'Safety" might not be the first word you think of when describing a tobacco product that threatens to turn people into nicotine fiends.
these"harm reduction" sites falsely claim: "It is a medically proven fact that is much less harmful than smoking," casaa boast. "Safety, from the harm of smoking ." Claims such as these are purely deceptive. They also profit from addicting your family and children to this dangerous addiction.
Just because there is no smoke, doesn't mean that smokeless tobacco is safe. Smokeless tobacco can cause cancer and a whole bunch of other bad health effects.

Recent research shows that smokeless tobacco use might also cause problems beyond the mouth. Some studies have shown that using smokeless tobacco may cause pancreatic cancer. And scientists are also looking at the possibility that its use might play a role in the development of cardiovascular disease--heart disease and stroke.

LINK

Nicotine already IS in the form of "an acceptable breath mint" and it's called a "Nicorette mini lozenge" - approved and endorsed by the FDA and available to youth without a prescription.

Have you really thought through the impact of banning innovative, lower-risk, smokeless tobacco products when cigarettes are still widely available? 47 million smokers, many of whom cannot or will not quit, could be using a much less harmful product instead. Youth smoking is on the rise again in many areas. Banning smokeless will not protect children - it will only leave the most harmful product on the market unchallenged. So long as cigarettes are available, it's simply irresponsible to ban or discourage less harmful options. And yes, it IS a scientific fact, acknowledged by the entire medical community, that smokeless tobacco does not carry nearly the same health risks as smoking. No, it's not "100% safe" and we don't make that claim, but neither is sugar, caffeine, fat, driving, sports, prescription medicine and a whole bunch of other things we consume and do. But it's better than the alternative these people have - smoking.

To believe that banning smokeless tobacco will stop kids from smoking or cause smokers to quit is simply wishful thinking while cigarettes are still for sale. These products fall under the same laws as other tobacco products and should not be sold to youth (and people who are not already using tobacco should NOT start.) But if kids would buy these illegally, then they would also buy cigarettes illegally, if the smokeless was not available. To believe otherwise is simply naive.

The best protection from youth nicotine addiction is educating and monitoring your children. But banning less harmful versions of tobacco simply leaves those youth who DO choose to use tobacco and adults who are already addicted with only the most deadly option. It's like removing seat belts from cars in hopes that youth will then start driving responsibly - no one would see that as a reasonable solution. We don't ban fatty foods from the market - we offer low fat and non-fat versions so people have options to lower the health risks in their diet. An appealing smokeless tobacco product that can convert smokers or keep youth from choosing to smoke in the first place offers the same kind of choice.

For the record, CASAA (the Consumer Advocates for Smoke-free Alternatives Association) is a non-profit organization, formed by former smokers to educate the public about tobacco harm reduction - safer alternatives for those who cannot or will not quit. None of the board of directors or officers get a salary for our organizational work - we are all volunteers. So we do not "profit from addicting your family and children" as CASAA members. Ideally, we'd want no one to use any product that is a health risk, but that isn't realistic. We simply acknowledge that people will do things that aren't necessarily good for them and they need to know that there are less risky options available and we want to keep those options available for them. We truly believe that removing or blocking lower risk products and leaving only the most dangerous product on the market is simply a bad idea for public health. We volunteer hundreds of hours of our own time (along with real jobs and our families to take care of) to this mission and our only motivation is saving lives. Anyone who accuses us of anything else either doesn't know us or has some reason to attempt to falsely discredit us for their own benefit.

That was very well written but you left out all the natural products that are available and legal for minors to purchase so while your on your rant about how dangerous smoking alternatives are why dont you do your research and start attacking the eggplant farmers and such other people who grow anything that contains nicotine naturally. Leave Smokeless tobacco alone, It has only helped thousands upon thousands of people to quit a death sentence and in no study has nicotine been found to cause any form of cancer. Is it 100 percent safe, no but is there anything in this world that is 100 percent safe? When you go to bed at night is there the chance that you wont wake up in the morning.

