CHAPTER

types of tobacco use Smoking tobacco

1 Tobacco smoking is the act of burning dried or cured leaves of the tobacco plant and inhaling the smoke.
Combustion releases biochemically active compounds in tobacco, such as nicotine and TSNA, and allows them to be absorbed through the lungs.

Smokeless tobacco
C
ROLL-YOUR-OWN MANUFACTURED CIGARETTES
igarettes account for the largest share of manufactured Smokeless tobacco is usually consumed orally or nasally, without burning or combustion. Manufactured cigarettes are
Roll-your-own
tobacco products in the world—96 percent of total There are two main types of smokeless tobacco: snuff and chewing tobacco. (RYO) cigarettes are the most commonly consumed
sales. Except for chewing tobacco in India and smoking cigarettes hand-filled tobacco products worldwide.
of kreteks in Indonesia, cigarettes are the most common method by the smoker from They consist of shredded or
of consuming tobacco throughout the world. fine-cut, loose tobacco reconstituted tobacco, processed
rolled in a cigarette with hundreds of chemicals and
The invention of the cigarette-rolling machine in 1881 rolled into a paper-wrapped
paper. RYO cigarette
accelerated the tobacco pandemic by mass-producing pocket- smokers are exposed cylinder. Usually tipped with a
DRY SNUFF
sized packets of cigarettes. Unlike tediously hand-rolled to high concentrations cellulose acetate filter, they
cigarettes and bulky water pipes, manufactured cigarettes offered Dry snuff is powdered tobacco of tobacco particulates, tar, nicotine, and tobacco-specific nitrosamines are lit at one end and inhaled
that is inhaled through the nose (TSNAs), and are at increased risk for developing cancers of the mouth, through the other.
a convenient and portable method to maintain addiction, even
and absorbed through the nasal pharynx, larynx, lung, and esophagus.
while driving a motor vehicle, working in a factory, or taking a mucosa or taken orally. Once Most Prevalent: Worldwide
MOIST SNUFF
stroll. widespread, particularly in Europe, Most Prevalent: Europe and New Zealand
In the current era of economic globalization, some forms of the use of dry snuff is in decline.
tobacco, historically localized to specific regions of the world
Most Prevalent: Europe
(such as the hookah and bidi), have spread to every continent. CIGARS
For instance, Indonesian kreteks—clove-flavored, loosely packed
Cigars are made of air-cured and fermented tobaccos with a tobacco-leaf wrapper. The long aging and
tobacco cigarettes—are currently being marketed to youth in fermentation process produces high concentrations of carcinogenic compounds that are released on
many industrialized countries. These regional forms of tobacco combustion. The concentrations of toxins and irritants in cigars are higher than in cigarettes. Cigars come
sometimes gain footholds in new countries based on their exotic Moist snuff is a small amount of ground
in many shapes and sizes, from cigarette-sized cigarillos to double coronas, cheroots, stumpen, chuttas,
cachet, but they rarely, if ever, displace manufactured cigarettes and dhumtis. In reverse chutta and dhumti smoking, the ignited end of the cigar is placed inside the mouth.
tobacco held in the mouth between
for a significant market share. Instead, they frequently serve as the cheek and gum. Manufacturers are
Most Prevalent: Worldwide
a gateway to addiction, luring youth and other fad smokers into increasingly prepackaging moist snuff
lifelong dependence on cigarettes. into small paper or cloth packets to make
the product more convenient. Other moist
snuff products are known as khaini, snus,
BIDIS KRETEKS
shammaah, nass, or naswa.
Bidis consist of a Kreteks are clove-flavored cigarettes widely
Most Prevalent: Worldwide small amount of smoked in Indonesia. They may contain a wide
sun-dried, flaked range of exotic flavorings and eugenol, which
tobacco hand- has an anesthetic effect, allowing for deeper and
wrapped in dried more harmful smoke inhalation.
temburni or
Chewing tobacco tendu leaf Most Prevalent: Indonesia

Oral smokeless tobacco products are placed in the mouth, cheek, or inner lip and (Diospyros sp.)
sucked (dipped) or chewed. Tobacco pastes or powders are similarly used, placed and tied with string.
on the gums or teeth. Sometimes referred to as “spit Despite their small size, WATER PIPES
tobacco” because users spit out the built-up tobacco bidis deliver more tar and
Water pipes, also known as shisha, hookah, narghile,
juices and saliva, this mode of tobacco consumption carbon monoxide than manufactured cigarettes
or hubble-bubble, operate by water filtration and
became associated with American baseball players because users are forced to puff harder to keep

! There is no safe way to indirect heat. Flavored tobacco is burned in a smoking

during the twentieth century. The tobacco industry bidis lit. Bidis are found throughout South Asia
use tobacco—whether bowl covered with foil and coal. The smoke is cooled
exploited these sports heroes to market their tobacco and are the most heavily consumed smoked
inhaled, sniffed, sucked, by filtration through a basin of water and consumed
products to youth. Smokeless tobacco causes cancer in tobacco products in India.
or chewed; whether through a hose and mouthpiece.
humans and leads to nicotine addiction similar to that
some of the harmful Most Prevalent: South Asia
produced by cigarette smoking. Most Prevalent: North Africa, the Mediterranean region,
ingredients are reduced;
and parts of Asia.
or whether it is mixed There are many varieties of smokeless tobacco, including
with other ingredients. plug, loose-leaf, chimo, toombak, gutkha, and twist.
Pan masala or betel quid consists of tobacco, areca
nuts (Areca catechu), slaked lime (calcium hydroxide),
sweeteners, and flavoring agents wrapped in a betel leaf
(Piper betel). There are endless varieties of pan masala, PIPES STICKS
including kaddipudi, hogesoppu, gundi, kadapam, zarda,
Pipes are made of briar, slate, clay, or other substances. Tobacco is Sticks are made from sun-cured
pattiwala, kiwam, and mishri.
placed in the bowl, and the smoke is inhaled through the stem. In tobacco and wrapped in cigarette
Southeast Asia, clay pipes known as sulpa, chillum, and hookli are paper—for example, hand-rolled
Most Prevalent: India
widely used. brus.

Most Prevalent: Worldwide Most Prevalent: Papua New Guinea

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