Other Forms of Tobacco Are Not the Answer
Although cigarette smoking continues to decline in the U.S., the use of other forms of tobacco and nicotine products has grown in popularity.
This includes smokeless tobacco, hookahs and e-cigarettes, also called electronic nicotine delivery systems (ENDS).1,2 People often think these products are less harmful, not addictive and can help when trying to quit smoking.1,3 However, this isn't accurate. In fact, regular use of these items can be a first step to becoming a lifelong cigarette smoker.
Smokeless tobacco
Types of smokeless tobaccos include chewing tobacco and snuff.5 Chewing tobacco comes in the form of loose leaf, plug or twist.6 Snuff is finely ground tobacco that can be dry, moist or in sachets (tea bag-like pouches). This product appeals to some people because it is not burned and is often flavored. Smokeless tobacco contains nicotine and other chemicals, which makes it as addictive as cigarette smoking.1,2,5 These products can cause many health problems, including cancers of the mouth, esophagus and pancreas.1,5
Hookah pipes
Hookahs are water pipes used by a group of people to smoke specially-made tobacco.7 The smoke produced by the hookah contains nicotine and many of the same toxic chemicals found in cigarettes.7 The smoke is filtered through water, which notably does not remove any nicotine or toxins.7 Each puff from the hookah is reported to deliver 12 times as much smoke as a cigarette smoking.7 What's more, since a hookah session typically lasts 20–80 minutes, a hookah user can inhale as much smoke during that time as a cigarette smoker would from smoking 100 or more cigarettes.7 The smoke from the hookah also can cause cancers of the lung, mouth, esophagus and stomach, and lead to other diseases of the gums, bladder, lungs, heart and mouth.7 In addition, because users share a common mouthpiece, there is a high risk of spreading infectious diseases like tuberculosis and hepatitis C because they are not frequently or thoroughly cleaned.8
E-cigarettes
Electronic cigarettes, also called e-cigarettes or vapes, are battery-operated devices that heat up liquid chemicals in a cartridge forming a vapor or steam that is inhaled by the smoker.1-3 E-cigarettes do not burn tobacco leaves. Still, the vapor from an e-cigarette contains harmful ingredients, like nicotine and other chemicals.1-3 Since e-cigarettes and vapes are not controlled by the U.S. Food and Drug Administration (FDA), people who use e-cigarettes have no way of knowing how much of these ingredients they are inhaling and what possible adverse effects include. Studies have shown that individuals who use e-cigarettes are more likely to start smoking cigarettes.3,9 Plus, there have also been reports of vape battery explosions which, although rare, are harmful.9
The bottom line
No matter what you have heard, using e-cigs and vapes is controversial. The safety of these products is unknown, and regulation is constantly changing. In addition, ENDS could act as a gateway to future smoking. ENDS may also stop people who smoke from quitting by keeping them addicted to nicotine or dissuading them from using effective smoking cessation tools.1-4
Though you may have heard using other forms of tobacco and nicotine are not placing your health in as much risk as smoking cigarettes, the reality is use of any tobacco or nicotine products will harm your health.1-9 E-cigarettes, hookas, and smokeless tobacco are not approved by the FDA as a way to help quit smoking.9 People who want to quit smoking should use FDA-approved medications to help them quit.9
If you or someone you care about wants to quit smoking, health care providers at the In-Store Clinics and MDLive are on hand to support you in your plans to be tobacco-free from cigarettes or other forms of tobacco. There are additional educational materials available in the Walgreens Answer Centers on walgreens.com to support you as well.
Updated on September 9, 2019
Sources:
1. "Health Risks of E-cigarettes, Smokeless Tobacco, and Waterpipes," American Society of Clinical Oncology. Web. 7 June 2019. https://www.cancer.net/navigating-cancer-care/prevention-and-healthy-living/tobacco-use/health-risks-e-cigarettes-smokeless-tobacco-and-waterpipes
2. "Vapes, E-Cigs, Hookah Pens, and other Electronic Nicotine Delivery Systems (ENDS)," U.S. Food and Drug Administration. Web. 7 June 2019. https://www.fda.gov/TobaccoProducts/Labeling/ProductsIngredientsComponents/ucm456610.htm
3. Center for Disease Control and Prevention. Tobacco Use Among Working Adults — United States, 2014–2016 Morbidity and Mortality Weekly Report/ October 27, 2017 / 66(42); 1130–1135
4. Bunnell, R. E., Agaku, I. T., Arrazola, R. A., Apelberg, B. J., Caraballo, R. S., Corey, C. G., … King, B. A. (2015). Intentions to smoke cigarettes among never-smoking US middle and high school electronic cigarette users: National Youth Tobacco Survey, 2011–2013. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 17(2), 228–235. doi:10.1093/ntr/ntu166
5. "Smokeless Tobacco Health Effects," Centers for Disease Control and Prevention. Web. 7 June 2019. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/smokeless/health_effects/index.htm
6. "Smokeless Tobacco: products and marketing," Centers for Disease Control and Prevention. Web. 7 June 2019. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/smokeless/products_marketing/index.htm
7. "Hookahs," Centers for Disease Control and Prevention. Web. 7 June 2019. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/index.htm
8. Sharma, G., & Nagpal, A. (2015). 'Hookah Smoking - An Age-old Modern Trend'. Journal of family medicine and primary care, 4(1), 151. doi:10.4103/2249-4863.152278 Accessed 5/14/2019.
9. "FDA announces comprehensive regulatory plan to shift trajectory of tobacco-related disease, death," U.S. Food and Drug Administration. Web. 7 June 2019. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm568923.htm