Types of Tobacco

    
There is no safe form of tobacco use.  All forms contain nicotine and can cause
addiction and health problems.

Bidis
Bidis (pronounced "bee-dees") are small, thin hand-rolled cigarettes
imported to the United States primarily from India and other
Southeast Asian countries. They consist of tobacco wrapped in a
tendu or temburni leaf (plants native to Asia), and may be secured
with a colorful string at one or both ends. Bidis can be flavored
(e.g., chocolate, cherry, mango) or unflavored. 
Bidi smoking is associated with an increased risk for oral, lung, stomach,

and esophageal
cancer and an increased risk for coronary heart disease and heart attacks, and risk for
chronic bronchitis.

Bidis are carcinogenic. There is no evidence to indicate that bidis are safer than
conventional cigarettes. They have higher concentrations of nicotine, tar, and carbon
monoxide than conventional cigarettes sold in the United States, so are even more addictive
than cigarettes.

Cigarettes
A cigarette is a combination of cured and finely cut tobacco,
reconstituted tobacco and other additives rolled or stuffed into a paper-
wrapped cylinder.  Many cigarettes have a filter on one end.
More than 4,000 different chemicals have been found in tobacco and
tobacco smoke. Among these are more than 60 chemicals that are
known to cause cancer.
Studies have proven that smoking cigarettes causes cancers of the bladder, oral cavity,
pharynx, larynx (voice box), esophagus, cervix, kidney, lung, pancreas, and stomach, and
causes acute myeloid leukemia.  It also causes heart disease and stroke.


Cigars, Cigarillos and Little Cigars
Most cigars are made up of a single type of air-cured or dried
tobacco. Cigar tobacco leaves are first aged for about a year and
then fermented in a multi-step process that can take from 3 to 5
months. Fermentation causes chemical and bacterial reactions that
change the tobacco. This is what gives cigars a different taste and
smell from cigarettes.
Regular cigars are larger than cigarettes and do not have a filter. 
Little cigars or cigarillos are very similar in size and shape of
cigarettes, have filters and are filled with pipe tobacco. Little cigars
are often flavored (e.g., chocolate, cherry, apple, mango). They are
sold in packs of 20 just like cigarettes or singly. 
Cigars contain higher level of nicotine than cigarettes. For those
cigar smokers who inhale, the nicotine is absorbed through the
lungs as quickly as it is with cigarettes. For those who do not inhale, the nicotine is
absorbed more slowly through the lining of the mouth.
Studies have shown that cigar smoking is linked to cancers of the mouth, lips, tongue,
throat, larynx, lung, pancreas and bladder cancer. Cigar smoking, like cigarette smoking, is
also linked to gum disease, where the gums shrink away from the teeth. It also raises your
risk that teeth will actually fall out.  
A study completed in 2000 found cigar smoking, like cigarette smoking, is linked to sexual
impotence in men (an inability to get an erection, known as erectile dysfunction).

Dissolvable Tobacco 
This type of tobacco is finely processed to dissolve on the tongue or in the
mouth. Varieties include strips, sticks,orbs and compressed tobacco
lozenges. They are smoke and spit free, are held together by food-grade
binders and look similar to a breath mint or candy. 
Since this product is very new to the market, research has not been
conducted on the health effects.  This product does contain nicotine.
Smokeless tobacco products are known to cause significant health
risks and are not a safe substitute for smoking tobacco.


Electronic cigarette or E- cigarette (nicotine delivery system)

The e-cigarette is a battery-powered device that contains a
cartridge filled with nicotine, flavor and other chemicals.  The e-
cigarrette is not a tobacco product but a nicotine delivery system.
The e-cigarette turns the nicotine and other chmicals into a vapor
that is then inhaled by the user.  The user will puff on it, similar to
a cigarette, and receive a vaporized solution of propylene
glycol/nicotine.  There is no tobacco or burning of tobacco involved and the e-cigarette
produces no smoke.  It does produce a fine, heated mist.
The e-cigarette often looks like a real cigarette and some have a glowing tip.  Other models
look similar to a ball point pen. Most electronic cigarettes are reusable.
Re-fillable and replaceable cartridges are available with different nicotine levels and flavors
such as menthol, cherry, chocolate, mint, and orange.  There are also cartridges available
that state they contain no nicotine, although the US Food and Drug Administration (FDA)
conducted studies showing that these cartridges do contain nicotine.
This product is often marketed as an alternative to smoking or an aid in quitting but the
World Health Organization claims there are no studies showing that the electronic cigarette
is a safe and effective nicotine replacement therapy and no scientific evidence to confirm
the product's safety. Recent studies by the FDA show that the e-cigarette contains known
carcinogens and toxic chemicals that are harmful to the user.


