How It Works
We know that all tobacco products contain dried leaves from the tobacco plant in various states, but now let’s take a closer look at the plant itself and how it is transformed into the products that warrant so much attention. This section will also explore the various tobacco products and discuss what makes them unsafe.
The Tobacco Plant
Although the tobacco plant is native to the Americas (and parts of Australia), it grows well in many climates and regions of the world. Today, tobacco is grown in almost every nation, especially China, Australia, Cuba, the Dominican Republic, Jamaica, and Puerto Rico. As production has scaled back in the United States, Mexico, and Canada, it has increased elsewhere, particularly in Asia and Africa. The World Health Organization reports that Brazil, China, the United States, India, and Turkey together produce two-thirds of the world’s tobacco.1
Tobacco’s genus, Nicotiana, includes more than twenty-one species. Today, the most frequently grown and used species are Nicotiana tabacum and Nicotiana rustica. Burley, flue-cured, dark air, and dark fire are the most common types of tobacco grown in the United States.2
Even with modern technologies, tobacco farming is labor intensive. Ten to eleven weeks after they are transplanted, the plants are mature and harvesting begins with the leaves that are ripened; the plants ripen from the bottom up.
After harvesting, the tobacco leaves are dried and cured. This drying process takes anywhere from one to eight weeks, depending on the method used: flue-cured, air-cured, or fire-cured.3 The curing process not only removes moisture from the tobacco leaves, but also enhances its color and aroma. The tobacco used in cigarettes is then ready to be shredded, rolled into paper, and packaged. Tobacco used for cigars is also aged and fermented after it is cured.4
Now let’s take a closer look at each of the main types of tobacco products.
Combustible Tobacco Products
Cigarettes
Traditional cigarettes are formed by rolling shredded or ground tobacco in paper or another material that is not made out of tobacco. Most manufactured cigarettes on the market today include filters. Cigarettes are sometimes called smokes, fags, heaters, cigs, butts—even cancer sticks.
Herbal Cigarettes
Herbal cigarettes—thin hand-rolled cigarettes wrapped in plant leaves—come in multiple flavors and do not include filters. Bidis are imported from India and other Southeast Asian countries. They may be flavored to taste like chocolate, licorice, or fruit. Kreteks are another type of herbal cigarette; these come from Indonesia and are flavored with cloves.5 As of 2009 with the passage of the Family Smoking Prevention and Tobacco Control Act, flavored cigarettes are not legal for sale in the United States, though it is not against the law to use such cigarettes. Users now typically purchase them from other countries through websites.
Bidis and kreteks contain high levels of nicotine and tar. Herbal cigarettes are becoming popular with young people.6 Though they may be portrayed as a safer alternative to traditional cigarettes, their use poses the same if not an increased level of risk.
Cigars
A third type of smoked tobacco is the cigar. To meet the legal definition of a cigar, these products must be wrapped in tobacco leaves or another product containing tobacco. While the word cigar still evokes images of a proud new father handing out a box cigars to celebrate, today they come in a variety of forms and are used on more than special occasions.
There are small cigars that closely resemble, and are typically used as, cigarettes; moderate-size cigars that match the image from days of yore; and large cigars that contain as much nicotine as an entire pack of cigarettes and take an hour or more to smoke. Cigars seem quite trendy at the moment, but they are also increasing in use because they are taxed at a lower rate than cigarettes and are not subject to the same FDA regulations. This means that cigars can be flavored (they are available in a wide range of flavors, including grape, strawberry, and apple) and claims of being “low-tar” or “lite” can still be made on their packaging. Even so, cigars have not been found to be safer than cigarettes; they contain the same basic ingredients, though most lack filters. Cigar smokers may be at an even higher risk of harming their health, as the lengthy fermentation process involved in making cigars means they develop higher levels of nitrosamines, the chemical compounds that are known as carcinogens. When the larger cigars are smoked, the user is also exposed to these dangerous chemicals for a greater length of time.7
Pipe and Loose Tobacco
Smokers who prefer to roll their own cigarettes using special cigarette papers use loose tobacco. This is often done because of the preferred taste, more control over the size and strength of the cigarette, or because it’s cheaper than prepackaged cigarettes. Pipe tobacco is similar, but is often flavored and moist, needing to be kept in an airtight container. While pipe and loose tobacco are slightly different from one another, users have lately been substituting pipe tobacco to roll their own cigarettes, since the excise taxes for pipe tobacco is substantially less than for either loose tobacco or cigarettes.8 As a result, sales of pipe tobacco have increased dramatically in the past few years.
