Emerging and Alternative Products

​​Alternative Tobacco Products

Tobacco comes in many different forms. Learn the basics about alternative and emerging tobacco products on the market.

Because the tobacco industry is always coming up with new products, this page is a constant work in progress. To share or request additional resources, please email richmondcenter@aap.org.

  • Heated Tobacco Products: Heated tobacco products produce an aerosol containing nicotine, chemicals, additives, and flavorings by heating tobacco. The products include a disposable tobacco stick filled with compressed ground tobacco which is inserted into an electronic holder. Heated tobacco products contain approximately the same amount of nicotine as traditional cigarettes. 

    Heated tobacco products contain tobacco, along with many chemicals and components that have been designated as harmful by the FDA. Heated tobacco products are addictive and pose health risks to the user. There is no evidence to demonstrate that heated tobacco products are less harmful than traditional cigarettes. 

    In 2019, the FDA allowed heated tobacco products to be sold in the United States. 

    Factsheet: IQOS and other Heated Tobacco Products: What Pediatricians and Families Need to Know

  • Cigars: A cigar is a large, tightly rolled bundle of tobacco wrapped in leaf tobacco (or another substance containing tobacco) that is smoked. Cigars contain the same carcinogens as cigarettes, so that even if cigar smoke is not inhaled, cigar smokers are still at risk from the carcinogens in the smoke they produce. For information on FDA regulations related to cigars, visit this website.

  • Dissolvable tobacco: Tobacco that is meant to dissolve in the user's mouth is given the broad term 'dissolvable tobacco.' Types of dissolvable tobacco include orbs (which resemble tic tac candies), strips (resembling breath strips that you place on your tongue to freshen your breath), and sticks (resembling  toothpicks) that are currently in some markets around the U.S. These items resemble candy or mints, and are sold in packaging that is easy to mistake for candy, making it a danger to children. These dissolvable forms of tobacco typically dissolve in anywhere from three minutes (for a strip) to 30 minutes (for a stick), and the nicotine content in each differs- some contain more nicotine than a typical cigarette, some contain less.

  • E-Cigarettes: Please see our page dedicated to these products- Electronic Nicotine Delivery Systems

  • Hookah: Hookahs, or waterpipes, are largely a social use for tobacco. Groups of people sit around a hookah, and tobacco- usually flavored- is heated, filtered by water, and passed through a hose to a mouthpiece, where it is inhaled, then passed to the next person in the group. Hookah use carries the same health risks for tobacco use and SHS exposure, and additionally carries a risk of communicable disease (herpes, tuberculosis, etc.) through use of the shared mouthpiece, which may not be properly sterilized between uses. Hookah use is especially popular with younger populations, and hookah bars can often be found near college campuses.

  • CDC Hookah Fact Sheet

    Hookah poster (courtesy of South Florida Area Health Education Center [AHEC])

  • Menthol cigarettes: Menthol cigarettes provide a minty sensation that masks the harshness of smoking. Menthol's cooling, numbing properties may permit users to take larger puffs, inhale more deeply, or allow smoke to stay in the lungs for a longer period of time, and is used as a local anesthetic to relieve throat irritation. Menthol cigarette advertising has been heavily targeted to African American communities for decades; as a result, 88.5% of African American smokers use menthol cigarettes. The FDA's Tobacco Products Scientific Advisory Committee has concluded that removing menthol cigarettes from the market would improve the public health of the U.S., and the FDA is determining whether regulatory actions should be taken.

  • Smokeless tobacco

    • Chewing tobacco: Also referred to as spit or chew, chewing tobacco can come in loose-leaf strips of shredded tobacco leaves, or in the form of a plug, where the tobacco is pressed together, wrapped in a tobacco leaf, then twisted to resemble a rope. Chewing tobacco is placed between the gum and the cheek.

    • Snuff: Also known as pinch or dip, snuff is a loose, finely-ground form of tobacco that can be dry or moist, and can be placed between gum and cheek.

      CDC Smokeless tobacco fact sheet

  • Snus: A spitless tobacco contained in small, teabag-like pouches, snus is a type of moist snuff. Snus is designed so that there's no need to spit the juices out, as is the case with snuff, so it may be attractive to those who are in smoke-free settings.

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