Spit: Tobacco’s Deadliest Little Secret

Niki Sue MuellerProgram Director

Wyoming Through With Chewwww.throughwithchew.com

What is Spit (Smokeless) Tobacco?

Snuff is finely ground or shredded tobacco. Typically, the user places a pinch or dip between the cheek and gum

Chewing tobacco is available in loose leaf and plug with the user putting a wad of tobacco inside the cheek

Smokeless is not harmless!

What is in Spit Tobacco?

contains 28 carcinogens

The most harmful are the tobacco-specific nitrosamines (TSNAs) that are formed during the growing, curing, fermenting, and aging of tobacco.

cancer-causing substances include N-nitrosamine acids, volatile N-nitrosamines, benzo(a)pyrene, volatile aldehydes, formaldehyde, acetaldehyde, crotonaldehyde, hydrazine, arsenic, nickel, cadmium, benzopyrene, and polonium–210. (NCI-2003)

Health Effects

Spit Tobacco users are 50 times more likely to get oral cancer than non-users

Spit tobacco use may cause cancer of the esophagus, larynx, stomach and pancreas and can form within five years of regular use

Leukoplakia is a white, leathery patch which forms in the mouth and is considered a pre-cancerous lesion

(S.T.O.P Guide, 1997; Hatsukami, D.& Seversen, Nicotine and Tobacco Research, 1999)

Big Tobacco Enters Smokeless Market

PM USA is test marketing a smoke-free and spit-free tobacco pouch product, called Taboka, designed especially for adult smokers interested in smokeless tobacco alternatives to smoking

Camel Snus, the first smokeless-tobacco product to be rolled out by a major U.S. tobacco company

Harm Reduction Strategy

Harm reduction is a term used by the tobacco industry referring to a “strategy that encourages tobacco users who cannot or will not quit smoking to switch to an alternative nicotine-delivery product that is potentially less harmful than their regular product,”

(Robins R, ed. The Seduction of Harm Reduction: Proceedings from the September 2004 Summit. Sacramento, CA: Department of Health Services; 2005)

U.S. Smokeless Tobacco’s “Graduation Strategy”

UST document exhibited in the Marsee vs. UST lawsuit in 1986

All roads lead to Copenhagen

“Graduation Strategy”“New users of smokeless tobacco . . . are most likely

to begin with products that are milder tasting, more flavored and/or easier to control in the mouth.

After a period of time, there is a natural progression of product switching to brands that are more full-bodied, less flavored, have more concentrated ‘tobacco taste’ than the entry brand.”

“Graduation Party”UST Sponsors College Parties

Industry Quotes

“Moist smokeless tobacco is the only growing segment of the tobacco industry” from the UST website

“Cherry Skoal is for somebody who likes the taste of candy, if you know what I am saying.” Quoted in Wall Street Journal article on UST’s marketing strategies by a former UST sales representative, Bob Deets

UST’s Use Of Heroes To Promote ST

Promoting Use of ST On Airplanes

Rodeo and Football Were Used to Promote Spit Tobacco in

AdvertisingWalt Garrison was a pro football player in the early 70’sEarly association of alternative to smoking promotions

UST Capitalizing on “Smoke Free Environments”

ST Sent to Soldiers

CHICAGO, October 16, 2006—Rates of spit tobacco use by high school males are nothing to smile about, reports Oral Health America’s National Spit Tobacco Education Program (NSTEP). Research by the independent group finds that nationally about one out of seven high school males currently use spit (or smokeless) tobacco products, and in some states that number is one out of four. Spit tobacco excise taxes, which can reduce use by children, are arguably low, also resulting in a national “D” grade.

Male HS use: Kansas “D”

Excise tax: Kansas “F”

Kansas Use Rates

Male High School Use Rate: 17.4

Female High School Use Rate: 3.8

Tobacco Industry Advertising in Kansas per year: 125.9 million dollars

Why Tax Matters

Increasing tax is the single best way to reduce tobacco use

Most effective is to base tax on price, not weight

UST has been effective in 8 states to get a weight based tax

Goal of Comprehensive Tobacco Control Programs:

is to reduce disease, disability and death related to tobacco use by:

Preventing initiation among youth

Promote quitting

Identifying and eliminating the disparities related to tobacco use and its effects among different population groups

Eliminating nonsmokers’ exposure to ETS

CDC Guidelines

Nine main guidelines

Recommends states establish programs that are comprehensive, sustainable and accountable

Evidence based

www.cdc.gov

Wyoming Through With Chew’s Comprehensive

Approach

Building partnerships

Promote cessation

Media advocacy

Counter advertising

Prevent youth initiation

Educate the public

Policy change

Building Partnerships

Health care providers

State organizations

Decision makers

Employers/workplace

Faith based Communities

Native American populations

Promote Cessation

Know your state protocol

Use all possible

opportunities to

promote cessation

Increase Awareness

Participate in Through With Chew Week

Counter advertising

Media advocacy

Educate why price matters

Health effects

Changing social norms

Get on the agenda at statewide conferences

Counter Advertising

QuickTime™ and aTIFF (LZW) decompressor

are needed to see this picture.

No Bull Poster

Save The Date!February 17-23, 2008

QuickTime™ and aTIFF (Uncompressed) decompressor

are needed to see this picture.

Policy Change Opportunities

Brief intervention among health care providersTobacco free workplacesTobacco free schoolsTobacco free community eventsReducing tobacco advertising and sponsorship

Business Toolkit

Native American Populations

Design materials so that they are culturally appropriate

Work with Native American communities to determine their specific needs

In Summary

A comprehensive approach is the best way to reduce use ratesWork to allocate funds to smokeless tobacco programming through statewide Department of HealthLocal communities may have to work to educate on their specific spit tobacco challenges

Contact Info

Visit:

www.throughwithchew.com

Contact:

nikisue@throughwithchew.com

National Spit Tobacco Summit

•You are invited!•March 4-6 2008 in Oklahoma City, OK•Presentations from national experts•We can make a difference!