| The Tobacco Reference Guide |
| by David Moyer, MD. |
| Chapter 17 Smokeless Tobacco |
| tobacco reference guideg (artefact pour |
| Smokeless Tobacco: Low nicotine starter products and |
| "graduated nicotine delivery" |
| globalink (artefact pour saut de ligne) |
| "...manufacturers of moist snuff may have a strategy of marketing starter brands |
| (Skoal Bandits and Hawken) that establish the initial nicotine dependence of young |
| people. With time, the dependence increases and, eventually, the young snuff user |
| may switch to products with medium (Skoal, Fine Cut) and eventually high |
| (Copenhagen, Kodiak) nicotine delivery, becoming thereby strongly dependent on |
| nicotine." |
| Tobacco Control, Spring 1995, p. 62 |
| tobacco reference guideg (artefact pour saut |
| Tobacco companies control nicotine doses delivered in smokeless tobacco by |
| manipulation of pH. Free nicotine per gram ranges from a low of 0.53 for the "starter |
| product" Skoal Bandits Wintergreen to a high of 9.03 for Copenhagen Snuff. |
| Tobacco Control, Spring 1995, p. 59 |
| tobacco reference guideg (artefact pour saut |
| The FDA learned that manufacturers of smokeless tobacco adjust the pH of their |
| products to produce intentionally graduated nicotine deliveries. The industry's "starter" |
| products for new users have a low pH and consequently deliver a low lever of "free" |
| nicotine, limiting the absorption of the compound in the mouth. Smokeless-tobacco |
| products intended for users who have already acquired a tolerance to nicotine have a |
| high pH and consequently deliver a high level of free nicotine, increasing the amount |
| of nicotine available for absorption. Indeed, internal documents from the United States |
| Tobacco Company, the nation's largest smokeless tobacco manufacturer, refer to an |
| explicit "graduation process" designed to encourage users to progress from |
| low-nicotine brands to high-nicotine ones. |
| Quote from NEJM, September 26, 1996, p. 990 |
| tobacco reference guideg (artefact pour saut |
| Page 21 of 30 |
| globalink (artefact pour saut de ligne) |
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