered and for a limited time shipping is free. UST’s has even had a “Free Gear for Lids” campaign in which tobacco tin lids were exchanged for free outdoor and recreational gear. One snus user has commented that the packet placed in my mouth was so small as to be unnoticeable to the person sitting next to me in the lecture hall.

It seems these players are gearing up to be in the smokeless tobacco business a long time. Tobacco smoking more and more, as sales continue to decline, is looked upon as anti-social and unacceptable behavior. Tobacco companies openly acknowledge that smoke-free laws reduce smoking and consequently cigarette sales.

Mark Smith of R.J. Reynolds, "We're meeting consumer demand. Smoking bans are making it more difficult for adult smokers to enjoy a tobacco product." Reynolds American Inc. on May 31, 2006 completed its $3.5 billion acquisition of a holding company that owns Conwood (traces its roots back to 1782 the founding of the Garrett Snuff Company), the nation's second largest manufacturer of smokeless tobacco products. Conwood is UST's largest competition, its share of the U.S. moist snuff market is approximately 13%. UST is the largest manufacturer of moist snuff product in the U.S. and controls 75-80% of the moist snuff markets (Skoal, Copenhagen). Two other competitors, Swisher International (Silver Creek, Redwood and Kayak moist snuff) having a market share of 4% and Swedish Match with a market share of 6% (Data from July 2002)."Snus and Conwood are separate initiatives but they both demonstrate how committed we are to the non-smoke category," Chief Financial Officer Diane Neal said on a conference call with analysts.

Conwood is the only company to compete in all five segements of the U.S. smokeless tobacco industry, manufacturing moist and dry snuff, and loose leaf, plug and twist chewing tobacco. Conwood holds the No. 1 or No. 2 position in every segment of the smokeless tobacco market. Moist snuff accounts for more than 70% of Conwood Sales, led by both its premium priced brand Kodiak brand and its rapidly growing value-priced Grizzly brand. Conwood will operate as a subsidiary of Reynolds American (Reynolds American News, April 2006). The purchase of Conwood gives Reynolds a quarter of the U.S. smokeless market (The Advocate, 9/19/2006).

Susan Ivey RAI chairman, president and CEO points out that Conwood has an impressive performance record. It’s the nation’s second largest manufacturer of moist snuff. It has No. 1 or No. 2 position in every smokeless category. Conwood has been the growth leader in the moist snuff category, where it has built a 23% share of the market. The moist snuff category, itself has been growing at an annual rate of 4 to 5% for the past five years.” Ivey said. Ivey goes on to say, this purchase, “provides us with an immediate platform that would have taken us years to build,” Ivey said. This purchase “gives us a strong presence in virtually every domestic tobacco category.”

Reynolds American Inc. said Wednesday 2/28/2007 that Conwood Co. LLC, its smokeless-tobacco company, will expand its operations in Winston-Salem and could add up to 100 jobs over the long term. The company said that Conwood will build a $30 million, 88,000-square-foot plant. Reynolds was mum about what products would be made there, however. Payne, a Reynolds spokesperson, said she would not speculate on whether Conwood planned to make any new brands in the plant. The smokeless-tobacco market "is an extremely competitive category," she said. (by M. Paul Jackson, Winston-Salem Journal, 3/1/2007)

For Philip Morris - Bonnie Herzog the tobacco analyst for Citigroup indicates in her report, “This is just the beginning for Philip Morris and depending on the success of this new product …we expect the company to organically (organic growth – typically refers to growth that is not fueled by mergers and acquisitions) launch a full range of other smokeless tobacco products.”

Targeting current cigarette smokers looking for an alternative to tobacco smoking. According to the Center for Disease Control and Prevention 44.5 million US adults were current smokers in 2004. Of these about 70% (33.3 million) want to quit smoking and free themselves of all tobacco products. Most of remaining smokers are older hardline smokers and refuse to quit. Will this latter group of around 11 million smokers be the only target group that the tobacco companies try to convince to go smokeless??

Do you think they have plans to grow the business by broading the target audience like through promotions and advertisements meant for smokers but also to catch the interest of others?? Ms. Judith Wilkenfeld of the Campaign for Tobacco-Free Kids has questioned the logic of promising to market only to adults. She said that kids increasingly aspire to the symbols of adult life -- not Barney (ASH: Tobacco Companies Proposes Weak Advertising Curbs, 9/11/2001.)In Sweden (2004) it has been found that the use of snuff decreases with age and was the highest in the age group 18-29 years (Moist snuff use increases the risk of cancer and death from cardiovascular disease, P. Nordgren, Swedish National Institutes of Public Health). In Swedish Match's homeland (Sweden), the industry portrays snus as an energy boosting stimulant which is becoming increasingly popular among the most discerning nicotine addict. It has been pointed out that snus use among Norway's 16-to-24-year-old men more than trebled between 2002 and 2003, while smoking slipped back (Snuff firms sniff a profit in smoking bans, Jorn Madslien, BBC Newsline Online Business Reporter, Oslo, Norway, 9/6/2004).