"Its hard enough worrying about all the future trouble coming my way using my own frame of reference as a background. But, turning nicotine into some sort of acceptable breath mint scares me more than a cheap six-pack and my kids home alone for an evening"

You do understand that we have both the nicotine gum and lozenge don't you? You do understand that it's actually given to kids freely, and a good portion of kids actually experiment with it?

Okay, think about it another way, it's estimated that over 400,000 people die from smoking, close to the figure of non-tobacco related heart disease. All an alternative product needs to be is 75% less harmful for your worst fear to be a net neutral, every kid growing up to reject cigarettes and opt for this hypothetical product. The estimates on ANY smokeless tobacco product represent a harm reduction of 98%. As in if everyone uses it, a 4x increase, that's an estimated 368,000 lives saved. It's a net win, making your biggest worry fast food.

Remember, about 1:4 kids try cigarettes, about 3:4 of those become habitual users, and 1:7 people continue smoking until death. If you fail to promote tobacco abstinence, and normal cessation methods fail as they often do, this is a plan B. Plan B increases the odds you'll outlive your child who was foolish enough to experiment with cigarettes.

Electricman, Is you're real name Zorba? or Dalli?

"Some studies have shown that using smokeless tobacco may cause pancreatic cancer."

Perhaps you can cite these studies.

The truth is NRPs have not been directly studied for long term use, the FDA had to defer to long term studies on Snus use in Sweden.

Dr. Neal L Benowitz, FDA's leading expert on tobacco products is 100% clear on this subject. "The lack of increase in common cancers in lifelong {Smokeless Tobacco} users indicates that nicotine is not a general cancer promoter"

LINK

I admire any parent for being concerned. However, the objective reality is a child is more likely to be exposed to "nicotine candy" in the form of NRPs . After all, there is no real age restriction on these products, and they do actually look like candy and they are sold without even the most rudimentary child proof containers. But we shouldn't take NRPs off the market.

It's sad that RJR specifically has better child proof containers than NRPs.

"A study published in the April 2010 issues of Pediatrics found that smokeless tobacco products are the second most common cause of nicotine poisoning in children. Only cigarettes caused more nicotine poisoning."

of these events how many lead to a fatality? Zero
Of these events how many lead to long term damage? Zero

lets put this in perspective instead of trying to drive it off of primal fears- According to poison control center across all substances -
1.2 million unintentional poisonings among children ages 5 and under were reported to US Poison Control Centers.

smokeless tobacco incidents numbered 1768 with Zero significant outcomes

Since nicotine replacement products are not tracked specifically they are in the group labeled Other which totaled 1197

The number of Cigarette/cigar is 10706

Just wanted people to know the numbers not the shock value quotes being used

CASAA's bylaws allow for a minority of the board of directors to be vendors of nicotine products/accessories ... Just ask Kristen what she sells (electronic cigarette accessories) the "harm reduction " site is run by ecf electronic cigarette forum. That's my problem with this "harm reduction " site if people profit from nicotine addiction how can you trust or believe anything that is said?

"I suggest you should jump on board helping get word out to parents that these products exist and they could be confused as mints"

You are making a classic error in your evaluation, which is one that is understandable. The FTC evaluation of nicotine delivery per cigarette does not equal the nicotine content of the cigarette. The FDA no longer sees fit to test cigarettes for nicotine content, nor requires this be posted on cigarettes. As a parent you can not say 1 cigarette only contains 1mg of nicotine thus if eaten by a child presents little to no risk. One cigarette can deliver 1 mg after being lit on fire. The FDA doesn't require this data, but a good estimate is at least 10mg/nicotine per cigarette in the tobacco, dry tobacco between 14-24mg/gram.

And we already do educate children on the risks of nicotine gum, lozenge, and mini lozenge, which also look like candy. We also educate children about the risks of mistaking Good and Plenty with Prozac, Sweet Tarts for aspirin. It's not a pharmaceutical conspiracy, nor big tobacco one. Candy and medication share a common design element because they're designed to go in your mouth.

