Introducing oral tobacco for tobacco harm reduction: what are the main obstacles?

The multiple bottle effect is overridden in male and female rats by simultaneous presentation of two oral nicotine solutions

BACKGROUND

Studies on the oral route of nicotine administration in rodents make important contributions to our understanding of human nicotine use, and alternative approaches to smoking cessation. While environmental availability of oral nicotine contributes to voluntary intake and appears to drive consumption initially, solution concentration may exert more control over intake with continued exposure. Further, it is believed that female rodents consume more nicotine and show greater motivation to obtain it than males.

OBJECTIVES

The purpose of our study was to determine voluntary oral nicotine intake patterns following continuous exposure to relatively high concentrations in male and female rats, employing a multiple bottle approach, and to describe the relationship between oral nicotine consumption and sera cotinine.

METHODS

Using five bottles, adult Sprague-Dawley rats were given continuous access to water and 15 μg/ml nicotine solutions or water and 15 and 30 μg/ml nicotine solutions for 2 weeks; blood serum was analyzed for cotinine.

RESULTS

Rats consistently consumed oral nicotine and female rats ingested more nicotine than males, even at relatively high concentrations. Yet, when both concentrations were presented simultaneously, oral nicotine intake did not exceed that of water, thus overriding an environmental, or multiple-bottle, effect. Cotinine was systemically circulated following first-pass hepatic metabolism of nicotine at early, but not at later stages of nicotine exposure.

CONCLUSIONS

Our findings suggest rats will readily and voluntarily ingest considerably higher doses of nicotine than previously reported resulting in initial systemic cotinine, and trends toward sex differences are mitigated by solution concentration.

Are smokers receptive to using smokeless tobacco as a substitute?

OBJECTIVES

Few studies have addressed the feasibility of promoting smokeless tobacco as an alternative for smokers. This study was intended to assess the characteristics and degree to which smokers from California are receptive to using the substitute for harm reduction.

METHODS

Daily cigarette smokers (n=2995) were selected from the 2005 California Tobacco Survey. Using ordinal logistic regression, four sets of variables (demographics, tobacco use, motivations and intentions to quit smoking) were examined as predictors of the outcome, willingness to use a form of smokeless tobacco perceived to be less harmful than cigarettes.

RESULTS

A majority of smokers (75.6%) expressed no interest in the tobacco substitute. Contrary to expectation, few of the measures for demographics, tobacco use and motivations to quit smoking were significantly correlated with the outcome. Irrespective of prior use of nicotine replacement therapy, smokers were more receptive if they had previously attempted to quit, or were currently attempting to reduce their consumption of cigarettes.

CONCLUSIONS

Smokeless tobacco is an unacceptable alternative for most California smokers. But, the expected correlates, notably gender, accounted for minimal variability in SLT receptiveness, an observation that challenges concerns about the product's limited appeal to any one group.

Is low-nicotine Marlboro snus really snus?

Swedish snus is a medium/high nicotine delivery, low-nitrosamine moist smokeless tobacco product that has been estimated to be at least 90% less harmful than smoked tobacco. More men use snus than smoke cigarettes in Sweden, and a quarter of male former smokers quit by switching to snus. Leading multinational cigarette manufacturers have begun test-marketing snus-like products in the United States and other countries. The version of Philip Morris' Marlboro snus currently being marketed in the United States differs from Swedish snus in many ways; it has lower moisture content and pH, but most puzzling is its very low nicotine delivery. Philip Morris, the market-leader in United States cigarette sales, may have designed the product so that it does not satisfy nicotine cravings and fails to enable smokers to switch. In this paper we compare and contrast Swedish snus and Marlboro snus, and speculate as to why Philip Morris may have intentionally designed a product that delivers very low levels of nicotine. We recommend that Philip Morris cease using the term "snus" to refer to dry tobacco products with low nicotine delivery, so that the term be reserved for moist, low-toxin, medium/high nicotine delivery smokeless tobacco products that are qualitatively similar to the leading brands in Sweden.