Smoking Cessation Aides and Cigarette Substitutes : New Products, New Dangers

1. Smoking Cessation Aides and Cigarette Substitutes:New Products, New Dangers Angela Shepard, MD

2. Cigarettes • Everyone understands that cigarettes are unhealthy • As parents, we keep those products away from our children • At our schools no smoking policies clearly prohibit them • They are easily recognized, so we can confiscate them

3. Nicotine Dangers • In 2007, 6,724 tobacco-related poisonings were reported among children five and under. • Small children can experience nausea and vomiting from as little as 1 mg of nicotine. • New candy flavored products (many of which look like gum or candy) present increased poisoning risk to small children. • Young adults may not view these products as harmful. • An article in April’s Pediatrics journal“Unintentional Childhood Poisonings Through Ingestion of Conventional and Novel Tobacco Products” highlights this danger.

4. Questions • Do you know what these nicotine containing products look like? • Does your school policy address smoking cessation products or other nicotine containing products?

5. Commit Lozenge • Can be a useful anti-smoking aid but does contain 2 - 4 mg nicotine (depending on strength purchased) • Comes in cherry, mint, original and now cappuccino flavor

6. Nicorette • Every kid loves gum, but this one contains 2 - 4 mg nicotine (depending on the strength purchased) • Comes in “six great tasting flavors” • White Ice Mint • Cinnamon Surge • Fruit Chill • FreshMint • Mint • Original

7. Camel Orbs – “Dissolvable Tobacco” • This product is designed to deliver tobacco by dissolving in your mouth and then being absorbed • Contains 1 mg of nicotine per pellet • The company has also launched • Camel Strips (containing 0.6 mg of nicotine per strip) • Camel Sticks (containin 3.1 mg of nicotine per stick) • Available in flavors • “mellow” (cinnamon) • “fresh” (mint)

8. Comparative Size of Orbs

9. Ariva • Dissolvable tablet of compressed tobacco powder with sweeteners and other flavorings • Resembles a brand of popular breath mints • Contains 1.5 mg nicotine • Available in wintergreen, java and original

10. Everyone’s favorite role model, Lindsay Lohan, with Ariva.

11. Stonewall • Stonewall is marketed as the “heavy duty” version of Ariva (Seeks to attract those who like chew instead of those who admire Paris Hilton) • It contains 4 mg of nicotine

12. Chew and Snuff Old fashioned chew and snuff have been rejuvenated with slick marketing and fun flavors.

13. Hookahs • Hookah smoking has been used by a surprising number of kids and young adults • The tobacco comes in a variety of flavors like … • The links below explains why hookah smoking may actually pose greater health risks than cigarettes. • http://www.health.harvard.edu/press_releases/dangers-of-hookah-smoking • http://www.webmd.com/smoking-cessation/news/20100510/hookahs-safer-than-cigarettes-thats-a-pipe-dream?src=RSS_PUBLIC

14. Take home lesson… • Be aware of new products that may be marketed to your students or your children. • Make sure that your school policies adequately address these new products. • Keep any tobacco or smoking cessation products away from children of any age.