As a point of interest, Ariva dissolvables are on par with nicotine gum, Stonewall specifically 4mg/piece. RJRs are actually lower, .6-3.1mg/piece (1mg orb, 3.1mg stick, .6mg strip) and have great child proof packaging. Altria AFAIK has no childproof packaging, but are less candy like looking more like chocolate covered toothpicks, 3.1mg/stick.

As you might imagine, oral NRPs are more widely available, and present a risk to children because they're given to kids freely and are sold without age restrictions typically.

LINK

The other error in your evaluation is a question of dose over time. Nicotine's LD50 is .5-1mg/kg of body weight, but has a half life in the human body of 1 hour. Where 30-60mg could kill an adult, toxic symptoms are seen with as little as 2-5mg according to the CDC. To be lethal it has to be consumed all at once.

LINK

It was a big deal with ground beef was intentionally poisoned by Blackleaf 40, a concentration of 40% nicotine. The CDC labs reveled 300mg/kg affecting 148 people. No one died. The only death they cite was an intentional poisoning in Europe where beer was contaminated in 1992.

As you might imagine, parents should already be teaching kids about the difference between medication and candy as they are easily confused as both are designed to go in your mouth. New tobacco products do not present a unique risk, but in fact mitigate that risk by reducing the speed of delivery, where dose and time equal the poison. Kids should be taught to report symptoms of toxic exposure to ANYTHING. If it's a nicotine product, take action but take some comfort statistically speaking it's the least of your worries.

Jessica, I apologize if my comment was misunderstood. The clarification about CASAA was not directed at your blog post but as a comment posted here by a reader. He goes around the web making false accusations and twisting the facts about CASAA.

On other points, have you seen the packaging for Ariva lozenges? Here is a link: LINK

They are packaged more like medicine than candy and not easy to get out - I bought some once and it was difficult to open.

Have you seen Nicorette Minis? Here is a link: LINK

Do those not also look like and packaged like Tic-Tacs? How come no one objects to those? They also come in orange, cherry, coffee, etc. the same as the tobacco lozenges.

Did you know that youth survey you are quoting was criticized for being very poorly done? They purposely set up the tobacco products to look like candy by showing them in pictures next to candy. They made sure they would get the answers they wanted in order to argue banning them. It was in no way a scientific study of potential use by youth.

The reason that these are marketed to use when you can't smoke is because the law forbids them to inform consumers that smokeless alternatives have less health risks. They lead smokers to believe that smokeless products are just as bad as smoking, so smokers think the only thing smokeless is good for is when you can't smoke. If more people knew the truth, they would switch completely and not just when they can't smoke. Again - this isn't about people who want to quit nicotine, this is about getting people who have no intention of quitting to use the safer alternatives. This also isn't about youth who have no intention of smoking - this is about youth who intend to use tobacco products - in spite of all of the warnings. In spite of all our best efforts, many kids are still going to try tobacco and some will continue to use it.

You included this quote in your blog post:

"Dr. Lee Beers, a pediatrician at Children’s National Medical Center in Washington D.C. says, “There doesn’t really seem to be any reason to have tobacco in a format that is much more easily ingestible and with quite a few downsides, particularly when you think about children and adolescents.”

That strongly suggests that these have no place on the market, ie. should be banned and that you agree with that. But if we do ban these, then those youth who DO still try tobacco will have only one thing to try - cigarettes - which are the most deadly form of tobacco use. It's like junk food. We know kids will eat it, but do we ban low-fat, low-sugar snacks and leave only the worst stuff as an option?

I'm not sure about your point about the smokeless having more nicotine than cigarettes. Nicotine isn't the real danger in smoking, SMOKE is the danger in smoking. The more nicotine in a lozenge just means that they will need to use less lozenges? I've tried the Ariva lozenge and it was strong, so I just took it out of my mouth when I had enough. There's not enough in a single lozenge to cause any adverse reaction in someone who would otherwise be smoking.