Hookah
Hookah is a pipe used to smoke Shisha, a combination of tobacco and fruit
or vegetable that is heated and the smoke is filtrated through water.  The
Hookah consists of a head, body water bowl and hose.  The tobacco or
Shisha is heated in the hookah usually using charcoal.
According to a World Health Organization advisory, a typical one-hour
session of hookah smoking exposes the user to 100 to 200 times the
volume of smoke inhaled from a single cigarette. Even after passing
through water, tobacco smoke still contains high levels of toxic compounds,
including carbon monoxide, heavy metals and cancer-causing chemicals (carcinogens).
Hookah smoking also delivers significant levels of nicotine — the addictive substance in
tobacco. 

Hookah smoking has been associated with lung, mouth and other cancers, heart disease
and respiratory infections.

The substances used to heat the tobacco also produce carbon monoxide, heavy metals and
cancer causing chemicals, creating it own health hazards. 

Sharing the mouthpiece of the Hookah has been associated with mouth and other infections
including herpes, tuberculosis and hepatitis.
 
Hookah smoking is no safer than other forms of tobacco use. 


Kreteks 
Kreteks (pronounced "cree-techs") are sometimes referred to as clove
cigarettes. Kreteks are imported from Indonesia, and typically contain a
mixture consisting of tobacco, cloves, and other additives. As with bidis,
standardized machine-smoking analyses indicate that kreteks deliver more
nicotine, carbon monoxide, and tar than conventional cigarettes.
Kretek smoking is associated with an increased risk for acute lung injury, especially among
susceptible individuals with asthma or respiratory infections. Research shows that regular
kretek smokers have 13−20 times the risk for abnormal lung function compared with
nonsmokers.

There is no evidence to indicate that kreteks are safe alternatives to conventional
cigarettes.


Pipe
Pipes are often reusable and consist of a chamber or bowl, stem and
mouthpiece.  Tobacco is placed into the bowl and lit. The smoke is
than drawn through the stem and mouthpiece and inhaled.
Pipe smoking has been shown to cause gum disease and tooth loss,
cancer of the mouth, lip, tongue, throat, larynx, lung, pancreas,
kidney, bladder, colon, and cervix as well as leukemia and
diseases such as chronic obstructive lung disease, stroke, and
coronary heart disease. Pipe smoking can also cause "hairy
tongue," furry-looking bumps on the tongue that can become stained by tobacco, making
the tongue look discolored or black.


Smokeless Tobacco 
The two main types of smokeless tobacco in the United States are
chewing tobacco and snuff.

  Chewing tobacco comes in the form of
loose leaf, plug, or twist.  Snuff is finely ground tobacco that can be
dry, moist, or in sachets (tea bag-like pouches). 
Although some forms of snuff can be used by sniffing or inhaling into
the nose, most smokeless tobacco users place the product in their
cheek or between their gum and cheek. Users then suck on the
tobacco and spit out the tobacco juices, which is why smokeless
tobacco is often referred to as spit or spitting tobacco. The nicotine in
this tobacco is absorbed primarily through the skin in the mouth.
Smokeless tobacco is a significant health risk and is not a safe substitute for smoking
cigarettes.

Smokeless tobacco contains 28 cancer-causing agents (carcinogens). It increases the risk of
developing cancer of the oral cavity, is strongly associated with leukoplakia (a lesion of the
soft tissue in the mouth that consists of a white patch or plaque that cannot be scraped off)
and recession of the gums.

Using smokeless tobacco can lead to nicotine addiction and dependence and is not a safe
alternative to smoking.