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April 2011
Gateways to DrugsTeens are still smoking. In a 2009 survey, approximately 1 in 6 teens reported having smoked in the past 30 days. Why is this important?
Youth aged 12-17 who smoke are:• 4x more likely to abuse alcohol
• 4x more likely to smoke marijuana
• 26x more likely to use cocaine
The earlier in life people use tobacco, the more likely they are to have tried cocaine, heroin, or other drugs, and the more likely they are to become regular drug users as adults.
Heavy smokers or heavy users of smokeless tobacco are much more likely to abuse marijuana or harder drugs.
25
50
80
6th
current marijuana use
non-cigarette smokers
current cigarette smokers
ever used cocaine
current cocaine use
ever used crack
current crack use
ever used oxycontin
current oxycontin use
2%4%
7%
11%
15%18%
21%
7th 8th 9th 10th 11th 12th
20
40
70
15
30
60
10
20
5
10
14.1
69.2
1.5
20.1
0.3
8.0
0.4
6.8
0.2 0.54.8
8.5
2.2
19.9
0
0
CURRENT CIGARETTE USE BY GRADE LEVELMA 2009
CIGARETTE SMOKING STATUS AND DRUG USE AMONG HIGH SCHOOL STUDENTS | MA 2009
Sources: Massachusetts Youth Health Survey, 2009. Massachusetts Youth Risk Behavior Survey, 2009.
March 2010
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April 2011
Blunt and Tipped CigarsWhat are blunts?Small cigars, with or without filters, in a variety of flavors, often used with marijuana.
HealthLike all smoking tobacco. Unfiltered cigars are worse for health when inhaled. Blunts are strongly associated with marijuana use.
Common BrandsPhillies, Black & Mild, White Owl, Swisher Sweets, Black Max, Prince Albert, Happy Hour, Prime Time
Common VarietiesBLUNTS Short, flavored cigars, often emptied and filled with marijuana
LITTLe CIgArS, CIgArILLOS, MINI CIgArS Smaller cigars with or without filters
TIP CIgArS, PIPe TOBACCO CIgArS Cigars with plastic or wood-tip filters. Black & Mild is most popular brand.
What’s the selling point?• Blunts are mentioned in songs and music videos, usually
associated with marijuana.
• Little cigars look ‘classier’ than cigarettes, though they’re mostly identical.
• Seductive flavors with names evoking candy, fruit, and alcoholic drinks.
Some Flavors: Appletini, Banana, Bellini, Berry, Cherry, Chocolate, Chocomint, Cinnamon, Coconut, Coffee, Cognac, Cosmo, Grape, Honey, Mango, Menthol, Peach, Pina Colada, Raspberry, Rum, Sizzurp, Sour Apple, Spearmint, Strawberry, Sugarillos, Sweet Vanilla, Tequila, Watermelon, Wine…
TIP CIgArS
BLUNT CIgArS
CIgArILLOS
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April 2011
BLUNT WrAPSBlunt WrapsWhat are blunt wraps?Leaf tobacco processed to form a hard, hollow tube. Filled with loose tobacco or marijuana.
HealthMost have no filters, effects of smoking are much worse than cigarettes. Strongly associated with marijuana use.
Common BrandsTrue Blunt, royal Blunt are most common. Also Juicy Blunt, Blunt Wrap USA, Bluntville, Cyclones (cone-shaped)
What’s the selling point?• Mentioned in songs and music videos, usually associated
with marijuana.
• Seductive flavors with names evoking candy, fruit, and alcoholic drinks.
• Notice: If a store sells these, do they also sell loose tobacco?
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April 2011
Roll Your Own (RYO)What is “roll your own”?Product sold to make your own cigarettes using loose tobacco. Often used for marijuana.
HealthMost have no filters, effects of smoking are much worse than cigarettes. Strongly associated with marijuana use.
Related Products ALUMINUM CIgAreTTeS Or ‘BATS’ Metal tubes about the size and shape of a cigarette. Also called “one-hitter” or “pinch hitter.”
‘DUgOUT’ Wooden box for storing a ‘bat’ and marijuana.
rOLLINg PAPerS Or CIgAreTTe TUBeS Now with machines to roll for you.
What’s the selling point?• Discreet way to smoke marijuana while pretending to smoke tobacco.
• Sold at head shops, popular among ‘stoners’.
• With loose tobacco, can be cheaper alternative to pre-made cigarettes.
• Notice: If a store sells these, do they also sell loose tobacco?
rOLL YOUr OWN
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April 2011
Hookah / ShishaWhat is a hookah?A water pipe. Sweetened tobacco is burned with charcoal, bubbled through water, and inhaled through a hose and mouthpiece.