Correct: the products are not marketed to adult smokers as a possible way to quit smoking, but there's a very good reason for that. The FDA prohibits it. The FDA also prohibits the companies from making claims that their products are safer than smoking, even though no one in their right mind denies it's the truth.

The FDA is out of control.

A few years ago, the FDA told the makers of Cheerios cereal that if they didn't stop claiming their cereal was good for the heart, then Cheerios would be considered an unapproved drug and subject to removal until it underwent clinical trials. I mean, really....

As for the shape of the products resembling Tic-Tacs ... what shape *should* they be? Round, square, triangle? I'd suggest those shapes would be far more "candy-like" than oval. Oval is the default shape for something you put in your mouth and allow to dissolve, right?

By law, tobacco products cannot be sold or marketed to minors. We need to enforce those laws. And, of course, parents should be made aware of the products to ensure their children aren't using them. But to say the products are being marketed to children simply isn't true.

I hate Big Tobacco, but geesh, let's not allow our emotions to destroy all semblance of reason. There are all manner of products intended for adults only. It's up to those adults to keep those products out of the reach of children, whether it's a tobacco orb, liquor-infused chocolate candy, or a piece of cinnamon-flavored Nicorette gum.

"CASAA's bylaws allow for a minority of the board of directors to be vendors of nicotine products/accessories ... Just ask Kristen what she sells (electronic cigarette accessories) the "harm reduction " site is run by ecf electronic cigarette forum. That's my problem with this "harm reduction " site if people profit from nicotine addiction how can you trust or believe anything that is said?"

This is what I was talking about, Jessica.

Yes, vendors must be a MINORITY per our bylaws, so they cannot ever have majority influence over the board. We have always let people know about that fact and it's no secret. We felt it was necessary to not exclude vendors completely, because it hopefully allows CASAA to influence responsible standards and testing in the vendor community. We currently have 1 active and 1 inactive vendor on our board and BOTH are also CONSUMERS who became vendors because they believed so much in the product. The active vendor owns a small company that started as a one-man shop - not some big, influential corporation. The inactive vendor is actually a full-time attorney who just recently decided to start a business partnership on the side. My little side business of carrying cases (which can hold e-cigarettes, but also are marketed and sold as tampon cases, make up cases, contact lens cases and pill box cases - I even sell the pill organizer insert and magnetic contact lens insert) is just that - little. If e-cigarettes were banned today I would still have my business, so I have no real vested interest in "keeping people addicted." I just filed my sales and use tax and my total sales for 2011 were less than $1,600 (I sold a whopping 49 hand-finished cases, which is about 4 cases and $70 net a month - hardly an income worth over 2 years and the hours and hours of volunteer time I put in as a CASAA director every week.) And I started that business AFTER I was elected to CASAA's board, so I was an advocate FIRST. My main source of income comes from my real estate business and mostly my husband's income. "Electricman" is twisting things to look shady when they are not.

The electronic cigarette forum (ECF) does NOT "run" casaa.org in any way, shape or form. No one employed by ECF is on the board of directors. No one on CASAA's board is paid by ECF to be there. All of our organizational expenses are paid through donations from members. None of the directors get paid for being on the board. CASAA is active on the ECF forum because we can reach a lot of people there. CASAA has spent countless hours advocating for smokeless products other than e-cigarettes - as seen by these comments on this blog post about dissolvable tobacco products. We testified at TPSAC about dissolvable tobacco products. Our web site discusses alternatives other than e-cigarettes. Why would we waste time doing that if we were just an "e-cigarette front group?" It is an outright lie that ECF owns or runs CASAA.

(Sorry for the derail, Jessica. It's just that this person keeps spreading these lies on every web site he can and it's getting really tiresome having to defend against it over and over.)

