Smokers: Step Away From the Fire With These Safer Cigarette Substitutes

Most cigarette smokers “say” they want to quit, but that is terribly misleading.  Most smokers answer yes to the quitting question because they know it’s the desired response.  In reality, the vast majority of smokers don’t quit in any given year.  All of them would welcome a healthier lifestyle, but they are unable or unwilling to abandon the immediate benefits of tobacco and nicotine, especially smoking.

If you smoke, here’s your guide to vastly safer substitutes that provide nicotine and tobacco satisfaction.

E-Cigarettes and Vape Products

The best harm reduction options for smokers unable or unwilling to give up nicotine and tobacco are e-cigarettes and vape products.  There are thousands of choices, reflecting the fact that they are the most popular – and most successful – quit-smoking aids. 

Vape Shops

Smokers can take the first step away from the fire by visiting local vape shops, which are often staffed by former smokers who are knowledgeable about your best options and dedicated to your success.  These shops sell popular products and also cater to vapers who want advanced hardware and special e-liquid flavors.  To locate nearby shops, check out Vaping 360’s online locator.  The Vapetrotter Directory is another valuable source.

For lots of factual information about e-cigarettes and vape products, visit the website operated by Consumer Advocates for Smoke Free Alternatives Association.  And for moral support, visit CASAA’s testimonials webpage containing thousands of success stories.

 

JUUL

JUUL has taken the vaping market by storm; it’s making cigarette manufacturers nervous, and for good reason.  JUUL pods contain a satisfying nicotine salt that won’t have you climbing the walls or kicking the dog because you don’t have the nicotine hit you need.  Additionally, the pods are inconspicuous, and easy to use and recharge. 

JUUL products are widely available, although the company is only selling tobacco and menthol flavors in convenience and other brick and mortar stores. Its popular flavors -- mango, cucumber, fruit, and crème – are available online.

Vuse

Vuse is another family of vaping products that are available in several hardware choices and a wide variety of flavors, including menthol, mint, mixed berry, melon, fruit-and-cream, chai, nectar, tropical fruit and classic tobacco. 

Vuse is available online and in stores nationwide.

Heat-Not-Burn Products

IQOS

The FDA recently approved the sale of IQOS heat-not-burn products in the U.S.  They are already available in over 30 other countries, and they have produced an unprecedented decline in cigarette consumption in Japan.  An FDA advisory committee in 2018 concluded that the products significantly reduce smokers’ exposure to toxic chemicals found in cigarette smoke.  I believe IQOS products have the potential to compete with vapor products, as they deliver the tobacco flavor and satisfaction many smokers find lacking in e-cigarettes. 

The first U.S. test market for IQOS will be Atlanta, where it will be available at a dedicated Lenox Square store. 

Nicotine Pouches

            ZYN

ZYN is a discrete new pouch product from Sweden that contains no tobacco, just nicotine and flavor – spearmint, wintergreen, cool mint, coffee, cinnamon or peppermint.  Also note that there are two strengths, ZYN 3 and ZYN 6 (milligrams). 

Originally launched in Western states, ZYN is now available nationwide anywhere cigarettes are sold.  It’s also available from Northerner.com. 

On!

On! is another nicotine pouch made in Sweden, available in mint, wintergreen, cinnamon, berry, citrus and coffee flavors and in three strengths, 2, 4 and 8 milligrams.

These pouches have been in limited distribution here in the U.S., and they are also available at Northerner.com.  However, Altria has just bought a large share of the company, so look for these pouches soon in your local convenience store.

Smokeless Tobacco

Camel Snus

Camel Snus packets come in several flavors: mint, frost (spearmint) and winterchill (wintergreen).  If you prefer more tobacco flavor, try Robust or Mellow.  There are also two sizes, a slim version containing 0.6 gram of tobacco, and a larger pouch with 1.0 gram.  I suggest that smokers start with the small size of their favorite flavor.

Camel snus is available nationwide anywhere cigarettes are sold, and online at Northerner.com. 

Skoal Snus

Skoal Snus packets come in mint and smooth mint. 

You can find them nationwide in the smokeless tobacco section of convenience stores, and they are available at Northerner.com.

Skoal Bandits

In 1995, when conducting the first-ever smoking cessation clinical trial using smokeless tobacco (abstract here), my research group recommended that smokers switch to Skoal Bandits, the only widely available pouched smokeless tobacco product at that time.  They are still available nationwide in wintergreen and mint flavors.

