Smokeless / Oral Tobacco's Nicotine

Smokeless / Oral Tobacco's Nicotine

FreedomNicotine
Joined: 06 Dec 2008, 16:58

25 Jul 2009, 12:33 #1


Smokeless / Oral Tobacco's Nicotine

The below background from a 2009 paper by Wake Forest University Professor John Spanler and co-authors (source link: http://dx.doi.org/10.1080/10401330802573944) is a typical example of how oral or smokeless tobacco is described in research literature. This thread will be used to explore nicotine in oral tobacco. While doing so, the most critical lesson of all is identical to that shared with smokers, The Law of Addiction. For just one pinch, dip, wad or pouch and all your hard work gets flushed down the drain. There was always only one rule ... no nicotine today!



BACKGROUND Smokeless tobacco (ST) use is often overlooked in research on tobacco control and in medical student education.1

This highly addictive substance2,3 contains many known carcinogens.4,5 ST also generally contains a higher concentration of nicotine relative to cigarettes. The typical single dose of nicotine in snuff is almost twice that of cigarettes, whereas the single dose of nicotine in chewing tobacco can be more than 15 times greater.6 Because of these nicotine levels, the addictive potential for ST use is likely greater than for cigarette smoking.6

The two most common forms of smokeless tobacco are chewing tobacco (plug or loose-leaf) and snuff (dry or moist powder and powder in small teabag-like sachets). Although most tobaccorelated cancer studies have focused on cigarette smoking, ST use also has carcinogenic potential, particularly for oral cancer and a number of other cancers as well (see Table 1).7-9

A number of studies10-16 indicate that ST has a unique epidemiology, different in many respects than cigarette smoking. For example, in 2005, approximately 21% of U.S. adults were current smokers; men (24%) and American Indian and Alaskan Natives (32%) had the highest prevalence of use. By contrast, the prevalence of current smokeless tobacco use was 2.3%.15 Smokeless tobacco use in the United States is higher among young White males (6%) and American Indians/Alaska Natives (9%). Rates are also above the national average for people living in southern and north central states and for people who are employed in blue-collar occupations or service/laborer jobs or who are unemployed.16 ST users tend to be older than cigarette smokers and tend to live in rural areas. A higher percentage of ST users are women compared to cigarette smokers, particularly older, minority women.10-16 ST use is associated with oral lesions, such as leukoplakia, gum recession, periodontal disease, and tooth abrasion.5 There is strong evidence in the literature for other health effects associated with ST use including cardiovascular disease.9 Combined with its unique epidemiology, nicotine pharmacology, and carcinogenic and health effects, specific training by clinicians in both ST cessation and smoking cessation is extremely important.

In 2002, we reported on the dearth of studies that have evaluated smokeless tobacco cessation educational efforts in U.S. medical schools.1 Since that report, no additional studies on this topic have emerged. Indeed, in 2005, the tobacco control competencies promulgated by the Prevention and Cessation Education Consortium-a group of 12 U.S. medical schools-did not list training in basic and clinical sciences of ST control.17
REFERENCES

