Spit: Tobacco

1
Spit Tobaccos Deadliest Little Secret

• Niki Sue Mueller
• Program Director
• Wyoming Through With Chew
• www.throughwithchew.com

2
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!

3
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 polonium210.
  (NCI-2003)

4
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)

5
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

6
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)

7
U.S. Smokeless Tobaccos Graduation Strategy

• UST document exhibited in the Marsee vs. UST
  lawsuit in 1986
• All roads lead to Copenhagen

8
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.
• 
  

9
Graduation PartyUST Sponsors College Parties
10
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 USTs marketing
  strategies by a former UST sales representative,
  Bob Deets

11
USTs Use Of Heroes To Promote ST
12
Promoting Use of ST On Airplanes
13
Rodeo and Football Were Used to Promote Spit
Tobacco in Advertising

• Walt Garrison was a pro football player in the
  early 70s
• Early association of alternative to smoking
  promotions

14
UST Capitalizing on Smoke Free Environments
15
ST Sent to Soldiers
16

• CHICAGO, October 16, 2006Rates of spit tobacco
  use by high school males are nothing to smile
  about, reports Oral Health Americas 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

17
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

18
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

19
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

20
CDC Guidelines

• Nine main guidelines
• Recommends states establish programs that are
  comprehensive, sustainable and accountable
• Evidence based
• www.cdc.gov

21
Wyoming Through With Chews Comprehensive Approach

• Building partnerships
• Promote cessation
• Media advocacy
• Counter advertising
• Prevent youth initiation
• Educate the public
• Policy change

22
Building Partnerships

• Health care providers
• State organizations
• Decision makers
• Employers/workplace
• Faith based Communities
• Native American populations

23
Promote Cessation

• Know your state protocol
• Use all possible
• opportunities to
• promote cessation

24
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

25
Counter Advertising
26
No Bull Poster
27
Save The Date!February 17-23, 2008
28
Policy Change Opportunities

• Brief intervention among health care providers
• Tobacco free workplaces
• Tobacco free schools
• Tobacco free community events
• Reducing tobacco advertising and sponsorship

29
Business Toolkit
30
Native American Populations

• Design materials so that they are culturally
  appropriate
• Work with Native American communities to
  determine their specific needs

31
In Summary

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

32
Contact Info

• Visit
• www.throughwithchew.com
• Contact
• nikisue_at_throughwithchew.com

33
National Spit Tobacco Summit

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