The US Federal Trade Commission's annual report on cigarette sales and advertising showed that the major cigarette manufacturers spent $15.15 billion on advertising and promotional expenditures in 2003, an increase of $2.68 billion (26.5%) from 2002 and the most ever reported to the commission. At the same time, the total number of cigarettes sold or given away by those manufacturers decreased by 19.8 billion cigarettes from 2002 to 2003.

Programs to Eliminate Tobacco are Working

Let’s not have another set back for the tobacco control (elimination) movement. Programs to eliminate tobacco are working – tobacco use is becoming a socially unacceptable practice. Aggressive anti-tobacco programs, enacting comprehensive smoke-free laws, increased cost of cigarettes resulting from the penalty from the MSA settlement and increased taxes (some 41 states have passed cigarette-tax increases in the past five years - Dan Smith, University of Florida, 10/11/2006)has lead to a decrease in the number of tobacco smokers putting another nail in the coffin. With the Surgeon General's comprehensive scientific report (The Health Consequences of Involuntary Exposure to Tobacco Smoke, June 2006) on the dangers of secondhand-smoke (involuntary smoking) will likely increase the enactment of more legislation on smoke-free work places. Omaha's tough new anti-smoking ordinance banning (October 2, 2006) the practice in nearly all public places comes with an even tougher enforcement policy. Elected leaders and police department are urging residents who see violations to call the 9-1-1 emergency system for an immediate response. Penalties are $100 for the first offense, $200 for the second and $500 for the third and subsequent infractions. Tobacco store (Tobacconists of Raleigh) is closing in Raleigh, North Carolina after 15 years in business cites declining sales because of the health risks if smoking (The News & Observer, 2/10/2007).

Also, Pfizer’s anti-smoking pill Champix has been approved in the United States and should be available soon to help smokers more easily give up tobacco smoking. In addition, there's a new vaccine called NicVax being tested that will prevent and treat nicotine addiction to help people quit smoking.

"Involuntary Smoking"
Montana State University-Bozeman
Worried about the health effects of secondhand smoke and sick of cleaning up discarded butts, jurisdictions are even banning smoking on beaches and in parks. Hotels, even in the tobacco state of North Carolina are snuffing out smoking in all rooms, restaurants, bars and public areas. Throughout the country including Raleigh, NC apartment renters are being told they or their guests cannot smoke tobacco.

Suffolk County, New York raised the legal age to purchase tobacco from 18 to 19 on May 16, 2005. It's the 1st county in New York State to raise the age to purchase tobacco.) Under the new law any store caught selling tobacco to someone younger than 19 will be subject to a $300 fine for a 1st violation and up to $1500 in fines for subsequent violations (behavorialhealth.typepad.com). Possibly the proper authorities should extent the age to purchase tobacco products until the age of 25. Tobacco companies put out a maximum effort to convince young adults, especially college students, between the ages of 18 and 24 that it's smart thing to do. Where's Philip Morris's anti-tobacco program for this group of youngsters. Thursday, November 16, 2006 — Tobacco Reporter: Belmont, California is set to make history by becoming the first US city to ban smoking on its streets and almost everywhere else, according to a report by Dana Yates in the San Mateo Daily Journal, California. The Belmont City Council voted unanimously on Tuesday night (11/14/2006) to pursue a strict law that would prohibit smoking anywhere in the city except for single-family detached residences. Smoking on the street, in a park or even in a private car would become illegal. The wording of the law still needs to be drafted and it will probably come back to the council either in December or early next year. Bangor, Maine - this week (January 15-19, 2007) a new ordinance went into effect that allows Bangor police to impose a $50 fine on anyone found smoking a cigar, cigarette or other material in a vehicle (on any public road withing city limits) if anyone under 18 is in the vehicle. The State of Connecticut is now starting to consider a similar ordinance for the entire state. Governor Jim Doyle in his State of State speech (1/30/2007) wishlist included a broad effort to stamp out cigarette smoking in Wisconsin (Wisconsin State Journal 2/1/2007).

Companies concerned about paying high health insurance premiums are hesitant to employ people that smoke or use other tobacco products. A healthcare benefits company fired four of its employees for refusing to take a test that determines whether they smoke cigarettes. Weyco Inc., a health benefits administrator based in Okemos, MI adopted this policy January 1, 2005 that allows employees to be fired if they smoke even if the smoking happens after business hours or at home. The company cites concerns over rising healthcare costs for those that smoke. "Wyco Inc. is a non-smoking company that strongly supports its employees in living healthy lifestyles."(TheBostonChannel.com, 1/25/2005). Effective January 1, 2002, as a part of our public health policy, and because of the known effects tobacco use has on our community, Tacoma-Pierce County Health Department does not hire applicants who use tobacco. Smokers at Scott's Miracle-Gro Co. won't even be able to do that much longer. In October 2006, the Marysville, OH based company will begin randomly testing employees and giving pink slips to those who test positive for nicotine. The company announced the ultimatum in November, saying it was giving employees a year to quit, and offered to help with smoking-cessation programs. Scott's officials say it's part of a larger effort to help their employees become healthier (Clock ticking down for smokers at Scott's Miracle-Grow, Susan Deutschle, Business First of Columbus, April 14, 2006).

