Keywords :
Alternative forms of tobacco, Electronic nicotine delivery systems, Heated tobacco products, Herbal cigarettes, Oral nicotine products
Citation Information :
Nagaraja R, Ather I, Teles M, Sumit K. A Perspective on Alternative Forms of Tobacco. Indian J Chest Dis Allied Sci 2024; 66 (4):132-136.
Tobacco use is a global epidemic. Smoking claims more than 8 million lives annually across the globe. Further, it even poses a threat to nonsmokers who are exposed to cigarette smoke. Tobacco is most commonly used in the form of cigarette smoking across the world. The COVID-19 pandemic has impacted smoking habits, leading to visible differences in smoking rates. The current paper highlights and discusses alternative forms of smoking. Undoubtedly in the recent years, there is an advent of forms of alternative smoking, and a variety of tobacco products have been gaining popularity beyond traditional cigarettes. These products are preferred widely by the youth. Noteworthy to mention, these alternatives raise concerns about potential health risks and addiction. There is a paucity of research on the impact of alternative form tobacco usage on human health. The paper will provide an impetus for the researchers to explore further on the perspective of alternative forms of tobacco. It will also provide some essential leads to implement measures to mitigate the impact of alternative forms of tobacco usage on human health.
Institute of Health Metrics. Global burden of disease [Internet]. Washington, DC: Institute of Health Metrics; 2019. Available from: https://www.healthdata.org/research-analysis/gbd. Accessed on December 17, 2023.
WHO. WHO global report on trends in prevalence of tobacco use 2000−2025. 4th ed. Geneva: WHO; 2021.
Sharma AD, Raghavan R, Garg S, et al. Challenges of secondhand smoke: Are we asking the right questions? Indian J Commun Health 2023;35(1):4−8. DOI: 10.47203/IJCH.2023.v35i01.002.
Mishra GA, Pimple SA, Shastri SS. An overview of the tobacco problem in India. Indian J Med Paediatr Oncol 2012;33(03):139–145. DOI: 10.4103/0971-5851.103139.
Campaign for tobacco-free kids. The toll of tobacco in India [Internet]. 2017. Available from: https://www.tobaccofreekids.org/problem/toll-global/asia/india.
Martins-Green M, Adhami N, Frankos M, et al. Cigarette smoke toxins deposited on surfaces: Implications for human health. PLoS One 2014;9(1):e86391. DOI: 10.1371/journal.pone.0086391.
John RM, Sinha P, Munish VG, et al. Economic costs of diseases and deaths attributable to tobacco use in India, 2017−2018. Nicotine Tob Res 2021;23(2):294–301. DOI: 10.1093/ntr/ntaa154.
Andersen AJ, Hecker I, Wallez S, et al. Are we equally at risk of changing smoking behavior during a public health crisis? Impact of educational level on smoking from the TEMPO cohort. BMC Public Health 2023;23(1):1016. DOI: 10.1186/s12889-023-15799-1.
Heydari G, Masjedi M, Ahmady AE, et al. A comparative study on tobacco cessation methods: A quantitative systematic review. Int J Prev Med 2014;5(6):673–678. PMID: 25013685.
Popova L, Ling PM. Alternative tobacco product use and smoking cessation: A national study. Am J Public Health 2013;103(5):923–930. DOI: 10.2105/AJPH.2012.301070.
WHO. WHO framework convention on tobacco control [Internet]. Available from: https://www.who.int/tobacco/framework/WHO_FCTC_english.pdf.
Legislation by country/jurisdiction India [Internet]. Available from: https://www.tobaccocontrollaws.org/files/live/India/India%20.%20COTPA%20.%20national.pdf.
Smoking alternatives [Internet]. Mouthhealthy.org. [cited 2024 Mar 17]. Available from: https://www.mouthhealthy.org/all-topics-a-z/smoking-alternatives.
Tobacco and nicotine products: Old, new & dangerous for kids [Internet]. Healthychildren.org [cited 2024 Mar 17]. Available from: https://www.healthychildren.org/English/health-issues/conditions/tobacco/Pages/Alternative-Forms-of-Tobacco.aspx.
Gravely S, Yong H-H, Reid JL, et al. An examination of quitting smoking as a reason for vaping by the type of nicotine vaping device used most often among adults who smoke and vape: Findings from the Canada, England and the United States 2020 ITC Smoking and Vaping Survey. Prev Med Rep 2023;33:102201. DOI: 10.1016/j.pmedr.2023.102201.
American Lung Association. What's in an E-cigarette? [Internet]. Lung.org [cited 2024 Mar 17]. Available from: https://www.lung.org/quit-smoking/e-cigarettes-vaping/whats-in-an-e-cigarette.
Jaswal N, Bhatt G, Goel S. Awareness of electronic cigarettes in India: Findings from the 2016−2017 Global Adult Tobacco Survey (GATS). Tob Prev Cessat 2023;9:03. DOI: 10.18332/tpc/156446.
