Utah Department of Health: Utah Tobacco Quit Line

David Neville with the Department of Health offers suggestions and also makes parents aware of new tobacco products that you may not realize contain nicotine and may be harmful to your children


Steps to help prepare for your Quit Day:

✓ Pick the date and mark it on your calendar.

✓ Write down the reasons why you want to quit and review them regularly.

✓ Tell friends and family of your quit day.

✓ Stock up on sugarless gum, cinnamon sticks, carrot sticks, hard candy.

✓ Decide on a plan and know how you will avoid triggers.

✓ Practice saying, “No thank you, I don’t smoke.”

✓ Set up a support system.

✓ Call the Tobacco Quit Line

Tips to help you keep your commitment to quitting:

Avoid. People and places where you are tempted to smoke. Later on you will be able to handle these with more confidence.

Alter. For example, switch to water or juice instead of alcohol or coffee. Take a different route to work; take a brisk walk instead of a coffee/smoke break

Alternatives. Use oral substitutions such as sugarless gum, toothpicks or hard candy, raw vegetables such as carrot sticks, or sunflower seeds. Handling substitutes such as stress balls can be helpful.

Activities. Exercise or hobbies that keep your hands busy (needlework, woodworking, etc.) can help distract you from the urge to smoke.

Deep Breathing. When you were smoking, you breathed deeply as you inhaled the smoke. When the urge strikes now, breathe deeply and picture your lungs filling with fresh, clean air. Remind yourself of your reasons for quitting and the benefits you’ll gain as an ex smoker.

Delay. If you feel that you are about to light up, delay. Tell yourself you must wait at least 10 minutes. Often this simple trick will allow you to move beyond the strong urge to smoke.

New Forms of Tobacco Still Dangerous

NEW SMOKELESS PRODUCTS

Smoking rates are falling in Utah and across the nation. But the tobacco industry has developed new products to addict users and help maintain their profits. Among these are:


1. Snus (oral moist snuff): [i] Smokeless tobacco, often flavored, that comes in pouches that look like small tea bags. The product is placed under the upper lip. Snus is currently available in Utah.

2. Dissolvables:[ii] These are products made of powdered tobacco held together by food-grade binders, designed to dissolve in the mouth without the need for spitting. They are currently available in markets including Columbus, OH; Portland, OR; and Indianapolis, IN, and we expect them to be across the nation before long.

As a comparison, a cigarette smoker typically takes in about 1 milligram of nicotine.

HEALTH CONCERNS

As these products are new, there is little research about their long-term effects or what additive chemical compounds could be in them. There is very limited research available and it is uncertain how these products affect the body and our health. However, there is enough information to cause alarm.

Nicotine

1. Nicotine is a highly addictive drug, comparable to cocaine or heroin.[iii] It raises blood pressure[iv] and is linked to circulatory disease.[v]

2. It is also toxic at high levels. The high nicotine content of several of these products combined with their nature and the ease of use is a potentially deadly combination. For example, users may be tempted to ingest multiple Orbs at one time, like they would “tic-tacs” or any other breath mints.

3. Smokers who use these products may get a higher dose of nicotine than they are used to, possibly resulting in nicotine poisoning. This leads to adverse reactions such as tremors, vomiting, agitation, and in more extreme cases, seizures, coma, and death.[vi]

4. An overdose of dissolvables can be especially dangerous for children

Other Health Effects

1. Dissolvable tobacco is not a safe alternate to cigarettes. People who use spit tobacco are at risk of many health problems including cancers (lip, esophagus, pharynx, larynx, stomach, pancreas, and bladder) and mouth diseases such as gum disease and leukoplakia (white lesions on the cheeks, gums, and tongue that can become cancerous).[vii]

2. Research on oral moist snuff use from Sweden shows it may elevate the risk of fatal stroke, and particularly of fatal ischemic stroke.”[viii]

3. A preliminary study reports that coumarin, a banned food and cigarette additive, and cinnamaldehyde, a toxic insecticide and skin irritant, are present in Orbs[ix].

CONCERNS FOR PARENTS

1. The slick packaging makes the products appealing to children—they are almost indistinguishable from mint or candy packets.