A Zogby survey of likely voters has found that 45% would support making cigarettes illegal within the next five to 10 years. Currently, cigarettes are not illegal anywhere in the United States (except some jails and prisons, where they are considered contraband), although moves to restrict smoking and tax tobacco products are winning broad acceptance (from Drug War Chronicle, Issue #459, 10/27/06).

In Ireland smoking is forbidden in enclosed places of work. This includes office blocks, various buildings, public houses/bars, restaurants and company vehicles (cars and vans). The Irish Government's ban on smoking in the workplace went into effect March 29, 2004 (Citizens Information Online, Information about Public Service in Ireland). Ireland was the first country in the world to introduce a full smoking ban.

The Framework Convention on Tobacco Control
(FCTC), adopted in 2003 has carried the force of international law since it took affect on February 28, 2005. Already, it has stimulated increases in tobacco excise taxes, the implementation of marketing bans, and the introduction of smoke-free public places in many countries. As we know, these actions have been well documented as effective. Click For further information on the FCTC

We now even find that the use of tobacco is prohibited by Jewish Law and the Christian faith frowns on the abuse of the body through the use of tobacco in any form.

With the limitations placed on smokers they are quitting. Carolyn Littlefield, a 44-year-old Florida resident in town for the summer horse racing season, said New York's rules on banning smoking helped her quit two years ago. "I felt like I had leprosy. After a while you end up outside smoking by yourself. So many people don't smoke now," Littlefied said while enjoying a drink at a popular downtown restaurant and bar.

Smoking cessation accounts for about 40% of the decrease in cancer deaths seen among U.S. men since 1991, according to a report by American Cancer Society researchers. From 1991 to 2003, reductions in tobacco smoking have prevented at least 146,000 cancer deaths among men. The decrease in lung cancer and overall cancer mortality among men began approximately 30 years after the downturn in the smoking rate of U.S. men, the investigators pointed out. Thun, MJ, Jemal, A "How much of the decrease in cancer death rates in the United States is attributable to reductions in smoking?" Tob Control 2006; Oct; 15(5): 345-347.

Regarding litter - in Sweden where snus originated grimy used snus packets litter the otherwise clean streets and subway stations of Stockholm. Besides the effect on the environment these used discarded packets after being in the users mouth for at least 15 minutes will enhance the transmission of contagious diseases such as tuberculosis (we're not talking about health conscious tobacco users here). Also, the more the snus user moves the packet around in their mouth the more juices--some possibly toxic--will be created.

Big tobacco companies are not going to give up. Reynolds American plans to spend $40-million to defeat proposed smoking bans in Arizona and Ohio as well as efforts to raise state cigarette taxes in California (is the single largest domestic market, accounting for about 6% of cigarette sales) and Missouri. On the ballot in November,2006 the measure in California calls for a 300% increase in the state tobacco tax to $3.47 a pack from the current 87 cents. (By the way - a similar increase would apply to cigars and other tobacco products - snus.) Philip Morris USA has invested about (so far) $1.4-million in two communities opposed to the California measure to boost state taxes on cigarettes. Missouri's tax increase will go from 17 cents a pack (second lowest in the nation, South Carolina has the lowest at 7 cents tax on a pack) in November,2006 (2006) to 97 cents and raise taxes on other tobacco products by 20%. October 11, 2006 - Peggy Roberts, a spokeswoman for Philip Morris, said the company has begun consumer and vendor campaigns to defeat a $1-a-pack tax in South Dakota and the 80-cent-a-pack increase in Arizona. Also tobacco companies like Reynolds try to confuse voters. In Ohio, voters are considering two smoking-related measures. SmokeFreeOhio would change state statutes to ban smoking in most buildings other than private homes and a certain percentage of hotel rooms. This one is supported health charities. A rival proposal, backed by Reynolds and a group called Smoke Less Ohio also purports to restrict smoking, through a constitutional amendment. But it would exempt restaurants, bars, bowling alleys and similar establishments, unwinding more restrictive existing municipal bans. Tracy Sabetta, of SmokeFreeOhio, admitted her group may have been politically outmaneuvered when it decided to pursue its measure as a statutory change in state law rather than a constitutional amendement. "We could get 90% of the vote and theirs (Reynolds measure) could still trump ours," she said(The Wall Street Journal, Christopher Cooper).

CLOSE VOTE (Tuesday, November 7, 2006): California Proposition 86 lost, received 48% of the vote, making it the closest statewide contest of the night, despite over $60 million spent by tobacco companies against the measure. A tobacco tax measure was also defeated in Missouri, but others passed in Arizona and South Dakota. Ohio, Arizona and Nevada will become the 15th, 16th and 17th states to implement comphrehensive smoke-free legislation. The other 14 states (as of 11/9/2006) are: California, Colorado, Connecticut, Delaware, Hawaii (effective Nov. 16), Maine, Massachusetts, Montana, New Jersey, New York, Rhode Island, Utah, Vermont and Washington (the Montana and Utah laws extend to bars in 2009, while the Washington DC law does so on January 1, 2007) and Puerto Rico. Two other states – Florida and Idaho – have smoke-free laws that exempt only stand-alone bars. Hundreds of cities and counties have also passed strong smoke-free laws. R.J. Reynolds, Philip Morris, and other tobacco firms reportedly spent $100 million fighting tobacco related ballot issues, with varying degrees of success. Election Results: Tobacco Ballot Initiatives, November 7, 2006

Furthermore, it looks like the tobacco industry has been increasing the levels of nicotine in their cigarettes over the last six years making it even more difficult for smokers to quit. According to the Massachusetts Department of Public Health the overall increase has been about 10% during 1998-2004.(Medical News Today, August 30, 2006)

Kenneth Warner, the Dean of the School of Public Health at University of Michigan – “We have excellent research that shows that work site prohibited smoking reduces smoking rates.” A product that subverted that goal would hardly be a gain for public health.

