Tobacco information

Nicotine - The Addiction

Smoking - Cigarettes and Cigars

Alternative Smoked Tobacco Products - Hookah, cloves, and bidis

Smokeless Tobacco - snuff/dip and chew

PREPs - Products advertised as less harmful, including snus and e-cigs

 

Nicotine

The Addiction

Nicotine is a naturally occurring drug found in tobacco. When consumed in various products, nicotine spreads rapidly throughout the body, and it is a highly addictive substance (as addictive as heroin and cocaine). Addiction is often accompanied by physical and psychological dependence on the substance. Regular use of tobacco products leads to addiction in a high proportion of users.  The most commonly used nicotine-delivery device is smoked tobacco, including cigarettes and cigars. There are also other smoked tobacco products used less often than cigarettes, including smoking hookah and cloves. Nicotine is absorbed readily from tobacco smoke in the lungs. Nicotine can also be administered through smokeless tobacco products, from oral tobacco in the mouth or nose, including dip or chew. In addition to nicotine, tobacco products include many chemicals and carcinogens (toxic to the human body). Tobacco use results in an annual cost of more than $167 billion ($75 billion in direct medical costs & $92 billion in lost productivity).⁴  Hence, several products that include nicotine and may or may not include tobacco are being advertised as "less harmful" than other tobacco products. These products are referred to as "potentially reduced exposure products" or PREPs. Here, MDQuit provides information on common products that include tobacco and/or nicotine.  

Cigarettes

The Facts

•  Almost 60 million Americans age 12 or older smoke cigarettes.³
• Cigarette smoke contains over 4,000 chemicals, including over 60 carcinogens,¹ such as Ammonia (used as a cleaning agent), Formaldehyde (used in embalming), and Acetone (used as a paint thinner).²
• Approximately 440,000 people in the U.S. die each year from smoking related-illnesses.⁴
• Approximately 50% of all of the smokers who continue to smoke will die from a smoking-related illness.⁵
• Cigarette smoking shortens smoker's lives. On average:
  • Men who smoke shorten their lives by 13.2 years⁵
  • Women who smoke shorten their lives by 14.5 years⁵
• Smoking is responsible for one of every five deaths¹ making it more lethal than AIDS, accidents, homicides, suicides, illegal drugs, and fire combined.⁶ Specifically, smoking is responsible for:
• At least 30% of all cancer deaths⁵
• Almost 90% of all lung cancer deaths⁶

Good News

• No matter how long a smoker has smoked, a smoker will live longer if he or she quits today!
• Smokers who quit prior to the age of 35 avoid 90% of the health risks associated with tobacco use.
• Even smokers who quit when they are older can significantly reduce their risk of early death.
• See our Programs and Materials on Cessation for more information on quitting tobacco use.

Helpful Links

• CDC Smoking and Tobacco Page: Contains a wide variety of tobacco information and resources for individuals, children and adolescents, as well as researchers and scientists. 

• National Cancer Institute Smoking and Cancer Page: Provides a variety of tobacco information, including quitting resources, clinical trials information, tobacco research, etc.

• The Tobacco Technical Assistance Consortium (TTAC): The goal of this resource is to assist organizations in building and developing highly effective tobacco control programs.

Cigars

Despite a decline in cigarette smoking in the United States, cigar consumption has been dramatically increasing since 1993. The 2005 U.S. National Health Interview Survey (NHIS) estimated that 2.2% of adults smoke cigars, which is about the same rate as smokeless tobacco use but is far less than the 21% of adults who smoke cigarettes.  There are significant gender differences in cigar use; about 4.3% of men, but only 0.3% of women smoke cigars.¹  Lately, new and more profitable forms of cigar-like nicotine products have gained popularity.  Two types of more modern cigar-like products are little cigars (also known as small cigars) and cigarillos. While these two products are very similar in nature, some distinctions do exist.

 Cigars

• Cigars contain the same toxic and carcinogenic compounds found in cigarettes and are not a safe alternative to cigarettes.¹
• Most cigar smokers do not inhale, as most cigarette smokers do. Therefore, the risk of lung cancer is lower for cigar smokers than cigarette smokers.  Lung cancer risk increases with more frequent cigar smoking and depth of inhalation.²
• Cigar smokers can spend up to an hour smoking a single cigar that can contain as much tobacco as a pack of cigarettes.
• After cigarette smoking, cigar smoking is the second most common form of tobacco use among youth.³
• In 2005, 14 percent of high school students reported current use of cigars (19.2% among boys; 8.7% among girls).
• Among all age groups, cigar use is higher among men than women.⁴

Little Cigars & Cigarillos

Little cigars and cigarillos differ greatly from regular cigars. They weigh less than cigars and cigarillos², but more importantly, they resemble cigarettes in size, shape, packaging, and filters.⁵  Little cigars are sometimes called "cigarettes in disguise", and unsuccessful attempts have been made to reclassify them as cigarettes. Sales of little cigars quadrupled in the U.S. from 1971 to 1973 in response to the Public Health Cigarette Smoking Act, which banned the broadcast of cigarette advertisements and required stronger health warnings on cigarette packs. Cigars were exempt from the ban, and perhaps more importantly, were taxed at a far lower rate. Sales of little cigars reached an all-time high in 2006, fueled in great part by their taxation loophole. Today, cigars are still taxed far less than cigarettes.  In fact, a pack of little cigars costs less than half as much as a pack of cigarettes in many states.⁶

What are little cigars?