1. Spangler JG, George G, Foley KL, Crandall SJ. Tobacco intervention training: Current efforts and gaps inUSmedical schools. Journal of theAmerican Medical Association 2002;288:1102-9.
2. Glover ED, Schroeder KL, Henningfield JE, Severson HH, Christen AG. An interpretive review of smokeless tobacco research in the United States: Part I. Journal of Drug Education 1988;18:285-310.
3. Glover ED, Glover PN. Smokeless tobacco cessation and nicotine reduction therapy. In: Smokeless tobacco or health: An international perspective (NIH Publication No. 93-3461, pp. 291-296). Bethesda, MD: U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, September 1992.
4. Hoffman D, Adams JD, Lisk D, et al. Toxic and carcinogenic agents in dry and moist snuff. Journal of the National Cancer Institute 1987;79:1281-6.
5. NIH Consensus Development Panel. National Institutes of Health consensus statement: Health implications of smokeless tobacco use. Biomedical Pharmacotherapy 1988;42:93-8.
6. Benowitz NL. Pharmacology of smokeless tobacco use: Nicotine addiction and nicotine-related health consequences. In: Smokeless tobacco or health: An international perspective (NIH Publication No. 93-3461, pp.
219-228). Bethesda, MD: U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, September 1992.
7. Winn DM, Blot WJ, Shy CM, et al. Snuff dipping and oral cancer among women in the southern U.S. New England Journal of Medicine 1981;304:745.
8. Winn DM. Epidemiology of cancer and other systemic effects associated with the use of smokeless tobacco. Advances in Dental Research 1997;11:313-21.
9. Critchley JA, Unal B. Health effects associated with smokeless tobacco: A systematic review. Thorax 2003;58:435-43.
10. Spangler JG, Dignan MD, Michielutte R. Tobacco use among Native American women in western North Carolina: Demographic, social support, health behavioral and cultural correlates. American Journal of Public
Health 1997;87:108-11.
11. Spangler JG, Bell RA, Dignan MB, Michielutte R. Prevalence and predictors of tobacco use among Lumbee Indian women, Robeson County, North Carolina. Journal of Community Health 1997;22:115-25.
12. Spangler JG, Bell RA, Knick S, Michielutte R, Dignan MB. Epidemiology of tobacco use among Lumbee Indians. Journal of Cancer Education 1999; 14:34-40.
13. Spangler JG, Bell RA, Knick S, Michielutte R, Dignan MB, Summerson JH. Church related correlates of tobacco use among Lumbee Indians in North Carolina. Ethnicity and Disease 1998;8:73-80.
14. Spangler JG, Michielutte R, Bell RA, Knick S, Dignan MB, Summerson JH. Dual tobacco use among Native American adults in southeastern North Carolina. Preventive Medicine 2001;32:521-8.
15. Centers for Disease Control and Prevention. Tobacco use among adults- United States. Morbidity and Mortality Weekly Report 2005;55:1145-8.
16. U.S. Department of Health and Human Services. Reducing the health consequences of smoking-25 years of progress: A report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services,
Public Health Service, Centers for Disease Control and Prevention. http://profiles.nlm.nih.gov/NN/B/B/X/S/ Accessed October 26, 2007.
17. Geller AC, Sapka J, Brooks KR, et al. Tobacco control competencies for US medical students. American Journal of Public Health 2005;95:950-5.
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JohnPolito
Joined: 11 Nov 2008, 19:22

21 Jan 2010, 17:53 #2

Nicotine and water levels in 25 commercial sub-brands of smokeless tobacco (SLT) products, and two types of standard reference SLT. All values are given ±1 standard deviation (sd) for three replicates.
Nicotine (mg/g) followed by Water (%)
Unflavored
Copenhagen Long Cut 11.24 ± 0.38 54.03 ± 0.26
Husky Long Cut Natural 11.53 ± 0.38 49.01 ± 0.22
Longhorn Long Cut Natural 13.30 ± 0.38 45.68 ± 0.60
Redman Fine Cut Natural 13.16 ± 0.49 46.59 ± 0.22
Skoal Long Cut Classic 12.28 ± 0.20 51.48 ± 0.43
Average: Nicotine = 12.30mg/g Water = 49.36%
Flavored
Camel Snus Frost 10.54 ± 0.29 28.09 ± 0.22
Grizzly Long Cut Mint 12.04 ± 0.20 52.29 ± 0.33
Grizzly Long Cut Straight 11.58 ± 0.33 52.07 ± 0.45
Grizzly Long Cut Wintergreen 9.63 ± 0.08 48.47 ± 0.53
Hawken WinterGreen 1.55 ± 0.13 22.56 ± 0.15
Husky Long Cut Wintergreen 9.63 ± 0.28 53.81 ± 0.45
Husky Long Cut Mint 9.84 ± 0.46 54.25 ± 0.13
Longhorn Long Cut Wintergreen 11.58 ± 0.27 52.26 ± 0.62
Longhorn Long Cut Mint 13.11 ± 0.66 50.17 ± 0.25
Kodiak Long Cut Ice 7.24 ± 0.27 51.72 ± 0.50
Kodiak Premium Mint 8.56 ± 0.18 51.00 ± 0.19
Kodiak Premium Straight 8.74 ± 0.55 50.59 ± 0.25
Kodiak Premium Wintergreen 8.42 ± 0.25 50.49 ± 0.30
Redman Long Cut Wintergreen 12.48 ± 0.43 51.98 ± 0.28
Rooster Bold Wintergreen 9.76 ± 0.22 52.62 ± 0.27
Skoal Pouches Mint 9.73 ± 0.05 51.35 ± 1.21
Skoal Bandit Pouches Mint 10.89 ± 0.66 50.72 ± 0.56
Skoal Long Cut Spearmint 12.16 ± 0.79 50.62 ± 0.30
Skoal Pouches Wintergreen 9.39 ± 0.19 52.64 ± 0.19
Timberwolf Packs Mint Pouches 11.75 ± 0.40 46.68 ± 0.53
Average: 9.93 48.72
Standard reference SLT
Standard Reference 1S3 7.05 ± 0.81 47.64 ± 0.20
Standard Reference 2S3 14.39 ± 0.42 51.44 ± 0.10
Average: Nicotine = 10.72mg/g and Water = 49.54%
All values calculated per grams of wet weight of smokeless tobacco.