Remember the rule of thumb that seems to always hang-true: that if a tobacco company comes out in favor of something – this signals that there must be something wrong. The only safe way to break the nicotine dependency is to quit using any form of tobacco.

Playing Right Into the Hands of Big Tobacco

Tobacco companies lack creditability so not many people will believe them when they promote smokeless tobacco as a safer alternative than smoking. (will have branch to highlights) (The level of trust with the tobacco industry is virtually nil, and if this is the industry we're going to rely upon to come up with safer products, we are going to be very, very cautious, very cautious," said Maureen Connelly of the Harvard School of Public Health.)

So these companies are prodding public health officials to come forward and support claims about how safe smokeless tobacco is when compared to tobacco smoking. If this wouldn’t happen tobacco companies before they could advertise smokeless as a harm reduction product would have to provide proof to the Federal Trade Commission.

Certain public health professionals have played right into their hands and have even been outspoken on how safe smokeless tobacco is compared to tobacco smoking. One fellow described as tobacco-policy expert David Sweanor, who teaches law and medicine at the University of Ottawa, puts it, "It's the smoke, stupid." But even Philip Morris’s (USA) Taboka Fact Sheet points out that smokeless tobacco products are addictive and cause serious disease. The U.S. Surgeon General and other public health authorities have determined that smokeless tobacco products: cause serious diseases such as cancer, cardiovascular disease and other diseases of the mouth, gums and teeth; may increase the risk of serious diseases when used in combination with smoking; cause adverse reproductive effects and should not be used during pregnancy; and are not a safe alternative to smoking. Philip Morris USA points out that smokeless tobacco product users and potential smokeless tobacco product users should rely on these messages in making all tobacco-use related decisions.

Public health researchers have come up with various percentages on just how safe going smokeless is compared to smoking. Some say 99% safer others at least 90% reduction in relative risk using low-nitrosamine smokeless tobacco use. (branch regarding nitrosamines and pasteurization of tobacco).

Dr. Jonathan Foulds , Ph.D., MAppSci., MA - Director of the Tobacco Dependence Program at the University of Medicine and Dentistry of New Jersey, has stated: "In comparison with smoking, experts perceive at least a 90 % reduction in the relative risk" of low-nitrosamine smokeless-tobacco use. This makes sense, since it is the 4,000 ingredients in the smoke that make a cigarette so lethal.” Well - smokeless tobacco even without burning has over 2,000 ingredients. Dr.Foulds has stated that smoking a cigarette, though, was not the same as using a smokeless tobacco pouch. The way in which nicotine is delivered makes all the difference, he says. "You can't beat a cigarette for nicotine delivery. It's much faster and in a more concentrated form," Foulds said. "Cigarettes are like a Ferrari, and the [smokeless] pouch is like a secondhand Ford." For tobacco smoking it takes about 10 seconds for nicotine to reach the brain but for smokeless tobacco it may take over a minute. Will this difference cause the smokeless tobacco user to switch back to tobacco smoking when possible. Maybe this delay in reaching active sites within the brain will not be sufficient to provide that instead reward for the nicotine addict. The smoker that is now using smokeless tobacco may switch back to tobacco smoking but now smoking even more cigarettes per day than before. Nicotine absorption, frequency and speed seem to have a direct relationship with how strong dependence and tolerance if any might be created.

Dr. Scott Tomar (DMD, MPH, Dr.PH, University of Florida, College of Dentistry) has found that many smokers who take up the use of snuff in an effort to quit instead end up asking for both products. In addition, he found that nonsmokers who use snuff are more likely than those who don’t to eventually begin smoking. “Men were more than 2.5 times as likely to have switched from snuff to cigarettes than to have switched from cigarettes to snuff,” said Dr. Tomar.

What if smokers switch to smokeless tobacco only to find out it’s not a satisfactory alternative. Smokeless tobacco usually has a higher concentration of nicotine and most likely higher pH so it can be more readily absorbed from the oral mucosa. However – it takes around a minute for sufficient levels to active sites within the brain compared to nicotine from inhaled smoke being absorbed in the lungs taking 10 seconds.

A web site has even been created by a two public health professionals entitled TobaccoHarmReduction.org that attempts to convince people that smokeless is the way to go using either moist snuff and even chewing tobacco. Let's look at two of the major heading on the first page of the site.

