Orbs, Snus, Sticks and Strips: New Tobacco Products

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Orbs, Snus, Sticks and StripsNew Tobacco
Products

• Linda Hancock, FNP, PhD
• Virginia Commonwealth University
• quit_at_vcu.edu [phone]

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Consider getting your own clickers

• Fun
• Increase Active Learning
• BREAK the spiral of silence
• Instantaneous Data
• useful for
• Positive norms
• Policy attitudes
• Grant reports
• www.Turningtechnologies.com

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Video Clip Instructionsviscog video or go
totake the awareness test at YouTube

• This video is very short 30 seconds
• You will see a team of players
• One wearing white shirts one wearing black
  shirts
• Try to count the total number of times someone
  wearing a white shirt passes the ball.

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What you focus on expands!
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The tobacco epidemic, like the flu is always
mutating. -Jack Henningfield, PhD NIDA

• 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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As no-smoking laws sweep the nation and
cigarette sales continue to fall, Big Tobacco is
alarming the public health community by devising
other ways to try to make tobacco appealing.
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We need to work with, listen to and collaborate
with the YOUNG!Middle schoolHigh
SchoolCollegeYoung adults in the work
forceMilitaryAnd ESPECIALLY any who use tobacco

• Not only are they very bright creative
• They are the target market for new products!
• They see things we miss.

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Purpose of the viscog.com video Clip

• Perception is NOT reality
• We must be Humble
• We will both over-estimate things totally miss
  things
• Work in TEAMS Others, especially the young,
  will see things you do not.
• Use all 3 TYPES of TRUTH in your work
• Counting Truth (Quantitative)
• Listening Truth (Qualitative)
• Universal Truth - people want health to be
  addiction free

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BE EVER VIGILANT

• NEW PRODUCTS have the SAME OLD ADDICTIVE NICOTINE

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Monitoring the Future DataTrends in 30 day use
8th, 10th and 12th graders
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Brilliance in marketing
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But the health community is brilliant too!The
story of Flavored Cigarettes
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Do your research!Be organized!Be persistent!
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Virginia Slims introduces Purse Packs

• In October 2008 Phillip Morris introduced "Purse
  Packs" for select Virginia Slims brands 
• The Purse Pack is pink, sleek rectangular
  packaging with square ends. It holds 20 sticks
  that are smaller in diameter than a typical smoke.

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To look for MUTATIONS follow the

• 10 million less American smoke than did in 1983
• That translates into lost sales revenue in the
  U.S.

• However, the sales of moist snuff in the USA more
  than doubled in volume from 1986 to 2005
• 6.1 million Americans used moist snuff in 2006,
  up from 4.7 million in 2001. Most of the new
  users are smokers, some of whom still light up.

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Traditional Tobacco Product Categories

• SMOKE PRODUCING
• Cigarettes
• Cigars
• Blunts
• Bidis
• Kreteks (cloves)
• Pipes
• Hookah
• PREPS (potential reduced exposure products)
• E-Cigarettes E-cigars

• SMOKELESS
• Chewing tobacco
• Dry Snuff
• Moist Snuff
• Swedish Snus
• Spitless Snus
• Dissolvable Tobacco
• Hard snuff
• Lozenges - Ariva

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Whats in tobacco products?

• CAUTION
• No body really knows everything!
• (Example-- worms)
• Thousands of chemicals exist in organic matter.
• Flavorings and preservatives are added.
• Combustion/Vaporizing complicates things
• NEW chemicals are created when you light a
  product on fire.

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What is Snus?

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

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SnusA form of Swedish smokeless tobaccoUsually
placed in upper lip
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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. This has become a
  concern.
• New types of smokeless snus are introduced to
  North America (e.g., Camel Snus, Marlboro Snus).
• Some of these products are clearly aimed at youth
  (e.g., Marlboro packaging resembles a cell phone).

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Advertising tagline pleasure for wherever"
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(No Transcript)
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The Snus Guide to Bars
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Workplace Boredom Causes, Manifestations
Solutions Includes 8 Pranks to Play in the
Workplace
Currently 4 Camel Snus Guides
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www.whitelies.tv/ Indianapolis community
organizers
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An alternative when you cant smoke inside so
you dont quit smoking
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Nicogel
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New smokeless, dissolvable tobacco products from
R.J. Reynolds
Test marketing in Columbus, OH, Portland, OR, and
Indianapolis, IN starting in January 2009
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Camel Orbs

• Columbus, OH
• Portland, OR
• Indianapolis, IN
• Test Market Dates
• January 09- Now
• Sticks Next

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Best tobacco you never smoked Camel Orb Website
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Appealing and Potentially LETHAL for Children
and Adolescents
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Social Marketing? YouTube Videos

• I wonder how many it takes to overdose.
• All Im saying is that if youre going to have a
  nicotine habit, smokeless is better.
• You can keep them hidden and theyre great for
  school. Sometimes I need more than one for a
  buzz.

