Declaration selleck screening library of Interests None declared. Acknowledgments We would like to acknowledge the assistance provided by the ITC project data management core team in the preparation of the data used for this paper.
Camel Snus and Marlboro Snus��novel ��spitless�� smokeless tobacco products promoted as an alternative for smokers to use in situations where they cannot smoke��have been marketed in the United States since 2006 and 2007, respectively. Information on the actual use of these products is limited. Available research demonstrates that 10% of smokers try novel snus products, with the trial being more likely among smokers who are young, male, and have no immediate plans to quit smoking (Biener, McCausland, Curry, & Cullen, 2011). Thus, 29% of the smoking men aged 18�C24 years were reported to have tried snus over the past year.

It is unknown whether these products will persist in the U.S. market. However, the observed high interest in trying snus among certain population groups, along with the successful transition from test marketing to national marketing for both Camel Snus and Marlboro Snus, suggests that there is a reasonable chance for this type of products to continue and grow in popularity in the future. The public health impact of tobacco use is substantially influenced by the addictive and carcinogenic potential of the tobacco products. The addictive potential of tobacco is determined by the levels of its main known addictive constituent nicotine.

Moreover, the effect of nicotine content on a user is greatly affected by how much of the total nicotine content is present in unprotonated form, which is rapidly absorbed in the mouth and results in a relatively rapid increase in blood nicotine concentration. Salivary pH can also influence the amount of nicotine present in unprotonated form; however, the buffering capacity of smokeless tobacco is higher than the buffering capacity of saliva, and the pH of a smokeless tobacco product is a major determinant of the amount of unprotonated nicotine to which a user is exposed (Tomar & Henningfield, 1997). While no tobacco product can be classified as ��safe��, there exists a diverse spectrum of products that vary in their toxicity profiles, the content of the main Cilengitide known addictive tobacco constituent nicotine, mode of use, and associated health risks. For example, cigarette smoking delivers a mix of over 5,000 chemicals directly to the lung and is associated with the risk of developing a wide range of cancers, with lung cancer being the highest risk (International Agency for Research on Cancer, 2004).

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