These professionals - Dr. Carl V. Phillips at the University of Alberta and Dr. Brad Rodu at the University of Louisville - James Graham Brown Cancer Center, receive funding from United States Smokeless Tobacco (UST) and it seems their results fit perfectly in line with the outcome UST wants to see. Dr. Rodu, a dentist with training in oral pathology, is a professor of medicine and the first holder of the endowed chair in Tobacco Harm Reduction Research The endowed chair and accompanying research fund were created by tobacco companies U.S. Smokeless Tobacco Co. and Swedish Match AB, who committed nearly $3.4 million.
It has been pointed out that much of the research on the relative health impact of smokeless tobacco has been funded by the tobacco industry (Smokeless Tobacco Poses Challenge for Stop-Smoking Advocates, Join Together, 9/20/2006).

Tobacco companies have warned public health professionals if they don’t support the smokeless tobacco alternative they’ll be at fault for the suffering from chronic sickness and death of tobacco smokers.. Even the Mayo Clinic, one of the most prestigious and affluent medical charitable organizations in the US has been accused of misinformation about smokeless tobacco. (“The Mayo Clinic Spreads Misinformation About Smokeless Tobacco by John K. Carlisle, CRC Highlight from Capital Research Center.)

Harm Reduction - The Pharmacology of Moist Snuff - SNUS

Cardiovascular Disease

We were shocked to learn that Dr. Neal Benowitz, a clinical pharmacologist (Professor of Medicine at UCSF and director of its cancer center’s Tobacco Control Program well respected clinical pharmacologist considered the expert in tobacco control told a Los Angeles Times reporter Valerie Reitman for a 2004 article, “If someone can’t quit smoking, there is no question that smokeless is much safer. It doesn’t cause heart or lung disease, and if it does cause cancer, it does slow at a much lower rate.” Dr. Gary Giovino, Director of the Tobacco Control Program at Roswell Park happened to be at the same interview and chimed in by saying that he totally agrees with what Dr. Benowitz has stated.

Smokeless tobacco will reduce the incidence of respiratory disease including lung cancer and the effects of secondhand smoke. But regarding heart disease the use of smokeless tobacco is definitely a major factor. Just look at the acute effects of nicotine. Immediate after exposure to nicotine, there is a “rush” caused in part by the drug’s stimulation of the adrenal glands and resulting in a discharge of epinephrine (adrenaline). The result of epinephrine release causes a sudden release of glucose, as well as an increase in blood pressure, respiration and heart rate. Nicotine also suppresses insulin output from the pancreas. (In fact, side effects, such as nausea and blood vessel constriction, have plagued attempts to test nicotine on patients with Alzheimer's disease, Parkinson's disease, and other maladies in which, studies indicate, nicotine could alleviate some symptoms.) These responses to nicotine uptake occurring most likely several times a day most have an overall negative effect on a smokeless tobacco users cardiovascular system. In a randomized, double-blind, placebo-controlled, crossover designed study was carried out with healthy volunteers to find the hemodynamic and autonomic effects of smokeless tobacco. It was found that smokeless tobacco is a powerful autonomic and hemodynamic stimulus increasing blood pressure on average by 10mmHg, heart rate 16 beats/minute and adrenaline blood level by 50%. It was concluded snuff tobacco has a powerful stimulant effect but that it also dampens the body's normal protective responses to blood pressure elevation. (Wolk, R et al. , J Am Coll Cardiol 45(6 – March 15) : 910-4, 2005)

In a recent editorial Dr. Meir J. Stampfer (Chair, Department of Epidemiology, Harvard School of Public Health) wrote, “The overwhelming conclusion from these mass of data is that tobacco exposure causes a large proportion of myocardial infarcts in men and women around the world.” When asked if the use of moist snuff (snus) should be included in these tobacco exposures he wrote: Yes, strong evidence shows that smokeless tobacco including snuff and chewing tobacco causes cancer and heart disease (M J Stampfer, M.D., Dr.PH).

Bolinder et al. (1992) showed that middle aged snus users had a significantly higher risk of mild hypertension (diastolic blood pressure >90 mmHg or systolic blood pressure >160 mmHg) than middle aged non-tobacco users. In a prospective cohort study comprising a large number of construction workers Bolinder et al. (1994) found an association between snus use and increased risk of death from all cardiovascular diseases for the age group 35-45 years but not for the age group 55-65 years. A study by Bolinder et al. showed a 40% increased risk of cardiovascular death among snus users. This study was a prospective cohort study of 235,036 industry employees, who were followed for cause-specific mortality during a 12-year period. The risk for cardiovascular death was even more pronounced among men aged 35 to 54 years old. This risk for cardiovascular death increased by 110% for snus users compared to non-tobacco users. (Bolinder et al. Am J Public Health 84: 339-404, 1994). There are few small case-controlled studies that have failed to show a significant cardiovascular risk among snus user. (Huhtasaari et al., J Am Coll Cardiology 34:1784-1790, 1999.) A Swedish study finds that people who use snuff are more likely to be overweight and to have high blood pressure and high cholesterol. Many people have turned to Swedish moist snuff or snus as a substitute for cigarettes. Researchers tracked 16,500 people in Västerbotten in northern Sweden and found that heavy snuff users were four times as likely to suffer from "metabolic syndrome," a cluster of symptoms that contribute to heart disease. Margareta Norberg, one of the scientists, said snuff is still better than cigarettes -- but that doesn't mean people should use snus to give up smoking. (United Press International, August 25, 2006) In another study, healthy middle-aged snus users underwent ultrasound assessment of endothelial-dependent flow-mediated dilatation (FMD) of the brachial artery. It was found that oral moist snuff impaired FMD (endothelial dysfunction predicts cardiovascular morbidity) of the brachial artery. (Rohani M and S Agewall, J Intern Med 255:379-383, 2004).