Oliver Twist

Oliver Twist is the planet’s most discrete smokeless tobacco product.  It consists of mini-rolls of tobacco (smaller than a pencil eraser), which are made in Denmark by rolling whole tobacco leaves into a rope, which is then cut into small pieces.  Flavors include original (tobacco), wintergreen, sunberry and tropical.

Oliver Twist can be difficult to find.  Look for stores that sell premium cigars and pipe tobacco, or order it at Northerner.com.      

Helpful Tips:

First and foremost, place smokeless products inside your UPPER LIP.  That is the key to minimize tobacco juice and the need to spit.  At first it might feel like a cannonball, but it won't be noticeable.

There are many options, so don’t be discouraged if one product doesn’t fit your lifestyle or taste.

Whatever product you use, get your nicotine buzz, but don’t overdo it. When you inhale cigarette smoke, you get an immediate nicotine kick, and during your smoking career you learned to optimize your buzz. The effect from e-cigarettes or smokeless tobacco may be different, but you’ll learn how to get a similar effect.

Stick to the switch. Although some smokers make the transition quickly, smoke-free tobacco products don’t automatically “cure” your desire for another cigarette. These products will make it easier to quit and they’ll make those cravings less intense, but they don’t entirely replace the smoking ritual. If you’ve smoked for years, breaking the habit can still be a challenge.

If your ultimate goal is complete nicotine and tobacco abstinence, stepping away from the fire is a critical first step.  Remember that it’s the smoke that kills, so becoming and staying smoke-free, not necessarily nicotine- or tobacco-free, is your first priority.  It’s the key to a longer and healthier life.

Vapers: Tell the FDA You’re Not Merely An Anecdote!

A year and a half ago, I blogged about government agencies ignoring federal survey data showing that 2.5 million former smokers were current vapers (here).  When FDA tobacco center director Mitch Zeller dismissed this evidence as mere “anecdotal reports,”  I argued that such data constitutes legitimate population-level evidence.

Aiming to build a fresh dataset on smokers’ success in using vapor as a quitting aid, the Vapor Technology Association (VTA) and Consumer Advocates for Smoke-Free Alternatives (CASAA) just launched a national campaign called “I Am Not An Anecdote” (here).

The groups are asking vapers to submit to the FDA detailed, sworn statements to “encourage Congress and federal regulators to reject any proposal that would ban OR limit flavored e-liquid products.” The groups note that “FDA Commissioner Scott Gottlieb has said that your ‘personal stories are important to me.’  But, he also refers to your stories of quitting cigarettes with vapor products as ‘anecdotes.’”

While individual cases are, in scientific terminology, anecdotal, their cumulative value is considerable.  Vapor is replacing combustion at dramatic rates worldwide.  My research team used 2013 FDA-funded survey data to produce a peer-reviewed report on U.S. e-cigarette use (here and here).  Our analysis showed that e-cigarettes are the most popular quit-smoking aid among American smokers and that they are the only aid more likely to make them former smokers (i.e., successful quitters) than are cold-turkey attempts (here).

FDA should give weight to published studies, even when they do not conform to visions of a tobacco-free society.  The agency should also recognize the scientific value of mass declarations of smoking cessation accomplished through vaping substitution.

A Call to Action

I am not inclined toward political action, but I am inspired by Clive Bates’s call to action against the European Union’s appalling new tobacco directive (here).  Americans should take action at home as well, in support of tobacco harm reduction and an open U.S. market for vastly safer smoke-free products.  I have long argued for this in my blog and at my Smokers Only website (here).

Bates describes the EU directive as doing “three main bad things,” which are analogous in the U.S. to local, state and federal tobacco-prohibition efforts.  The strategies are the same.  The EU directive, he writes:

1. Bans snus, the least hazardous form of tobacco known to mankind, whilst allowing cigarettes to be widely sold.  Snus (or oral tobacco) is much less dangerous than cigarettes, and widely used in Sweden, where it is the main reason why Sweden has much lower rates of cancer and other smoking-related disease than anywhere else in Europe.

Why ban these products when they have been so successful at reducing harm in Sweden?

2. Treats e-cigarettes as though they are medicines – effectively banning or marginalising them…

3. Prevents any claim that one tobacco product is less harmful than another. The truth is that smokeless tobacco products may be many times less harmful than cigarettes, perhaps 10-1000 times less harmful.  So what looks like an attempt to stop false or excessive claims, is actually going to do real harm:

It denies consumers the most relevant information about lower risk tobacco products – information they could use to reduce their own risk and protect their health. This is misleading by omitting the most important information.