I got involved with CASAA because I was a smoker who found a smokeless alternative that the government and health groups were trying to ban. I was in complete shock that they were against products which were far less hazardous than smoking. They tried to ban these products while leaving cigarettes on the market. They use every trick in the book, including "save the children" when children are far more threatened by cigarettes. It made absolutely no sense unless they were really just trying to protect the cigarette and pharmaceutical nicotine markets. I dedicate my time and efforts not for a measly $70 a month but because I believe the public, especially smokers, need to know the truth about smoke-free alternatives and once they do, millions of lives can be saved. Not to mention the millions of youth who would have otherwise started smoking.

No offense, Jessica, but you are really being duped by the special interest groups trying to protect THEIR funding and pharmaceutical profits. By creating a negative buzz and panic in well-intentioned folks over smokeless tobacco, they protect their market share. Why else do they not try to get the worst tobacco product off the market? Why else do they not object to pharmaceutical nicotine that also looks and tastes like "candy" yet studies show they don't really help people quit nicotine? Why did they ban all flavored cigarettes (which made up only 1% of the market) yet leave the most popular flavor - menthol - on the market? Because it's all a diversion to make people think that these groups and the politicians have their best interests in mind. Think about it.

Sorry - you posted while I was writing my book, lol.

Yes, you are absolutely right that parents should be made aware of these products so they can be on the lookout - same as any other potentially abused product.

What we object to is that the tobacco products are being singled out and accused of "marketing to children" when pharmaceutical nicotine products that look like Tic-Tacs have been available in fruity flavors for years. Why were parents not warned about those, too? No one has tried to get those off the market, yet they HAVE tried to ban the sale of tobacco lozenges - even ones that DON'T look like "candy." And they accuse these tobacco products of "just trying to avoid smoking bans" when they know full well that the FDA forbids them to market them in any other way or telling people that smokeless has less risk than smoking.

Yes, Big Tobacco has earned their reputation as underhanded and shady - but is "Big Pharma" and "Big Gov" really any more trustworthy these days?

"Matt Zuke - as I am sure you are aware, prozac requires a prescription, it is not sold on display at a gas station or a drug store. It is not a fair comparison. "

If you're a parent, you need to educate your kids about risks, and it just so happens Good and Plenty look JUST like Prozac. It being prescription only doesn't change the objective fact that kids are likely to be exposed to it, either though their parents or fellow classmates. Red Hots look just like Robitussin caplets, which are available over the counter. I'm sure there is also candy that looks like Comtrex cold capsules.

"so I have no idea who you are referring to when you say "we educate children"."

We as a society. Health care professionals, educators, entertainers, all address this issue pretty well when they say "don't put this in your mouth".

See the following PSA




"My goal is to educate other similiarly situated adults about something I find to be unfairly confusing."

No more confusing than cold lozenges, which to be fair Camel orbs do resemble Fisherman's Friend Herbal Cough-drops. Also to be fair, cough drops have far more kid appeal than Tic Tacs. This would include Choraseptic or Ludens. I still drool when I think about Ludens as an adult.

Well, you're putting undue emphasis on a new product that presents no greater threat than products that have existed for a long time, or more recently oral NRPs which look just like Chiclets, TicTacs, or little candys. Medicine and candy share a common design element because they are designed to go in your mouth. In fact, these products actually represent a reduction in risk because they're designed to retard delivery, unlike if a child consumes cigarette which contains 5-10x the nicotine as either oral NRPs. Your own citation addressed specifically smokeless, not dissolvables.

Existing provisions we have regarding medication should cover these new products perfectly well. If you honestly think a prescription would resolve a child's confusion over Prozac and Good and Plenty, you're respectfully fooling yourself. By all means educate kids about this, but if you're not already teaching kids "don't put it in your mouth", you're kind of neglecting your duties as a parent. I'd humbly suggest buying some Swedish Salted Licorice like Salmiakki to reinforce "don't put it in your mouth".

FYI, I tried the same experiment, and I got yucky breath fresher or icky cough drop as a response.