According to a recent study in Lancet 2006 Aug 19;368(9536):621-2 covering a total of 27,000 people in 52 countries found that all forms of tobacco use and consumption heightened the risk of heart attack by up to 3 times. (KK Teo et al. An Interheart Study)

Oral Lesions

First, just using common sense if you place moist sniff packet in your mouth in just about the same location several times a day for a periods of 30 minutes or more the mucosa surface in the mouth will become irritated and eventually inflamed. There is more nicotine in one smokeless tobacco pouch then in a single cigarette but maximum levels of nicotine were similar. If the user would move the packet around in other parts of their mouth – even with less salt and moisture compared to chewing tobacco he’d release more saliva and would have to swallow the poisonous mix or spit it out – so the tobacco would no longer be spitless. Take a look at a couple typical snuff users and an up-close look at an oral lesion.

In 1986, the U.S. Surgeon General concluded that the use of spit tobacco is not a safe substitute for smoking cigarettes or cigars, as these products can cause various cancers and noncancerous oral conditions, and can lead to nicotine addition.

Some of these conditions are listed below.
Cancer of the mouth and pharynx
Leukoplakia (white sores in the mouth that can lead to cancer)
Gum recession, or peeling back of gums
Bone loss around the teeth
Abrasion of teeth
Bad Breath
This could be you..

Proponents of using another tobacco product for harm reduction would say things are different now because we are using pasteurized tobacco with lower levels of nitrosamines.

CDC’s Smokeless Tobacco Fact Sheet (November 2005) provides the following information. Smokeless tobacco contains 28 cancer-causing agents (carcinogens). It is a known cause of human cancer, as it increases the risk of developing cancer of the oral cavity. Oral health problems strongly associated with smokeless tobacco use are leukoplakia (a lesion of the soft tissue that consists of a white patch or plaque that cannot be scraped off) and recession of the gums.

The most common adverse effect of snuff is a lesion in the oral cavity. Even Swedish Match - the largest supplier of snus in the world provides the following information entitled important research regarding oral lesions on Swedish snus Important research results on Swedish snus:

It is unclear whether use of Swedish snus causes dental caries.
• Use of Swedish snus causes reversible inflammation in the gingival mucosa (gingivitis) in some individuals at the site
where the pinch is placed. There seems not to be any association between the use of snus and periodontitis (loosened teeth). • Gingival recessions are more common in users of loose snus than in users of portion-packed snus and are irreversible.
• Snus use causes benign changes in the oral mucosa (snus dipper’s lesions). These changes arise at the site where the pinch is placed.
• There is an association between the degree of oral mucosal lesion and consumption factors such as daily duration, daily consumption and number of years.
• When snus users reduce their daily consumption or when users of loose snus switch to portion-packed snus the degree of oral mucosal lesions decrease both from a clinical and a histological perspective.
• The degree of oral mucosal lesion increases both with increasing pH and nicotine content.
• Snus lesions are reversible, i.e. the oral mucosa reverses to normal condition after cessation of snus use.
• Users of portion-packed snus have less pronounced snus lesions than users of loose snus.
• Epidemiological data do not indicate any association between snus use and serious dysplastic oral mucosal changes or pre-carcinogenic effects in the oral cavity. These results agree well with the fact that no tumours or dysplasia have been found in the oral cavity among 500 snus users who have been examined annually for several years.
For more information from Swedish Match - http://www.gothia-tek.com/templates/start.aspx?page_id=74

The carcinogenicity of snuff has been evaluated twice by the International Agency for Research on Cancer, 1985 and 2005. On both occasions it was concluded that oral use of snuff is carcinogenic. More reports suggesting that snus causes leukoplakia and irreversible gingival recessions. (Axell T, Oral Oncol 29B: 299-302, 1993)

According to the American Cancer Society, more than 30,000 people each year across the nation will be diagnosed with oral cancer. More than 7,000 will die. One person every hour dies of oral cancer.

Pancreatic Cancer

Pancreatic cancer is a very lethal disease. Approximately 30,000 people (about equal number men and women) are diagnosed annually in the U.S. while about the same number die annually from the disease.. Due to the difficulty in diagnosis, the intrinsic aggressive nature of the cancer and sparse systemic treatment options available only approximately 4% of patients disgnosed with pancreatic adenocarcinoma will be alive after 5-years.