Why should a manufacturer bother to make or market these products or invest in innovation if they can’t say the one (truthful) thing that makes them valuable as alternatives to cigarettes? All this does is reinforce the market for the most harmful tobacco products by shielding them from competition from less harmful forms.

This makes a law out of misleading consumers – who benefits from it?

Bates encourages tobacco users to write representatives in their home country and in the EU parliament.  American tobacco consumers who are fed up with unscientific and inappropriate U.S. laws and regulations should do the same with their elected officials and government institutions. 

In other words, tobacco users should engage in political and policy matters that threaten your rights.  You need to protest if your city or state attempts to impose TIP-TOE (Tacit Incremental Prohibition - Tobacco Elimination), which involves banning nearly risk-free smokeless tobacco and e-cigarettes and assuring the continued market dominance of killer cigarettes (here).

You should respond by writing your public officials – mayor, city council members, governor, state and federal legislators.  I have adapted Bates’s Euro-centric suggestions for Americans who wish to express their views.

1. Be decent.  Always be polite and dignified, don’t make accusations or question motives – most public officials want to do a good job.

2. Be engaging.  Assume the official is open-minded but might need some persuading.  Don’t dismiss other views; tackle them.

3. Be authentic.  Express your views in your own words; public officials want to hear genuine heartfelt views, not borrowed text.

4. Be natural.  Formal language and legal terms aren’t required; it’s their job to understand you, not your job to understand the technicalities of legislation.

5. Be concise.  Concentrate on the things that really matter to you and stay focused – if you are writing about e-cigarettes, don’t dilute your message with views on other issues.  Keep it short (max two pages or 800 words) and to the point.

6. Be personal.  E-mail each legislator individually.  You can use the same basic text with each, but the personal touch goes a long way.

7. Be relevant.  When writing to Congress, for example, only write to your own legislators.

Bates also offers some great content suggestions:

1.  Write about your own experience – e.g., have you tried to quit smoking?  What experience have you had with e-cigarettes or smokeless tobacco use?

2. Tell why you think the proposed action will hurt you personally.

3.  Suggest what the official ought to do.

4. Ask questions that require a response; ask for a reply or a meeting.

5.  Explain how the proposed action may limit smokers’ options to quit cigarettes by switching to products that are much less risky, resulting in more smoking-related death and disease.

6. Describe how the proposed action could tie e-cigarettes in regulatory red tape, effectively banning these products by the back door.  It makes no sense to ban safer products while leaving dangerous cigarettes on the market.

7. Explain why the proposed action will make smoke-free products less attractive, more expensive and less innovative – for example by banning flavors, making the packaging look like medicine, and limiting advertising and marketing.

8. Tell the official why it is wrong to pretend that all tobacco and nicotine products are the same – smokers should have accurate information about risks so they can make informed choices.

9.  Explain why all smokeless tobacco products are much safer than cigarettes and are viable substitutes for smoking.  Smokers should not be denied this option.

10.  Convince officals that e-cigarettes should be regulated for what they are – consumer products, placed on the market as alternatives to cigarettes. 

11.  Note that if e-cigarettes are removed from the market, vapers will return to smoking.

12. Tell officials that government should encourage smokers to switch to e-cigarettes or smokeless tobacco, not ban or marginalize these products through regulation.

I will add one more content tip that is especially relevant to Americans: Strongly object to tobacco prohibitionists’ baseless claim that adult access to safer tobacco products is a problem for children.  It isn’t a children’s issue.  FDA regulation will ensure that tobacco companies don’t advertise or sell tobacco to children.  There are 45 million smokers in the U.S., and the eight million who will die from smoking-related illnesses in the next 20 years are not children today; they are adults, 35 years and older.  Preventing youth access to tobacco is vitally important, but that effort should never be used as a smokescreen to condemn smoking parents and grandparents to premature death.

In the U.S., the Consumer Advocates for Smoke-Free Alternatives Association (here) is active on e-cigarette issues.  They post calls to action on their website, and members of CASAA’s board of directors, including Elaine Keller, Kristin Noll-Marsh, Gregory Conley and Carl V. Phillips, are credible, persuasive spokespersons on the full range of smoke-free tobacco issues.

Smokeless tobacco users and switchers should take CASAA’s approach.  This post gives you some basic tools.  Get involved!