2. The packages are child resistant, but they are likely to be carried in pockets or left in other easy-to-access places. The difficulty of opening them may actually backfire, if users leave them open to avoid the difficulty, or empty them into another container.

3. The products are disturbingly simple to use. There’s no lighting, up, no spitting required. The dissolvables would be very easy to swallow.

4. Teenagers are also at risk, for a few additional reasons. They are unlikely to be deterred by child resistant packaging. The products are easier to disguise as something else, and easier to hide when using than cigarettes, whether at school, home or in public places. There have been reports of teens putting them between their toes to get a secret nicotine high.

5. Marketing material and website content indicates that these products are being marketed as an “alternative” to smoking when the user is in a situation where they cannot smoke (a smoke free school, workplace, restaurant, on an airplane, while riding a bike). There is the potential for “dual use” of these smokeless products with cigarettes or other smokeless tobacco products. The health impact of such dual use has not been studied.

6. Parents need to be aware of what these products look like, and the potential harm caused. They can talk to their teens about them and let them know that they are not a good alternative to smoking. There is no such thing as a safe tobacco product.

7. Tobacco companies spend about $58.7 million dollars on marketing in Utah alone every year.[x] They are eager for new customers to replace those that die from their deadly products. Products such as the ones we see today show that they are not relaxing their efforts—neither can we. We must keep educating our youth to prevent them from starting to use tobacco, and must keep helping youth and adults quit. This saves lives and money here in Utah.



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Call the Utah Tobacco Quit Line at 1-888-567-TRUTH or visit Utah Quitnet www.utahquitnet.com for help in quitting. This service is free and confidential.

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References:

[i] tobaccoproducts.org/index.php/Marlboro_Snus#Market_Testing; http://tobaccoproducts.org/index.php/Camel_Snus

[ii] http://tobaccoproducts.org/index.php/Camel_Sticks,_Camel_Orbs_and_Camel_Strips

[iii] www.drugabuse.gov/Nida_notes/NNVol13N3/Nicotine.html Epping-Jordan, M.P.; Watkins, S.S.; Koob, G.F.; and Markou, A. Dramatic decreases in brain reward function during nicotine withdrawal. Nature 393:76, 1998.; Picciotto, M.R., et al. Acetylcholine receptors containing the b2 subunit are involved in the reinforcing properties of nicotine. Nature 391:173-177, 1998. Pidoplichko, V.I.; DeBiasi, M.; Williams, J.T.; and Dani, J.A. Nicotine activates and desensitizes midbrain dopamine neurons. Nature 390:401-404, 1997.

[iv] University Of Chicago Medical Center (1998, October 13). Trace Amounts Of Nicotine Raise Blood Pressure In An Animal Model.

[v] International Journal of Epidemiology, doi:10.1093/ije/dym039 Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2007; all rights reserved. Circulatory disease and smokeless tobacco in Western populations: a review of the evidence, Peter N Lee

[vi] http://www.nlm.nih.gov/medlineplus/ency/article/002510.htm

[vii] www.oralcancerfoundation.org/tobacco/types_of_tobacco.htm; Clinico-pathological features of bladder carcinoma in women in Pakistan and smokeless tobacco as a possible risk factor, Muhammad Rafique, Department of Urology, Nishtar Medical College, Multan, Pakistan Received April 12, 2005; Accepted August 5, 2005.; 2008: Bahmanyar S; Lambe M; Zendehdel K; Nyrén O; Boffetta P; Ye W, Parity and risk of stomach cancer by sub-site: a national Swedish study., British journal of cancer 2008;98(7):1295-300.; 2007: Luo Juhua; Ye Weimin; Zendehdel Kazem; Adami Johanna; Adami Hans-Olov; Boffetta Paolo; Nyrén Olof, Oral use of Swedish moist snuff (snus) and risk for cancer of the mouth, lung, and pancreas in male construction workers: a retrospective cohort study., Lancet 2007;369(9578):2015-20.

[viii] Smokeless tobacco and the risk of stroke. Epidemiology. 2008 Nov;19(6):794-9. www.ncbi.nlm.nih.gov/pubmed/18854704

[ix]http://oralcancernews.org/wp/?p=6823

[x] http://www.tobaccofreekids.org/research/factsheets/pdf/0271.pdf

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