Megan Dann Fesinmeyer, MPH (School of Public Health and Community Medicine, Institute for Public Health Genetics, University of Washington, Box 357236, 1959 NE Pacific Avenue, Seattle, WA 98195)performed a literature review (PubMed from 1966 to 2005) of studies (cohort and case-control human studies) investigating the association between all types of smokeless tobacco and pancreatic cancer. She realized that although snus and other smokeless tobacco present a lesser lung cancer risk than cigarettes, these products may carry serious, uncharacterized risks. Four studies from the United States and two from Norway were identified. In total, these six studies included 1,383 pancreatic cancer cases, although the two Norwegian cohorts shared some subjects. Three out of six studies found that use of smokeless tobacco increased pancreatic cancer risk, with statistically significant odds ratios ranging from 1.67 to 3.5, although adjustment for potential confounders (smoking, alcohol, age, race) varied. Definitions of smokeless tobacco also varied between studies, including products of differing toxicity such as snus, chewing tobacco, and inhaled snuff. Smokeless tobacco exposure in study populations ranged from 1.3% to 19.7%. It was concluded that additional work is needed to clarify the association between smokeless tobacco and pancreatic cancer, to elucidate the smokless tobacco-related etiology of the disease, and to develop strategies to reduce pancreatic cancer risk among tobacco users. (Smokless Tobacco, Swedish Snus and Pancreatic Cancer, 13th World Conference Tobacco and Health, Friday, July 14, 2006).

Nov. 14, 2005 - Dr. Stephen Hecht at the Univ. of Minnesota Cancer Center – concludes – “The evidence suggests, he continued, “that smokeless products are in fact a cause of oral cancer and pancreatic cancer in humans. The current evidence does not support smokeless tobacco as a substitute for cigarette smoking.” (Heart Center Online – Reuters)

Smokeless tobacco (snus and chewing tobacco) may be a risk factor for pancreatic cancer. (part of the found at Gothiatek web site – Swedish Match). In a recently published prospective cohort study, comprising more than 10 000 Norwegian men, the relationship between the use of smokeless tobacco (snus and chewing tobacco) and the risk of cancer of pancreas and other organs, such as oral cavity/pharynx, esophagus, stomach, lung, kidney or bladder was studied. The authors found that snus use was associated with significant increase in the risk of pancreatic cancer. The increase in risk was only seen among ever-users of snus who were smokers at the start of the study, 40 years earlier. Snus use was, however, not associated with increases in risk of cancer of the oral cavity/pharynx, esophagus, stomach, lung, kidney or bladder (Boffetta et al., 2005).

Even Chris Proctor, head of science and regulation for British American Tobacco stated that snus is less harmful but not harmless. “Smokers who switch should reduce their health risk, although the best way to avoid the risks is still not to consume tobacco at all.”

Pregnancy - the evidence regarding snuff use during pregnancy is limited. The results of one Swedish study showed an increased risk of preterm delivery and preeclampsia and probably also reduced fetal growth, in the offspring of mothers who used snuff during pregnancy . (2006 Tobaksfakta) Premature birth is now considered the leading cause of infant mortality in the United States - more than a third of all infant deaths (William M. Callaghan et al., Pediatrics, October 2006).

Smokeless Tobacco Use Increases Cataract Risk - using snuff or chewing tobacco is associated with an increased likelihood of developing cataracts, Indian researchers report Dr. Prema Raju of the Vision Research Foundation, Sankar Netralaya, Chennai and colleagues evaluated tobacco use among 3924 adults from rural areas. In all, 1705 used tobacco in various forms. Nine hundred subjects, mainly women, used smokeless tobacco -- either as snuff or for chewing -- while 731 smoked tobacco predominantly in rolled cigarette-style bidis. The remainder used both forms. Overall, tobacco users had 72 percent higher prevalence of cataracts, the team reports in the British Journal of Ophthalmology. However, the prevalence of cataracts was more than twice as great among those using the smokeless forms as compared to smokers. Also, cataracts affected nine times more heavy users of smokeless as compared to heavy smokers, the researchers report. Dr. Raju mentioned that smokeless tobacco users have three-times higher levels of cadmium in their blood than non-users. Cadmium present in tobacco inactivates superoxide dismutase, an antioxidant, resulting in oxidant damage to the lens of the eye British Journal of Ophthalmology, online July 12, 2006.(Reuters Health News, 7/24/2006)

Metabolic Syndrome - researchers from Umeå University in Sweden have discovered that consuming more than four cans of oral smokeless tobacco (snus) per week increases the risk of developing metabolic syndrome, which in turn can increase the risk of heart and circulatory disease and diabetes. This fact is demonstrated by the world’s most extensive long-term study on oral smokeless tobacco (snus) use. Margareta Norberg, a doctor in the Epidemiology and Public Health Studies Department at Umeå University and one of the researchers involved in the study, states: “Our results are a warning that show it is important to continue vigilance on the adverse health effects of snus.” The study is due to be published in the December 2006 issue of the Scandinavian Journal of Public Health (Globalink, Global Tobacco Control), European News Bulletin 176:18-24, August 2006).