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e-cigarettes, e-cigars
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Njoy

• a rechargeable battery-powered microelectronic
  device that, when used in conjunction with
  replaceable cartridges, mimics the process of
  smoking.
• The cartridges are offered without (Zero) and
  with (Light, Medium and Full) nicotine
• Njoy is currently being market tested in select
  U.S. regions with plans to roll out nationally
  this fall through a fully-integrated and
  cross-platform marketing program.

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E-cigs or Electronic Cigarettes

• A battery operated Art Deco styled tube which
  contains a cartridge and rechargeable battery.
• Contains water, propylene glycol, nicotine, and a
  tobacco flavor.
• One Crown7 cartridge is the equivalent to about
  two packs of cigarettes

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Thoughts about products here and on the horizon
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PREPsPotential Reduced Exposure Products(snus,
dissolvables, e-cigs)

• "It's like setting up a methadone program next to
  a drug house, then keeping your fingers crossed
  and hoping it all works out."

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Whats this?
Not..
Hookah
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History of Hookahs

• 16th century
• Use declined, almost died out by 1980s
• 1990s Maassel came on the market
• Maassel is Arabic for honey
• Maassel is a moist tobacco fermented with
  molasses/honey and fruit
• Easier to use with more pleasant taste and aroma

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(No Transcript)
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Hookah Materials
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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Toxin Content of smoke(single hookah session
compared to a single cigarette)
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Does Hookah tobacco have tar?Yes, but nothing
has tar until you light it on fire.
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Lindas Clicker findings about hookah

• Straight A students who would NEVER smoke
  cigarettes do smoke hookah
• Some groups have a higher ever tried hookah
  than ever tried cigarettes.
• Up to 20-30 may have used in the past month.
• Daily hookah use rates of 3-4
• One group had 8 daily use
• Most recent study -10 own a hookah

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2005 study of HS students in Arizona
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Feel free to adapt this pdf for local
use quit_at_vcu.edu
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What will hookah use do to nicotine use and
tobacco addiction?No one yet knows the answer
to that question.
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2005 Study by Ward, et al

• Study of 268 water pipe users, sampling frame
  constructed, random sample
• 28.4 said they wanted to quit
• (Most reported health concerns as the reason for
  wanting to quit)
• 59.7 had made an unsuccessful attempt to quit in
  the past year.

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Tom Eissenberg, PhDVCU psychology professorand
internationally recognized hookah expert

• His thoughts on the relative risk of tobacco in
  cigarettes vs. hookah
• While we dont yet have the necessary data to
  make an empirically based statement, there is no
  reason a priori to expect that the risk of a
  hookah would be any less than cigarettes, and
  several reasons to think that it might be as high
  or higher than cigarettes.

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• To beat this epidemic,we must simultaneously
  address
• prevention,
• cessation
• policy!
• - Jack Henningfield

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The 3 Ds of tobacco prevention

• DEGLAMORIZE
• DELEGITIMIZE
• DENORMALIZE

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Toto, I dont think we are in Kansas anymore.
Social Norms Challenge
Perception versus Reality
Becoming a Scientist Seeker of the Truth
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Health MISPERCEPTIONSwww.socialnorms.org
Overestimate Unhealthy visible behaviors
-smokers, drunks, violence, goofing off,
credit card debt, etc. Underestimate
Healthy less visible behaviors
-non-smokers, moderate drinkers academic
seriousness, prayer
Perception REALITY
GAP
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EXAMPLE OF FRESHMEN SEMINARCan this class agree
to tell the TRUTH about the following 3 health
behaviors?-Past month cigarette smoking-Past
month alcohol use-Past year number of sex
partners

• If you dont feel comfortable
• telling the truth with these clickers
• just play Air-Clicker
• and dont press a button

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Clicker Data College freshmens perception n337
Fall 2009
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Clicker Data - VA College Freshmens behavior
n337 Fall 2009
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Most VCU students (7 of 10) didnt smoke at all
in the past month.Only about 8-12 smoke
daily.FREE Quit Kits at OHPsmoking cessation
pills Chantix
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We need to stop making healthy teens feel like
they are the minority!
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How Do Misperceptions Occur?

• OVER Estimations of Unhealthy Behavior
• We notice the difference not pattern.
• Out of the Ordinary gets the attention.
• Over-time, focusing on the unusual makes it
  appear the Norm.
• UNDER Estimations of Healthy Behavior
• When we focus too hard we miss things.
• Our brains fill-in the meaning we expect.
• Because of Media we expect the worst

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What Stands Out?
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Majority versusVisibility
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Conclusion

• We have come a long way!
• We deserve to celebrate, but
• WE CAN NEVER REST!
• Integration Framework for ALL addiction
• Session tomorrow on
• The greed and money are too powerful.
• Be Vigilant - Listen to young people.
• Please talk to and LISTEN to the young people at
  this conference tomorrow.
• Thanks for inviting me to Iowa Im proud of the
  great work you have done here.