• Little cigars light and burn like cigarettes and users inhale the smoke, unlike with a traditional cigar.
• Little cigars contribute to a multitude of ailments, including cancer and cardiovascular disease.
• The only difference between cigarettes and little cigars is that the paper wrapping of little cigars contains some tobacco; any amount of tobacco in the paper wrapping removes little cigars from the cigarette category.
• Brands of little cigars currently sold in Maryland include Winchester, Dutch Masters, and Captain Black.
• Many small cigars and cigarette-like “little cigars” are produced in different flavors, such as candy, fruit, chocolate and various other tastes, which may especially appeal to children and teenagers.⁷

How much do little cigars cost and where are they available? ⁸

• A package of little cigars sells at retail for approximately $2.00 to $2.50 for the premium brands.
• The tax of little cigars is 15% of the wholesale price of the product, making the tax on a pack of little cigars less than 30¢.
• Comparatively, a pack of cigarettes costs approximately $5.00 to $6.00 for a premium brand, $4.00 or so for a cheap brand.
• Little cigars can be sold individually - sometimes for as little as a quarter a piece!
• The single sales restriction applicable to cigarettes does not apply to little cigars, therefore the packs can be broken down and the sticks can be sold individually.
• Little cigars are sold in the same places as cigarettes - most convenience stores, mom and pop shops, and gas station stores.

Why are legal groups advocating that little cigars be included in the definition of cigarette? ⁸

• Little cigars look like cigarettes, smoke like cigarettes and are harmful like cigarettes.
• The availability of cheap little cigars as a cigarette substitute may cause cigarette smokers who are inclined to quit because of a tax increase to instead smoke little cigars, reducing the fiscal and public health impact of the 2007 tax increase.⁹
• The cheap cost of little cigars makes the product more accessible to young people and those with little disposable income.
• Increasing the tax to make the price of little cigars comparable to that of cigarettes may reduce the risk that would-be quitters will switch from cigarettes to little cigars.

What is a Cigarillo?

Cigarillos are similar to “little cigars” in both size and structure, and the two terms are often used synonymously. A cigarillo (Spanish for "cigarette", pronounced "see-gah-ree-yoh" in Spanish and "see-gah-ree-loh" in English) is a short, narrow cigar.  While cigarettes are wrapped in paper, cigarillos are wrapped in whole-leaf tobacco.  Cigarillos can be found for purchase alone or in packs, and are sometimes made without filters. Unlike a cigarette, the smoke of a cigarillo is not meant to be inhaled, but rather puffed like a cigar.

• Cigarillos are known in Europe as a 'Seven Minute Cigar'. This due to the fact that they can be smoked in seven minutes, making them an alternative for someone who does not have enough time to smoke a full cigar, as well as an alternative to cigarettes.
• Generally, a cigarillo contains about 3 grams of tobacco.
• Comparatively, a cigarette contains less than 1 gram of tobacco¹⁰ and is smaller in length and diameter.
• Cigarillos are often machine made, resulting in a lower price than handmade cigars.
• Cigarillos are often smoked in quantities similar to cigarettes (between 5 and 10 per day)

Helpful Links

• Campaign for Tobacco-Free Kids:  The Rise of Cigars and Cigar-Smoking Harms PDF
  
  
• American Lung Association: Cigar Smoking Fact Sheet
  
  
• Smokers’ Choice: What Explains the Steady Growth of Cigar Use in the U.S.?
  
  

1. National Cancer Institute. (1998). Cigars: Health Effects and Trends. Smoking and Tobacco Control Monograph No. 9. Bethesda, MD: NIH Pub. No. 98–4302.
2. Mariolis, P., Rock, V.J., Asman, K. et al. (2006). Tobacco use among adults—United States, 2005. MMWR Morbidity Mortality Weekly Report, October 27, 2006. 55(42), 1145–1148.
3. U.S. Centers for Disease Control & Prevention. (2006). Youth Risk Behavior Surveillance, United States, 2005. Morbidity and Mortality Weekly Report 55(SS-5), June 9, 2006. Whites (14.9%) and Hispanic high schoolers (14.6%) smoke cigars more than African Americans (10.3%).
4. Baker, F., Ainsworth, S.R., Dye, J.T., et al. (2000). Health Risks Associated with Cigar Smoking. Journal of the American Medical Association, 284(6), 735-740.
5. Connolly, G.N. (1998). Policies regulating cigars. In Shopland, D.R., Burns, D.M., Hoffman, D., Cummings, K.M., Amacher, R.H. (Eds.), Cigars: Health Effects and Trends, Smoking and Tobacco Control Monograph No. 9, National Cancer Institute.
6. Delnevo, C.D. (2006).  Smokers’ choice: what explains the steady growth of cigar use in the U.S.? Public Health Reports 121 (2): 116–9.
7. Boonn, A., Lindblom, E. (2008). The Rise of Cigars and Cigar-Smoking Harms. Campaign for Tobacco-Free Kids.
8. Dachille, K. (2008). Cigar Fact Sheet. Center for Tobacco Regulation.
9. Delnevo, C.D., Hrywna, M. (2007). "A whole 'nother smoke" or a cigarette in disguise: how RJ Reynolds reframed the image of little cigars. American Journal of Public Health, 97 (8): 1368-75. 
10. National Cancer Institute. (200). Questions and Answers About Cigar Smoking and Cancer. Retrieved from http://www.cancer.gov/cancertopics/factsheet/Tobacco/cigars