Delayed Wound Healing - the association between cigarette smoking and delayed wound healing is well recognized in clincal practice. This same adverse condition most likely occurs in users of smokeless tobacco. Potential mechanisms by which tobacco use delays wound healing include: nicotine is a vasoconstrictor that reduces nutritional blood flow to the skin resulting in tissue ischemia also nicotine reduces the proliferation of red blood cells, fibroblasts and macropahges (Smoking and wound healing, P Silverstein, Ann J Med 93(1A):225-245, 1992). In addition, in orthopaedic conditions - several studies have shown that nicotine interferes with healing of bone fractures and also inhibits bone fusion processes --- many spine surgeons, e.g., won't do certain operations on people who smoke because of the risk of failure. Nicotine has also been found to effect tendon and ligament healing. Studying rotator cuff injury in rats, researchers at Washington University School of Medicine in St. Louis found exposure to nicotine delays tendon-to-bone healing, suggesting this could cause failure of rotator cuff repair following surgery in human patients (Nicotine Delays Tendon-to-Bone Healing In A Rat Shoilder Model, L Galatz et al., Journal Bone Joint Surgery 88:2027-2034, 2006).

Nicotine Promotes Growth Of Tumors Already Established By Tobacco Carcinogens While it is established that nicotine by itself is not carcinogenic, researchers have now shown that nicotine promotes cell proliferation and the progression of tumors already initiated by tobacco carcinogens. In a study by Srikumar Chellappan and colleagues from the University of South Florida appearing online on July 20 in advance of print publication in the August (2006) issue of the Journal of Clinical Investigation, the authors show that the presence of receptors that bind nicotine, known as nicotinic acetylcholine receptors (nAChRs), on bronchial cells as well as lung cancer cells are key to nicotine-induced cell proliferation of lung cancer cells. Also, Christopher Heeschen, James J. Jang, Michael Weis, Anjali Pathak, Shuichiro Kaji, Robert S. Hu, Philip S. Tsao, Frances L. Johnson & John P. Cooke, Nicotine stimulates angiogenesis and promotes tumor growth and atherosclerosis, Nature Medicine 7: 833 - 839, 2001.

Nicotine: the Link Between Cigarette Smoking and Kidney Disease A new study has demonstrated that human mesangial cells (cells in the blood vessels of the kidneys) are endowed with nicotinic receptors and may play an active role in the development of certain kidney diseases. Nicotine, at concentrations similar to those found in the plasma of smokers, promote mesangial cell proliferation and may accelerate and promote the progression of chronic kidney disease. (EA Jaimes, Run-Xia Tian and L Raij, Am J Physiol Heart Circ Physiol 292: H66-H75, 2007).

Nicotine: (from John Polito, Esq, Editor - Why Quit? - written communication 8/15/2007) There is growing concern that nicotine contributes to poor memory, a host of mental health disorders, destruction of brain gray matter, early dementia, cardiovascular disease, kidney disease, stomach and duodenal ulcers, and macula degeneration that produces blindness? Is it true that nicotine accelerates tumor growth rates and reduces chemotherapy effectiveness?

Promotion of Moist Snuff - NO - More Research/Regulations Needed

Both the social and life scientist involved with tobacco control (elimination) must come together to prevent the wide distribution of smokeless, spitless tobacco products - SNUS. Dr. Gunilla Bolinder, director of education at Stockholm's Karolinska University Hospital points out, "To sing the praises of SNUS is a deathblow to 20 years of hard tobacco preventive work in Sweden. SNUS only saves the life of the tobacco industry" (SNUS gets the thumbs-down NEWS-24 1/31/2007).

In a cohort study it was found (after 20 years of follow-up) the risk of dying from major tobacco-related diseases including lung cancer, coronary heart disease, stroke and COPD were higher among former cigarette smokers who switched to spit tobacco after they stopped smoking than among those who quit using tobacco entirely. The cohort consisted of 116,395 men that were identified as switchers (n=4443) or cigarette smokers who quit using tobacco entirely (n=111,952) when enrolled in the ongoing ACS Cancer Prevention Study II. (Tobacco-related disease mortality among men who switched from cigarettes to spit tobacco, S. Jane Henley et al., Tobacco Control 16:22-28, 2007)

Scott Ballin, the former chairman of the Coalition on Smoking and Health points out that such moistened snuff products are on the way and the public health community needs to start thinking hard about how to deal with them – like NOW.

Smokeless tobacco use between 1986 and 2003 was low among adolescent girls and remained unchanged during the study period. For 12th grade boys, it rose slightly from 1986 until the early 1990s. From the mid-1990s to 2003 smokeless tobacco use among 8th, 10th, and 12th grade boys dropped sharply.(Nelson, DE et al, Am J Public Health 96(5): 897-905, 2006). Let's make sure this trend continues.

In conclusion the Surgeon General stated that, “We simply do not have enough quality scientific evidence to conclude that any tobacco product, including smokeless tobacco, is a means of reducing the risks of cigarette smoking. At this time, any public health recommendation that positions smokeless tobacco as a safer substitute for cigarettes or as a quitting aid would be premature and dangerous. With the memory of our experience with low-tar cigarettes fresh in our minds, we must move extremely cautiously before making any statement or endorsement about the potential reduced risk of any tobacco product."

We are in agreement with Drs. Dorothy Hatsukami, Charlotte Lemmonds and Scott Tomar in that considerable more quality research and product regulation is necessary prior to considering smokeless tobacco as a harm reduction method (Prev Med 38(3):309-317, 2004).

WHO World NO Tobacco Day 5/31/06 – Tobacco, Deadly in Any Form or Disguise.