TABLE 2

Tobacco Products Currently Available in the United States

ProductDescriptionComments
CigarettesA small roll of paper that is filled with cut tobacco and smokedCigarettes are still the most common form of tobacco used by youth
Cigars and little cigarsA tightly-rolled bundle of dried and fermented tobacco, wrapped in a tobacco leaf. Cigars come in a variety of flavors, including “cherry,” “peach,” and “grape”In the United States, cigars are exempt from many of the marketing regulations that govern cigarettes, and cigars are taxed at a far lower rate than cigarettes. Flavors and lower cost appeal to children. Little cigars are similar to regular cigarettes, except wrapping is tobacco leaf rather than paper
PipesA tube with a small bowl at one end; used for smoking tobaccoPipes use black (air-cured) tobacco, which carries a higher risk of esophageal cancer
Hookahs or narghileA single or multi-stemmed instrument for smoking in which the smoke is cooled by passing through waterLonger duration of a smoking session and deeper inhalation leads to much higher smoke intake than cigarette smoking
Bidis (or beedis)A thin, South Asian cigarette filled with tobacco flake and wrapped in a tendu leaf tied with a string at 1 endBidis must be puffed more rapidly than regular cigarettes to remain lit. Bidis contain more tar, nicotine, and carbon monoxide than the typical cigarette
KreteksCigarettes made with a blend of tobacco, cloves, and other flavors. The word “kretek” is an onomatopoetic term for the crackling sound of burning clovesCloves contain eugenol, whose local anesthetic effect allows deeper inhalation
Chewing tobaccoLoose leaves, plugs, or twists of tobacco that are placed between the cheek and gum
SnuffFinely ground tobacco packaged in cans or pouches, which can be sold dry (powdered form that is sniffed) or moist (placed between the lower lip or cheek and gum)
SnusA moist powder tobacco product originating from a variant of dry snuff. It is usually not fermented
Dissolvable tobaccoUnlike ordinary chewing tobacco, it dissolves in the mouth. Orbs or pellets look similar to small breath mints. Sticks similar to toothpicks are for insertion between the upper lip and gum. Strips administer nicotine by using thin-film drug delivery technology and look similar to breath-freshening stripsDiscreet form, candy-like appearance, and added flavorings make them attractive to young children
Electronic nicotine delivery systems, electronic cigarettes, e-cigarettes, e-cigs, hookah sticks, e-hookahs, e-cigars, e-pipes, mechanical mods, vape pens, othersBattery-powered devices heat a solution to create an aerosol. Devices usually contain nicotine, propylene glycol, and flavoring agents. There is no regulation on contents or manufacturing standards. Heating the mixture creates other toxins.Flavors and promotion increase appeal to youth