What

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Whats old is new again, reinvention of the old
and invention of new tobacco products

• Ventura Unified School District
• September 25, 2009

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(No Transcript)
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Youth Smoking Prevalence Rate

• Smoking National 20.0
• California 14.6
• Ventura County 15.4

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Traditional Tobacco Product Categories

• SMOKE PRODUCING
• Cigarettes
• Cigars
• Blunts
• Bidis
• Kreteks (cloves)
• Pipes
• Hookah
• Miscellaneous
• Hard snuff
• Lozenges

• SMOKELESS
• Chewing tobacco
• Dry Snuff
• Moist Snuff
• Swedish Snus
• Spitless Snus

• Coming to a store near you in June 09
• Orbs
• Sticks

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The tobacco epidemic, like the flu is always
mutating.- Jack Hennengfield

• Tobacco Companies and others out to
• make money on nicotine are always
• changing-
• what they market
• how they market
• to whom they market

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Flavored Cigarettes
BAnned By F.D.A
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Camel Crush

• Crushable blue pellet hidden inside filter.

BAnned By F.D.A
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Cigar prevalence

• Percent of youth that have ever tried
• smoking cigars, cigarillos, or little
• cigars
• Ventura County 31.4
• Statewide 29.1
• Source
• California Student Tobacco Survey (CSTS)

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Little Cigars Cigarettes in Disguise

• Flavored products to
• mask the harness of the
• tobacco.
• Low cost product sold in
• singles or small packs.
• Little cigars can deliver
• between 2 and 5
• times the nicotine
• per gram of tobacco.
• Weigh less than cigars
• Resemble cigarettes in size,
• shape, packaging, and filters

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Alcohol flavored little cigars
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Hip Hops influence

• WASHINGTON Rapper Lil
• Wayne will be seen endorsing a
• new range of cigars specially
• made for smoking marijuana.
• According to Hip Hop Weekly
• magazine, the Lollipop hitmaker
• is a well-known advocate of the
• drug.
• Hes a huge fan of Bogey Blunts
• and thus has allowed the
• manufacturers to use his image
• on the packaging, reports
• Contactmusic.
• The cigars are made with
• leaves that can be easily
• unrolled for users to add their
• own tobacco.

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Cigarillos is a short, narrow cigar and are
similar to little cigars in both size and
structure. 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.
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Kreteks

• Kreteks are made up of 60-70 percent tobacco and
  30-40 percent shredded cloves (a spice)
• Clove cigarettes appeal to adolescents
  experimenting with smoking and may influence the
  development of later smoking habits

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Side note on Kreteks

• Based here in Ventura County
• To escape the new FDA regulations, Kreteks will
  cease to produce clove cigarettes.
• Will now market clove little cigars instead.

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Blunts
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Smokeless Tobacco
American smokeless tobacco product designed for
tobacco satisfaction without smoking.
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Smokeless Tobacco and Youth

• Current youth smokeless tobacco use
• Ventura County 5.7
• Statewide 4.2
• California Student Tobacco Survey (CSTS) 2008

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Whats in smokeless tobacco?

• Smokeless tobacco contains sweeteners,
  flavorings, abrasives, salt and other chemicals.
• Over two dozen cancer-causing agents have been
  identified in traditional smokeless tobacco.

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Health risks of traditional smokeless tobacco in
the US

• While the jury is still on whether out on the
  health risks of smokeless tobacco are lower than
  for cigarettes, use of smokeless tobacco has a
  number of serious health consequences
• Oral cancer (up to 50-fold increased risk)
• Periodontal disease loss of tooth structure
• Nicotine addiction
• Possible contribution to the development of
  cardiovascular disease, peripheral vascular
  disease, hypertension, peptic ulcers, and fetal
  morbidity and mortality.

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Something old, something borrowed

• Something called SNUS

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What is Snus?

• Rhymes with "goose"
• Cynics might say "noose
• Swedish type of smokeless tobacco
• Comes in teabag-like pouches
• User sticks between the upper lip and gum
• Use for 30 minutes
• Then discards without spitting

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Where is Snus most popular?

