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No matter what form it takes, tobacco is not safe.

Many people — especially teens — believe that if it isn’t a cigarette, it isn’t that harmful. Not true. Research suggests that the nicotine in all tobacco products is as addictive as heroin and cocaine. And tobacco can cause health problems even if it’s not smoked.

Chewing tobacco pouches

All tobacco is harmful.

There is no “safe” tobacco. According to the Centers for Disease Control and Prevention (CDC), smokeless products contain 28 cancer-causing agents and are known to increase the risk of oral and pancreatic cancers. Even cigar smokers, whether they inhale or not, are at a higher risk for lung, esophageal, laryngeal, and oral cancers than nonsmokers. In every form, tobacco is toxic, addictive, and deadly.

E-Cigarettes

E-cigarettes are a dangerous new phenomenon.

E-cigarettes are nicotine-delivery devices. They are battery operated but do not burn tobacco. They heat substances, turning them into inhalable vapor. One brand named Juul® is disguised as a USB flash drive, making it easy for students to plug it in and charge it on school-issued laptops. One Juul pod contains as much nicotine as an entire pack of cigarettes.

How to spot an e-cigarette.

E-cigarette starter kits contain two rechargeable batteries, five 16 mg nicotine cartridges, and a charging pack that looks like a cigarette pack and plugs into a computer or car. E-cigs generate little or no odor.

Vaping is especially harmful to teens.

The CDC reports vaping is harmful to teens:

  • Nicotine exposure during adolescent brain development can disrupt the growth of brain circuits that control attention, learning, and susceptibility to addiction.
  • In 2015, more than 3 million youth in middle school and high school, including about one in every six high school students, used e-cigarettes.
  • E-cigarettes’ aerosol vapors contain harmful ingredients, including diacetyl; volatile organic compounds such as benzene; and heavy metals such as nickel, tin, and lead.

Menthol

Minty, mellow, and deadly.

Menthol cigarettes contain oils or other substances to create a minty effect when they’re smoked. They’re not as harsh, but that’s exactly why they’re more appealing and dangerous. Because inhaling is easier, people are more likely to start smoking earlier in life, and to smoke more often. This accelerates addiction and causes health effects to set in sooner. And in 2019 and 2020, menthols made up 37% of all cigarette sales in the U.S. — the highest number since 1967.

Smoking is killing our community

Targeting African Americans for decades.

Tobacco companies use aggressive advertising, free sampling, community event sponsorships, and promotional pricing to appeal to Black smokers. Menthols are widely available and priced cheaper in Black communities, and it’s having a devastating impact on their health and their lives. Today, as a result of over 60 years of targeted marketing, 45,000 African Americans die every year from tobacco-related illnesses.

What can be done about it?

States and communities can enact policies that prohibit or decrease sales of menthol tobacco products, in ways such as:

  • Raising prices or prohibiting discounts
  • Prohibiting advertising to young people
  • Ensuring that all tobacco users have access to counseling and medication to quit tobacco, including ones specifically tailored to menthol users.

Teach people to recognize the tactics used by the tobacco industry and warn them of the risks of menthol use.

Increase access to quit resources for all tobacco users, including counseling and medication — especially in communities most affected by menthol cigarettes.

Tobacco companies win.
Black communities suffer.

  • In the 1950s, less than 10% of Black smokers smoked menthols. Today, it’s 85%.
  • In a 2013-2015 survey, 93% of Black adult smokers started with menthols, compared with only 44% of white adult smokers.
  • Tobacco use exacerbates every health condition, including diabetes and COVID-19, in addition to heart disease, cancer and stroke — three of the leading causes of death in African Americans.
  • Lung disease is the most common cancer among African Americans.
  • Smoking contributes to diabetes, which is more common among African Americans.
  • Menthol smokers make more attempts to quit but are often less successful than people who smoke regular cigarettes. And because Black communities have less access to quitting treatments and resources, it may be even more difficult to quit.

Cooling flavor.
Devastating effects.

  • Menthol reacts with nicotine in a way that makes people more likely to continue smoking — and makes menthols harder to quit.
  • Most minority smokers use menthols, and most youth who start smoking try menthols first.
  • While fewer people are smoking overall, the percentage of people who smoke menthols is going down more slowly — so menthols occupy a larger share of the market than ever before.
  • According to the U.S. Surgeon General, people who smoke menthols inhale more deeply and keep the smoke in their lungs longer, which increases their exposure to chemicals and poisons in cigarettes.
  • Young people, racial and ethnic minorities, LGBTQ+ people, women, people with a low income, and people with mental health conditions are all more likely to smoke menthols than other population groups. Tobacco companies aggressively target these groups.
  • In 2021, 51% of smokers ages 18 to 25 used menthols.

Cigars

Many cigars are designed to appeal to younger smokers.

Some cigars come in sweet candy or fruit flavors. Many are sold as singles, so they’re cheaper and easier to buy. For these reason and others, cigar smoking is on the rise among teens and young adults.

