Unique Tobacco Products

Some tobacco products present special concerns for youth. Because they are sold in sweet flavors or pose as healthy or appealing alternatives to cigarettes, they are used primarily by younger smokers. Though these products often masquerade as safe, they aren’t – in fact, some are considered to be more harmful than cigarettes.

Kreteks and Bidis

Clove and other flavored cigarettes are used mostly by younger smokers. They are nearly ideal in design as a “trainer cigarette” and give youth another way to experiment with tobacco and get them addicted to nicotine. The false image of these products as clean, natural, and safer than conventional cigarettes attracts some young people who may otherwise not start smoking.

• Kreteks (Clove Cigarettes): Clove cigarettes, also called kreteks (“kree-teks”), are a tobacco product with the same health risks as cigarettes. They are imported mainly from Indonesia or other Southeast Asian countries. Kreteks contain 60 – 70% tobacco and 30 – 40% ground cloves, clove oil, and other additives. They deliver more nicotine, carbon monoxide, and tar than conventional cigarettes. Kretek smokers have higher risks of asthma and other lung diseases than nonsmokers. Regular kretek smokers have up to 20 times the risk for abnormal lung function compared with nonsmokers. Unfortunately, users often have the mistaken notion that smoking clove cigarettes is a safe alternative to smoking tobacco – this is not true.
• Bidis (Flavored Cigarettes): Flavored cigarettes, called “bidis” or “beedies,” are imported mainly from India or other Southeast Asian countries. Their popularity among young people in the United States has grown in recent years. This is in part because they are sold in a variety of candy-like flavors such as chocolate, cherry, strawberry, and orange. Some people think they are safer and more natural than regular cigarettes. They are also usually less expensive than regular cigarettes and they give the smoker an immediate buzz.
  Bidis are tobacco hand-rolled in a tendu or temburi leaf (plants native to Asia) and tied with colorful strings on the ends. Even though bidis contain less tobacco than regular cigarettes, they have higher levels of nicotine (the addictive chemical in tobacco) and other harmful substances such as tar and carbon monoxide. Because they are thinner than regular cigarettes, they require about 3 times as many puffs per cigarette. They are also unfiltered. Bidis appear to have all of the same health risks of regular cigarettes, if not more. Bidi smokers have much higher risks of heart attacks, chronic bronchitis, and some cancers than nonsmokers.

Hookahs (Water Pipes)

Hookah (narghile) smoking, which started in Asia and the Middle East, involves burning tobacco that has been mixed with flavors such as honey, molasses, or dried fruit in a water pipe and inhaling the flavored smoke through a long hose. Hookah smoking is usually a social event which allows conversation to take place among the smokers as they pass the pipe around. It has become popular in Western countries, especially among younger people in recent years.

Hookahs are marketed as being a safe alternative to cigarettes. This claim is false. The water does not filter out many of the toxins. In fact, hookah smoke has been shown to contain concentrations of toxins, such as carbon monoxide, nicotine, tar, and heavy metals, which are as high as or higher than that seen with cigarette smoke. Several types of cancer, including lung cancer, have been linked to hookah smoking. Hookah smoking is also linked to other unique risks not associated with cigarette smoking. For example, infectious diseases including tuberculosis (which can infect the lungs or other parts of the body), aspergillus (a fungus that can cause serious lung infections), and helicobacter (which can cause stomach ulcers) may be spread by pipe sharing or the uncontrolled, manual preparation of the tobacco used.

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