• Snus is the Swedish word for moist snuff.
• It is manufactured and mainly consumed in Sweden
  and Norway.
• Snus is subjected to a heating treatment process
  that sharply reduces microorganism content no
  fermentation has been used in its production
• This processing method and refrigerated storage
  reduce the formation of nitrates and
  nitrosamines, resulting in a product low in
  TSNAs.

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The verdict is out about the safety of snus

• The long-term health effects of snus use starting
  early in life are also unclear.
• New types of smokeless snus are introduced to
  North America (e.g., Camel Snus, Marlboro Snus,
  Taboka)
• Some of these products are clearly aimed at youth
  (e.g., Taboka packaging resembles a cell phone).

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Snus

• Camel Snus and Philip Morris' Taboka are two
  types of smokeless, spitless tobacco products.

• Tobacco companies' spending on promoting such
  products rose more than five-fold.

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Snus also represents something more

• The new smokeless, spit-free products are an
  effort to create a different tobacco category in
  the United States,"

• -Tommy Payne,
• Executive Vice President for public affairs of
  Reynolds American, parent company of R.J.
  Reynolds.

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Snus also represents something more

• An attempt to move smokeless tobacco beyond
  stereotypical users such as baseball players and
  rodeo cowboys...and into offices or restaurants
  where people want a nicotine fix but can't light
  up.
• "This is a growth strategy for us," says Bill
  Phelps, spokesman for Philip Morris USA

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Snus advertisements

• Advertising tagline pleasure for wherever
• New way to enjoy tobacco"

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Abridged guide to snusing

• Picture yourself stuck in the center seat 44B of
  an airplane --You can mope, or you can Snus!

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Skirting the Smoking Bans

• Neater and more discreet than conventional oral
  tobacco.
• You can receive pleasure anywhere.
• Smoke-free, that makes it a hassle-free new way
  to enjoy tobacco.

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Pilot testing of SNUS in Indiana, Oregon and
Ohio

• "It's going to take some time for these products
  to take off," says Modi, the tobacco industry
  analyst. For that to happen, he says, they have
  to work. In other words, they have to give people
  a nicotine buzz.
• R.J. Reynolds Executive Tommy Payne says one
  pouch of Camel Snus offers about as much nicotine
  as a cigarette.

Snus not
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Whats this?
Water Pipe
NOT!!
Hookah
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Two types of Hookahs
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Water Pipes or Hookahs have many names

• Africa, India, Egypt, US
• Saudi Arabia
• Jordan, Lebanon, Syria
• Iran
• Pakistan
• China
• Many places

• Hookah
• Shisha, Borry, Goza
• Narghile, Arghile
• Ghalyoun, Ghalyan
• Huqqa
• Shui yan dai
• Hubble Bubble

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History of Hookahs

• Also known as Narghilè or Shisha is an ancient
  waterpipe invented by the Turks over 500 years
  ago and still remains an integral part of Middle
  Eastern culture.
• Use declined, almost died out by 1980s
• 1990s maassel came on the market
• Maassel is tobacco fermented with molasses and
  fruit
• Easier to use with more pleasant taste and aroma

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How the pipes work
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Hookah Materials
Coco Nara Coals are 100 natural, made from
compressed coconut husks and shells. The
dimensions of the briquettes are 1 inch by 5/8
inch. They burn hotter and much longer than most
other natural coals. Coco Nara is the preference
of most hookah connoisseurs, because they are
virtually odorless and tasteless. Like many other
natural coals, a stove or torch is necessary to
get them going.

• Maassel or muessel
• (assal means honey in Arabic)
• Moist paste like mixture
• 30 crude cut tobacco
• Fermented with approximately 70 honey, molasses
  and pulp of different fruits.

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Hookah Materials

• The quick-lighting charcoal used by many hookah
  smokers may be an additional hazard, because it
  produces greater levels of carbon monoxide and
  other dangerous substances than standard charcoal.