Health• Because smoke is cooler and sweeter, users think smoke is
less dangerous, or that water removes anything dangerous.
• Hookah smoke has same chemicals as cigarette smoke, but in higher concentrations, especially “tar.” Charcoal contains chemicals and lighter fluid.
• Deep inhales are needed to burn moist tobacco. Smoking hookah for an hour will inhale as much tar and nicotine as from a pack of cigarettes.
• Shared mouthpiece and water can transmit TB, herpes, mono, hepatitis, flu.
• Highly addictive, leading to strong correlation with cigarette smoking.
• Could be used to smoke marijuana, hashish, opium.
Common Varieties• Flavors: apple, apricot, mint, banana
• Water in bowl can be mixed with wine, ice, fruit juice, etc.
• Pipes and tobacco available online. More often, smoked at restaurants or hookah bars. Found in towns with colleges or many young adults.
What’s the selling point?• exotic, trendy, communal alternative to cigarettes.
• Water cools smoke, making it ‘smoother.’
HOOKAH
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April 2011
SnusWhat is snus?Moist snuff in small teabag-like pouches. Used like snuff, but no spitting.
Health• Similar risks to chewing tobacco.
• Needs refrigeration, or carcinogenic nitrosamines build up.
• Could lead to use of regular snuff and chewing tobacco and cigarettes.
Common Brands and VarietiesCAMeL SNUS Mellow, robust, Frost and Winterchill
MArLBOrO SNUS rich, Mild, Peppermint and Spearmint
TrIUMPH (Swedish Brand)
Other common snuff brands as a ‘pouch’ variety.
What’s the selling point?• No smoke or spitting; can be used where smoking or
regular chewing tobacco is prohibited.
• Burns cheek less than chewing tobacco.
• Flavors mask the tobacco taste.
SNUS
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April 2011
Dissolvable TobaccoWhat is dissolvable tobacco?Fine-milled tobacco in a dissolvable candy-like base. Dissolves completely in mouth.
Health• except for nicotine amounts, unknown and untested for safety.
• Full package may contain enough nicotine to kill a small child, if chewed or swallowed all at once.
• Visual and taste similarity to candy could lead to first use of tobacco by minors.
• Clerks may not even realize it is tobacco, and may sell to minors.
Common Brands and VarietiesCAMeL OrBS, STICKS, AND STrIPS Fresh and Mellow
ArIVA AND STONeWALL Wintergreen and Java
What’s the selling point?
• No spitting, no smoke, no leftovers.
• Burns cheek less than chewing tobacco.
• “Anytime, Anywhere”: can be used where smoking is prohibited, like an office (or a classroom).
• Celebrities Lindsay Lohan, Paris Hilton have promoted Ariva for smoking cessation.
DISSOLVABLe
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April 2011
Electronic CigarettesWhat are electronic cigarettes?Metal device resembling a cigarette, but does not use tobacco. electricity vaporizes liquid nicotine solution, vapor is inhaled.
Health• Unknown, very limited testing. Contains propylene glycol, which is
untested for direct inhaling. FDA has found toxic diethylene glycol and carcinogenic nitrosamines in some samples.
• Liquid contains up to 18 mg of nicotine, enough to kill a young child if accidentally swallowed.
• Widespread use could send a social message that smoking is once again a norm. even though illegal for import, available online and at malls.
Common Brands and Varieties• gamucci, Smokingeverywhere.com, Jaunty and NJoy
• Different brands have different volumes of liquid
• Different nicotine strengths available
What’s the selling point?• Manufacturer claims does not cause cancer. Also claims no risk to
others from ‘second-hand vapor’. No research to prove either claim.
• No tar, carbon monoxide, or other effects of burning tobacco.
• Theoretically can be used in public places where smoking is banned.
eLeCTrONIC
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Tobacco in Disguise> lip balm or tobacco?
> pretty in pink?
> packaging makes tobacco seem fashionable or attractive.
> mints or tobacco?
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April 2011
Other Tobacco Product UsageCigarette smoking is declining among youth.
However, cigar smoking and smokeless tobacco use is on the rise.
Source: Youth Risk Behavior Survey 1993-2009
*Used one or more days during the past 30 days.
1999 2001 2003 2005 2007 2009
17.2%
15.1%
13.3%15.0%
16.8% 17.6%
16.0%
10%
20%
30%
40%
0%
Pe
rC
eN
T O
F S
TU
De
NT
S
OTHer TOBACCO PrODUCTS
CIgAreTTeS
OTHER TOBACCO PRODUCT USE* AMONG HIGH SCHOOL STUDENTS: | MA 1999 - 2009