There's half a pack in every cigar

Cigars are not safer than cigarettes.

Smoking one cigar is equivalent to smoking 10 cigarettes. Cigar smoke contains higher levels of cancer-causing agents (carbon monoxide, hydrogen cyanide, benzene, arsenic, cadmium, and nitrosamines), tar, and toxins than cigarette smoke. Smoking cigars can cause oral, laryngeal, esophageal, and lung cancer. Cigars take longer to smoke, increasing toxic-compound exposure, which can increase the risk of heart and lung diseases.

Shapes, sizes, and flavorings vary.

Tobacco products come in all sizes, from large cigars to cigarettes. Sweet aromas indicate flavored varieties and can linger on clothes. Cigarillos are often sold as singles, two-packs, or four-packs. Little cigars are often sold as singles or 20-packs. The Black & Mild brand is particularly popular.

Teen-popular products currently on the market.

There are three basic types of cigars with the most teen appeal today:

Little Cigars
  • Available in filtered and unfiltered, and in flavors (fruit or alcohol) to mask the taste.
  • Contain just 1 gram of tobacco but many more harmful ingredients than cigarettes, such as arsenic, cyanide, formaldehyde, and cadmium.
  • Often disassembled and repacked — or “freaked” — with marijuana or other drugs.
Cigars
  • Contain air-cured, fermented tobacco, with tobacco wrapper.
  • Can measure more than 7 inches long.
  • One large cigar contains up to a cigarette pack’s worth of tobacco: 20 grams.
Cigarillos
  • Short, narrow version of cigars, but larger than a cigarette.
  • May be filtered or tipped.
  • Often flavored, containing up to 3 grams of tobacco.
  • Often smoked daily and inhaled.

Dissolvables

You just pop it in your mouth.

Dissolvables come in sticks, strips, and little round dots of nicotine. They’re easy to just slip into your mouth, packing a nicotine punch. Nationwide, some 80,000 high school students used dissolvable tobacco in 2014, according to the U.S. Food and Drug Administration.

What dissolvables can do to you.

Though information on the specific health effects of dissolvables is not yet available, smokeless tobacco is linked to oral cancer, gum disease, nicotine addiction, and cardiovascular disease. Constant exposure to tobacco juice can cause cancer of the esophagus, pharynx, larynx, stomach, and pancreas. Children may mistake these products for candy and ingest them, which can result in tobacco poisoning.

It looks like candy.

Dissolvables come in colorful plastic packaging that resembles the kind used for candy, mints, and breath strips.

Flavorful little nicotine delivery systems.

Dissolvables come in three standard varieties:

Orbs
  • Flavored pellets or tabs made of finely milled tobacco.
  • Dissolve in the mouth like candy or mints.
  • Deliver 1 mg of nicotine each, like a cigarette.
Strips
  • Strips of tobacco that mimic breath strips.
  • Dissolve in mouth in two to three minutes.
  • Deliver about 0.6 mg of nicotine each.
Sticks
  • Look like oversized toothpicks.
  • Dissolve in mouth in 20 to 30 minutes.
  • Deliver 3.1 mg of nicotine, equal to two cigarettes.

Smokeless Tobacco

Chewing and dipping are familiar terms to Delaware teens.

Smokeless tobacco has been around for many years. Some people think it’s a safe form of tobacco. Nothing could be further from the truth. Using smokeless tobacco is as dangerous as smoking cigarettes. According to the Centers for Disease Control and Prevention (CDC), the use of smokeless tobacco is on the rise among teen boys.

Smokeless tobacco contains 28 cancer-causing agents.

Smokeless tobacco increases the risk of oral and pancreatic cancers, and is strongly associated with leukoplakia, a precancerous lesion of the soft tissue of the mouth. Receding gums, gum disease, tooth decay, and tooth loss can also result. Use during pregnancy increases risk for preeclampsia, premature birth, and low birth weight. Use by males can cause reduced sperm count and abnormal sperm cells.

Be on the lookout for tins and pouches.

Smokeless tobacco comes in small tins and pouches that are easy to hide in pockets. Bad breath and stained teeth are also indicators of smokeless tobacco use.

Forms of smokeless tobacco.

Smokeless tobacco is available in these forms, with these features:

Snus
  • Flavored, ground tobacco packaged in pouches, held between the lip and gum.
  • No spitting required. Often used where smoking is not permitted.
  • Packaged in brightly colored tins, like breath mints.
Dip
  • Fine-ground tobacco packaged in round tins.
  • Pinch of tobacco held between the lower lip and gum.
  • Tobacco juice usually spit out, but sometimes swallowed.
Chew
  • Loose tobacco leaves in pouches.
  • Wad of tobacco held between the cheek and gum.
  • Tobacco juice usually spit out, but sometimes swallowed.
Snuff
  • Dry or moist finely ground tobacco in tins.
  • Pinch held between the cheek and lower lip or gum.
  • Dry, powdered snuff can be inhaled.