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Hookah cultural use is changing
Make me smarter Tell me about Hookah bars
Hookah Etiquette Where? When? How?
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Literature Review suggests a potential for
these types of infections to be spread

• Tuberculosis
• Mono
• Respiratory viruses
• Hepatitis
• Herpes simplex
• Helicobacter Pylori (bacteria that causes stomach
  ulcers)
• Pulmonary Aspergillosis (fungus)

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Chemicals in hookah smoke

• Chemical exposure also depends upon the type,
  shape and size of the hookah

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Chemicals in hookah smoke

• Tar
• Carbon Monoxide
• Nicotine
• Polyaromatic Hydrocarbons
• Carcinogenic Nitrosamines
• Heavy Metals (lead, arsenic, cadmium)

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Is hookah smoking addictive?

• Not many studies on this issue.
• After a 45 minute session of smoking
  Concentrations of nicotine and cotinine are found
  in blood, urine and saliva.
• Depending upon puff topography A hookah
  smoking session can be the equivalent of 15-20
  cigarettes. (Silhadeh, 2003)

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Toxin Content of smoke (single hookah session
compared to a single cigarette)

• 100 times more tar
• 5 times more cancer causing agents than
  cigarettes
• 11 times more carbon monoxide
• 45-60 minute session of hookah smoking is the
  same as chain smoking 15 cigarettes.

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E-Cigarettes
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Electronic Cigarette Concerns

• Recent FDA analysis finding cancer-causing
  chemicals and an antifreeze ingredient in some of
  the devices.
• Another product making smoking seem safer.
• Still contains nicotine. Has not received FDA
  approval
• Allows nicotine consumption in places where
• smokers would normally abstain.
• Unregulated. No quality control, most are made in
  China.
• Dont really know the contents of the nicotine
  vapor amount of nicotine present or how much
  nicotine is delivered to the body or what other
  elements are present.

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NEW PRODUCTS

• Coming to a store or website near you!

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Nicotine Water

• Example Nicotine Water is NO longer available

NOT!
A reformulated version is being manufactured in
Ventura and marketed as a homeopathic alternative
called NICO-Water.
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Tobacco Candy???
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Camel Orbs

• Nicotine delivery is high.
• Cigarette smoker typically takes in about 1
  milligram of nicotine, the Camel dissolvable are
  said to deliver about .6 to 3.1 milligrams of
  nicotine.

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Sticks and Strips and OrbsOH MY!!

• Camel Sticks resembles a toothpick. Dissolves
  in the mouth in about 10 -15
• minutes. Comes in Mellow flavor.
• Camel Orbs resembles a mint. Dissolves in 10-15
  minutes. Flavors Fresh and Mellow.
• Camel Strips Resembles a melt-away breath
  freshener. Dissolves in 2-3 minutes. Comes in
  Fresh flavor.

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Strips, Toothpicks and OrbsOH MY!!

• Currently being test marketed in three cities
  Columbus, Ohio, Portland Oregon, and
  Indianapolis, Minnesota. (Same as SNUS)
• Expected to be available nationwide beginning in
  late 2009.
• Only promotion of these products is via company
  website.
• Promotion coupons are available on E-Bay.

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Marketing Tactics

• For smokers who cant light up in the office or
  at a restaurant.
• Meeting the needs of smokers.
• The best tobacco you never smoked.
• Fact the future Join the Movement
• Revolution in Pleasure
• No Spitting Required

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Straight from the Horses mouth!

• Keeping up with new products designed to
• make tobacco use cooler, easier, more
• discrete, more fun and more appealing.
• Smokeless is a growing category with
• sales rising 6-8 annually. Cigarette sales
• are falling 2 3each year.
• David Sutton, spokesman of Altria Group,
• which owns Phillip Morris USA

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Family Smoking Prevention and Tobacco Control Act

• New chapter of the Food and Drug Administration
• Gives the FDA jurisdiction to regulate
• both current and new tobacco
• products and restrict tobacco marketing.
• It is predicted that the law will
• reduce youth smoking by 11
• and adult smoking by 2 over
• the next 10 years.

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Smarties

• http//www.youtube.com/watch?vEIAC3hM2aus

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Questions???
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Contact Information

• Ventura County Public Health
• Tobacco Education Program
• 805-652-3311 or 805-652-3306