Caution: Don't Assume 'Smokeless' Substitutes for Cigarettes Are Safe

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The ability to use tobacco in its most popular form—cigarettes—has been taking a hit in recent years, in great part because of a rising tide of smoking bans and per-pack tax hikes. But getting a nicotine fix isn't just about lighting up. The American Lung Association's new annual report, State of Tobacco Control, notes an expanding product line: new smokeless alternatives to cigarettes.

Snus, a small, teabag-like pouch with tobacco inside that is commonly used in Sweden and elsewhere, is now being marketed in the United States under the Camel and Marlboro brand names. And since last fall, dissolvable tobacco products by Camel—in the form of toothpick-like "sticks," tablet-shaped "orbs," and stamp-sized melting "strips"—have been test-marketed in Columbus, Ohio; Indianapolis, Ind.; and Portland, Ore. Unlike the familiar bump of loose tobacco jammed between lip and gum, the newer products are promoted as "spitless" options. "Adults can continue to enjoy tobacco pleasure in places where they can't smoke," says David Howard, spokesman for Reynolds American, Camel's parent company. "The products meet societal expectations."

But some experts warn of health concerns. Using snus is less risky than smoking a cigarette, but "it's like saying you can reduce your harm if you jump out of a fifth-story window instead of a 20th-story window," says Stanton Glantz, director of the Center for Tobacco Control Research and Education at the University of California-San Francisco. Research suggests that using snus raises the risk of pancreatic cancer, and it may also boost the likelihood of oral cancers and negatively affect the cardiovascular system, though the evidence is not as definitive.

Moreover, Dorothy Hatsukami, director of the Transdisciplinary Tobacco Use Research Center at the University of Minnesota, predicts that "snus is not going to be a complete substitute for cigarettes." Using smokeless tobacco to wean oneself off of cigarettes—an idea that has been floated by some—is unproven, especially in comparison to nicotine replacement therapy medicines, she points out. Indeed, consumers may become "dual users" who smoke when they can but tuck a snus packet into their lip when, say, on an airplane or at the office.