Smokeless Tobacco Products
Pipe and Loose Tobacco—Hookah
Loose tobacco that is not smoked can be used in a water pipe, often called a hookah. (The most famous depiction is that of the Caterpillar character in Alice in Wonderland.) With this pipe, charcoal-heated air passes through flavored tobacco and into a water-filled chamber. From there, the user inhales the “smoke” or vapor through a tube and mouthpiece.9 Water pipes, which originated in Persia and India, are becoming more popular with young people in the United States, especially college students and young urban professionals. Hookah “smoking” is considered a social activity, and restaurants and special hookah bars across the country offer groups a place to use together. (As with other forms of smokeless tobacco, the regulations on water pipe usage are currently less stringent than for tobacco that is smoked.) Even though the smoke inhaled while using a hookah passes through water, it poses the same risks as other forms of tobacco use. According to the American Cancer Society, social users may be at higher risk for additional health problems, as they can contract infectious diseases by sharing hookahs.10
Chewing Tobacco
Chewing tobacco is also called spit, dip, chew, pinch, or snuff. It is sold, dry or moist, in small packets/pouches or tins, and comes in wads, leaves, or plugs. Users place the sweetened tobacco between their cheek and gum or between their lower lip and gum. It may also be chewed. Nicotine is absorbed through the skin when the person’s saliva mixes with the tobacco. The tobacco juice is then often spit out. Dry snuff may also be sniffed up one’s nose. Users may keep chewing tobacco in place for up to an hour.
Snus
Snus is sold in teabaglike pouches that users place between their cheek and gum or under their upper lip. This tobacco is sold in many flavors, including licorice, peppermint, vanilla, mint, and natural. Snus is considered a spitless form of smokeless tobacco and is advertised as tobacco that can be used “in any social situation.” Snus bags are generally held in place for about thirty minutes and then discarded.
Dissolvable Tobacco
Dissolvable tobacco products are finely milled tobacco that is pressed into various shapes, including tablets or sticks. The shapes and the packaging that contain this tobacco bear a strong resemblance to mint and candy; they have even been referred to as “nicotine candy.”11 As their name implies, they dissolve completely in the mouth, usually in five to fifteen minutes, depending on their shape. They are often flavored—mint, java, and natural, for example—and also deliver a dose of nicotine, ranging from 1.5 to 4 milligrams.12 (By comparison, smoking a cigarette typically delivers between 1 and 2 milligrams of nicotine.) And because dissolvable tobacco can be used so discreetly, the website for Camel dissolvables is correct when it proclaims, “Dissolvables are not subject to smoking restrictions.”13
E-cigarettes
Electronic cigarettes, commonly called e-cigarettes, are battery-powered and produce a vapor “smoke” that contains nicotine but not tar or carbon monoxide. E-cigarettes typically resemble cigarettes, cigars, or pipes, though some are made to look like common items such as pens or USB memory sticks. They include three elements: a cartridge filled with liquid nicotine and other chemicals, a battery that is used to heat the liquid, and an atomizer that turns the mixture into a vapor that the user inhales. E-cigarettes are available in either disposable or rechargeable form.
The FDA does not regulate or currently oversee the manufacturing of e-cigarettes. Thus the safety, contents, and potential benefits of these nicotine products are yet unknown. When the FDA did analyze a sample of e-cigarettes, it found inaccurate labeling—some products labeled as nicotine-free actually contained nicotine—and inconsistency among the amount of nicotine released in the vapor of various brands that, according to the label, contained the same amount of nicotine.
Critics of e-cigarettes argue that the industry is trying to skirt regulations, particularly against marketing their products to young people and claiming that e-cigarettes can help people stop smoking. In September 2010, the FDA sent a letter to e-cigarette manufacturers in the United States, warning them to stop making tobacco cessation claims and to clean up their manufacturing practices. Drugs that are lawfully marketed to help people quit tobacco need to be able to substantiate such claims—prove the drugs are safe and effective—before the FDA approves them. They also need to be manufactured so the products are consistent in strength, quality, and purity.16