India: E-cigarette and vaping sales volume [Internet]. Statista [cited 2024 Mar 17]. Available from: https://www.statista.com/statistics/1189383/india-electronic-cigarette-and-vaping-sales-volume/.
Psmarketresearch.com [Internet]. 2024. Available from: https://www.psmarketresearch.com/market-analysis/india-e-cigarette-market.
Sharan RN, Chanu TM, Chakrabarty TK, et al. Patterns of tobacco and e-cigarette use status in India: A cross-sectional survey of 3000 vapers in eight Indian cities. Harm Reduct J 2020;17(1):21. DOI: 10.1186/s12954-020-00362-7.
Mohanty VR, Chahar P, Balappanavar AY, et al. Electronic nicotine delivery systems (ENDS): Mapping the Indian online retail market. Nicotine Tob Res 2017;19(11):1386–1389. DOI: 10.1093/ntr/ntx044.
6Wresearch. India E-cigarette market [Internet]. 6wresearch.com [cited 2024 Mar 17]. Available from: https://www.6wresearch.com/industry-report/india-e-cigarette-market-2019-2025-e-cig-forecast-by-device-type-demography-distribution.
Znyk M, Jurewicz J, Kaleta D. Exposure to heated tobacco products and adverse health effects, a systematic review. Int J Environ Res Public Health 2021;18(12):6651. DOI: 10.3390/ijerph18126651.
Upadhyay S, Rahman M, Johanson G, et al. Heated tobacco products: Insights into composition and toxicity. Toxics 2023;11:667. DOI: 10.3390/toxics11080667.
Glasser AM, Collins L, Pearson JL, et al. Overview of electronic nicotine delivery systems: A systematic review. Am J Prev Med 2017;52(2):e33–e66. DOI: 10.1016/j.amepre.2016.10.036.
Royal Swag ayurvedic & herbal cigarette Frutta nicotine free & tobacco free cigarettes [Internet]. Accessed on 2020 Jun 02. Available from: https://www.amazon.in/dp/B07J5KY683/ref=sspa_dk_detail_3?psc=1&pd_rd_i=B07J5KY683&pd_rd_w=iIgqB&pf_.
Bak JH, Lee SM, Lim HB. Safety assessment of mainstream smoke of herbal cigarette. Toxicol Res 2015;31(1):41–48. DOI: 10.5487/TR.2015.31.1.041.
Rahman RTA, Kamal N, Mediani A, et al. How do herbal cigarettes compare to tobacco? A comprehensive review of their sensory characters, phytochemicals, and functional properties. ACS Omega 2022;7(50):45797–45809. DOI: 10.1021/acsomega.2c04708.
Marques P, Piqueras L, Sanz M-J. An updated overview of e-cigarette impact on human health. Respir Res 2021;22(1):151. DOI: 10.1186/s12931-021-01737-5.
Glantz SA, Bareham DW. E-cigarettes: Use, effects on smoking, risks, and policy implications. Annu Rev Public Health 2018;39:215–235. DOI: 10.1146/annurev-publhealth-040617-013757.
Farsalinos K. Electronic cigarettes: An aid in smoking cessation, or a new health hazard? Ther Adv Respir Dis 2018;12:1753465817744960. DOI: 10.1177/1753465817744960.
Dai H, Leventhal AM. Prevalence of e-cigarette use among adults in the United States, 2014−2018. JAMA 2019;322(18):1824–1827. DOI: 10.1001/jama.2019.15331.
Ruszkiewicz JA, Zhang Z, Gonçalves FM, et al. Neurotoxicity of e-cigarettes. Food Chem Toxicol 2020;138:111245. DOI: 10.1016/j.fct.2020.111245.
Irusa KF, Vence B, Donovan T. Potential oral health effects of e-cigarettes and vaping: A review and case reports. J Esthet Restor Dent 2020;32(3):260–264. DOI: 10.1111/jerd.12583.
Gan Q, Yang J, Yang G, et al. Chinese “herbal” cigarettes are as carcinogenic and addictive as regular cigarettes. Cancer Epidemiol Biomarkers Prev 2009;18(12):3497–3501. DOI: 10.1158/1055-9965.EPI-09-0620.
Ye D, Rahman I. Emerging oral nicotine products and periodontal diseases. Int J Dent 2023;2023:9437475. DOI: 10.1155/2023/9437475.
Robichaud MO, Seidenberg AB, Byron MJ. Tobacco companies introduce “tobacco-free” nicotine pouches. Tob Control 2020;29(e1):e145–e146. DOI: 10.1136/tobaccocontrol-2019-055321.
Kaur G, Muthumalage T, Rahman I. Mechanisms of toxicity and biomarkers of flavoring and flavor enhancing chemicals in emerging tobacco and non-tobacco products. Toxicol Lett 2018;288:143–155. DOI: 10.1016/j.toxlet.2018.02.025.