Friday, August 19, 2011

Colorado Board of Health - Dissolvable Tobacco Products Hearing

Public health supporters presented strong testimony against dissolvable tobacco products at Board of Health hearing (meeting audio and presentations)

It’s not every day we get to witness our public health servants and supporters take center stage. Most of the great work in public health happens behind the scenes.  The recent state Board of Health meeting provided the venue for public testimony on dissolvable tobacco products being test-marketed in Colorado.  Public health supporters outnumbered tobacco advocates and focused on the potential health risk to our kids.

From data-driven tobacco prevention experts, to a former smoker concerned about keeping his 11 grandchildren from using tobacco, the message was loud and clear – Dissolvables are not a safe alternative to cigarettes and Colorado is not the place to test-market these products.  

With the news media in the background and the room filled to capacity, the Colorado Department of Public Health and Environment’s  tobacco prevention experts set the stage for a line-up of compelling exchange. Stephanie Walton, a youth tobacco specialist, led the presentation with colleagues, Celeste Schoenthaler and Jason Vahling. Board of Health members listened intently and probed for more information as they scrutinized the R. J. Reynolds Camel Sticks, Strips, and Orbs samples and tested the tobacco company’s highly touted child resistant packaging. Board members agreed that the products resemble mints, breath strips and toothpick and could pose a potential health threat to kids.

As the testimonies unfolded, we heard questions about the accuracy of tobacco industry information and that tobacco is addictive and can cause disease and death. One testimony offered a “harm reduction” theory − arguing that dissolvables do less harm than smoking a cigarette.  A tobacco industry representative from R. J. Reynolds who testified remained adamant that the test-marketed products were directed to adults who smoke – not kids. When questioned about the tobacco company’s marketing in Colorado or tobacco retailer competition, he claimed repeatedly that he was a scientist and knew nothing about his company’s marketing tactics or about marketing.  

After the final testimony, Board of Health members deliberated and Dr. Chris Urbina, executive director and chief medical officer at the Colorado Department of Public Health and Environment, summed up his thoughts by saying, “The only kind of tobacco harm reduction is no tobacco use.” He emphasized that the state of Colorado has made significant progress in reducing youth smoking rates and the dissolvable products may impede that progress.  The Board of Health may adopt a health resolution addressing their concerns about the Camel dissolvables. Board members will review a drafted resolution at the September meeting.  

For meeting audio and for copies of presentations provided at the meeting

Selected Media Coverage:


  1. I have seen no evidence that the Ariva and Stonewall dissolvable tobacco products, on the market for 10 years, have turned any kids into smokers. If you have such evidence, present it.

    I challenge any "public health supporter" who believes that 100% of smokers are healthier without nicotine to experience what 2/3 of the smokers who try to quit go through. The experts would need to take a substance that causes cognitive impairment and increase the dosage until they feel groggy, confused, forgetful, inattentive, and sad. They would know they have the dosage high enough when they forget what they were doing a dozen times and day and begin making numerous mistakes, despite their best efforts to be vigilant.

    I would bet that none of these folks would make it past three days before they began to panic about making too many mistakes at work or having problems safely driving their car. I'm positive that none of them would last the six months that I waited for my cognitive impairments to magically cure themselves, before I relapsed to smoking. Researcher John Hughes pointed out that many youngsters took up smoking as a multi-purpose pharmacological coping mechanism for underlying problems with mood and cognition. When nicotine is discontinued the underlying pathology reemerges.

    I am now (finally!) smoke-free for 2 years, 5 months, and 1 day and still have the use of my cognitive abilities by having switched to smoke-free alternatives. Encouraging such switching could save the lives of 658,000 Colorado citizens.

  2. "The only kind of tobacco harm reduction is no tobacco use"

    This is a silly statement. It's observed reality that people smoke, and at least 70% want to quit. Either they can't, or they won't. That's the concept of harm reduction. Even doctors like Dr. Hurt from the Mayo clinic suggest using NRPs "AS LONG AS IT TAKES" which could be a lifetime. It's rather why the FDA is testing denicotinized cigarettes, to see their potential at promoting smoking cessation.

    "Public health supporters outnumbered tobacco advocates and focused on the potential health risk to our kids."

    Precedent has already been established on this front. NRPs are allowed on the market even though we know kids use them, kids abuse them (~30% never-smoker use - Austin Study), and kids can buy them (~80% Austin study), or get them though non-smoking organizations. Even with only a 7% cessation rate, or under 3% in 20 months, kid use is an acceptable risk, and in fairness there is no evidence a lozenge habit equates to a smoking habit.

    SNUS has been shown in studies to promote at least double the smoking cessation as NRPs. Whether orbs, strips, and sticks are equal to NRPs or SNUS remains to be seen, but all that needs to be shown is a cessation rate of at least 3% in adults for these products to be an acceptable risk.

    And to be fair, still 1 in 3 kids try smoking, 1 in 4 become habitual users, and 1 in 7 will continue smoking until they're dead. We need a plan B.

  3. Get rid of smoking at the four toxic air bars and restaurants at Denver's Airport before you bother with complaining about smoking substitutes!

  4. Don't start smoking. Simple.

  5. Elaine, you might want to check this out...if you haven't already. Congrats on your smoke-free living...but now maybe you should take the next step towards a healthier you!

  6. Piasecki, Fiore, and Baker studied the time course and severity of withdrawal symptoms in two clinical trials of the nicotine patch in 1998. At that time, everyone believed that withdrawal symptoms follow a pattern of steady decline in severity across time. But in both studies, the authors found two additional patterns.

    In the first study, Cluster II showed gradual improvement over the first three weeks, and then returned to the original quit-day level of severity. Cluster III showed little change during the first 3 weeks, a slight decrease in severity between weeks 3 and 6, and a return to the quit day level of severity during the final 2 weeks.

    Members of Clusters II and III had lower abstinence rates at both end of treatment and 6 months, and higher odds of relapsing when compared to Cluster I.

    In the second study, the authors found three similar patterns of withdrawal severity. Cluster membership was a significant
    predictor of relapse in both analyses.

    Bottom Line: Most people believe that cognitive and mood impairments triggered by nicotine absinence are temporary. But this study and others show that only about 1/3 of smokers experience an abatement of symptoms, while 2/3 continue to suffer indefinitely. This research is ignored because the tobacco control community wants to believe the fiction that nicotine abstinence is 100% healthier for 100% of the people.

    The growing movement to refuse employment to those who use nicotine (even if they do not smoke) will result in creating a group of citizens who are unemployable. If they don't stop using nicotine, they can't get hired (or will be fired). If they do stop using nicotine, they become too impaired to perform the duties adequately.

  7. What are dissolvable tobacco products? Seriously, I have never heard of them. Are they like e-cigarettes, which contain only nicotine, or do they also contain other dangerous substances associated with tobacco? As far as I know, nicotine, by itself, is no more harmful than caffeine. They both make you addicted and are a cardiac stimulant, but other than that... Still, I don't know anything about these dissolvable things. Who would even want to drink tobacco, anyway?