Data Source:

Levels of mint and wintergreen flavorants: smokeless tobacco products vs. confectionery products


Food Chem Toxicol. 2009 Dec 21. [Epub ahead of print]

Chen C, Isabelle LM, Pickworth WB, Pankow JF.

Abstract

Nicotine and flavorant compound levels were measured in 10 "mint"-related sub-brands and 8 "wintergreen" sub-brands of smokeless tobacco (SLT). Also analyzed were "mint"-related and "wintergreen" confectionery products. Of the "mint" SLT, "Timberwolf Packs Mint Pouches" contained the highest menthol level (5.3 mg/g); the average for the five most-highly mentholated SLT products was 4.3 mg/g. The average for the most five most-highly mentholated confectionery products was 3.5 mg/g. For hard candy, a reported average of maximum use levels is 2.1 mg/g (Burdock, 2010). Of the "wintergreen" SLT, "Hawken Wintergreen" was found to contain the highest methyl salicylate (MS) level (29.7 mg/g). The average of the five highest SLT MS levels was 23.8 mg/g, i.e., 5x higher than the level found in the confectionery product with the highest MS level (LifeSavers Wint O Green Sugar Free, 4.6 mg/g). For hard candy, a reported average of maximum use levels is 2.0 mg/g (Burdock, 2010). Assuming 23.8 mg/g MS in SLT, SLT use at 15 g/day, 100% bodily absorption of the MS, and 60 kg body weight, the average daily intake would be 6.0 mg/kg-day, i.e., 12x the acceptable daily intake (ADI) of 0.5 mg/kg-day established for this compound by a joint FAO/WHO committee.

Journal Link: http://www.sciencedirect.com/science/journal/02786915
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JohnPolito
Joined: 11 Nov 2008, 19:22

21 Jan 2010, 18:28 #3

The above study evidences that menthol and wintergreen flavored smokeless tobacco contains less nicotine than non-flavored brands. Why? The below two charts teach us that the amount of menthol and methyl salicylate in oral tobacco products is vastly greater gram for gram than found in wintergreen flavored chewing gum or mint candy. Again, why? Frankly, there's lots of speculation but little hard research. The following are direct quotes from the full-text of the above new study. Note tht SLT is the study's abbreviation for smokeless tobacco:
An example of a potentially important effect due to flavorant compounds in SLT would be enhanced permeation of nicotine and toxicants into oral tissue. Indeed, permeation enhancement by menthol and other organic compounds has been investigated as a means to accelerate transdermal delivery of drugs (
Aungst and Rogers, 1988; Rachakonda et al., 2008; Shojaei, 1998; Shojaei et al., 1999, 2001; Williams and Barry, 2004). For example, Shojaei et al. (1999) reported that menthol increases the absorption of dideoxycytidine, and Aungst and Rogers (1988) studied the effects of sodium salicylate on absorption of insulin by rat buccal tissue.

Two mechanisms by which one chemical can enhance the transport
of another into and through tissue are: (1) increased local blood flow (Ryatt et al., 1986); and (2) increased permeability of biological membranes (Nicolazzo et al., 2005). [Skin and buccal tissue may be affected differently (Nicolazzo et al., 2005) by a given permeation enhancing chemical.] A clinical study by Hong and Shellock (1991) found increased blood flow following topical applications of the menthol-containing ointment Eucalyptamint which is marketed for its pain masking (i.e., ''counterirritant") effects. Cremes that contain both methyl salicylate and menthol are Ben Gay, Icy Hot, and Arthritis Hot.

Despite the extensive use of flavorant compounds in SLT products,
little is known about either their levels in contemporary products or their effects on the user. Menthol in cigarettes has, in contrast, received considerable study (e.g.,
B&W, 1986; Celebucki et al., 2005). Here we report on the levels of major flavorant compounds, nicotine, and water in selected SLT products. For comparison, the levels of the major flavorant compounds in selected confectionary products are also discussed.
Source: Chen C, et al, Levels of mint and wintergreen flavorants: smokeless tobacco products vs. confectionery products, Food and Chemical Toxicology, December 21, 2009, Page 2 of 9 - http://www.sciencedirect.com/science/journal/02786915

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Last edited by JohnPolito on 22 Jan 2010, 01:54, edited 2 times in total.
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JohnPolito
Joined: 11 Nov 2008, 19:22

21 Jan 2010, 18:30 #4

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Joel Spitzer
Joined: 13 Nov 2008, 14:04

19 Jun 2013, 19:45 #5

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