# data[].attributes.body
- maryland wants to raise the tobacco legal to 21
- also adding vaping also
-also people who are 18 with military IDS to purchase tobacco

# data[].attributes.attachment_link.readable_text
The legal age to buy tobacco and nicotine products in Maryland will be raised from 18 to 21, and the state will add vaping devices to the list of tobacco products, under legislation signed Monday by Gov. Larry Hogan (R).

The law was passed in response to an uptick in teen vaping, which federal officials have declared an "epidemic." The law will take effect in October.

"There is no more important job than protecting the health and safety of Marylanders," Hogan said in a statement.

The law will require retailers to post warning signs that tobacco products can only be sold to people age 21 or older. The law will apply to all types of tobacco products, including cigarettes, cigars, smokeless tobacco, e-cigarettes and vaping devices.

The law includes an exception that will allow people 18 and over with military IDs to purchase tobacco, a provision that anti-tobacco advocates oppose.

The rise in teen vaping has helped propel more states to try to raise the legal age to purchase tobacco. According to the American Lung Association and the Campaign for Tobacco-Free Kids, the law makes Maryland the 13th state to pass some version of "tobacco 21" legislation. Similar bills are moving through legislatures and .

While such laws have been shown to be somewhat effective, advocates say the public health response to ending the youth smoking epidemic needs to include much more, including bans on the sale of flavored tobacco.

Maryland's law is supported by public health advocates as well as tobacco companies. Kevin Burns, CEO of the leading e-cigarette company Juul, commended Hogan and the state legislature.

"We cannot fulfill our mission to provide the world's one billion adult smokers with a true alternative to combustible cigarettes, the number one cause of preventable death in this country, if youth-use continues unabated," Burns said in a statement. "That is why we are committed to working with lawmakers to enact these effective policies and hope more jurisdictions follow in Maryland's example."

Juul has been under fire for allegedly marketing flavors that appealed to young people, but has been recasting itself as a company focused on providing an alternative to combustible cigarettes for adult smokers.

Public health groups have said any tobacco industry support makes them wary. Tobacco companies have been on the front line pushing for "tobacco 21" legislation at the federal and state levels recently, mainly in an effort to stave off stronger regulations that could have disastrous effects on the industry. They are also trying to argue that merely raising the legal purchasing age is all that's needed to curb youth smoking and vaping rates.

Altria, one of the largest tobacco companies in the U.S., and Juul recently backed measures authored by Senate Majority Leader Mitch McConnell Robert Aderholt Robert Brown Aderholt Maryland raises legal tobacco purchasing age to 21 Anti-smoking advocates question industry motives for backing higher purchasing age Barr forms team to probe FBI actions in Russia investigation: report MORE (R-Ala.) that would increase the nationwide purchasing age to 21. Addison (Mitch) Mitchell McConnell Top Republican says Senate unlikely to vote on any election security bills Senate confirms controversial 9th Circuit pick without blue slips Pence, McConnell eulogize Sen. Richard Lugar MORE (R-Ky.) and Rep.

# data[].attributes.attachment_link.title
Maryland raises legal tobacco purchasing age to 21

# data[].attributes.attachment_link.description
The legal age to buy tobacco and nicotine products in Maryland will be raised from 18 to 21, and the state will add vaping devices to the list of tobacco products, under legislation signed Monday by Gov. Larry Hogan (R). The law was passed in response to an uptick in teen vaping, which federal officials have declared an "epidemic."

# data[].attributes.body
-therapy
- group sessions
- motivational interviewing
getting you self ready for not smoking anymore

# data[].attributes.body
-cigarettes: 2,569.60
-juul; 180 month

# data[].attributes.body
- cigarettes : $7.01
- chewing tobacco $2
- juul : $49.99
-vape pen: $40

# data[].attributes.body
- butane
- methanol
- radon
- tar
- nicotine
-carbon monoxide
cadmium
-

# data[].attributes.body
- oral cancer
- more nicotine than cigarettes
- products helped to quit chewing tobacco

# data[].attributes.attachment_link.readable_text
What is chewing tobacco?

Chewing tobacco contains nicotine and many known cancer-causing substances.

Chewing tobacco is sometimes known as smokeless tobacco or spitting tobacco. It is available in two forms, snuff, and chewing tobacco. Both types of chewing tobacco are held in the mouth inside the cheek or between the cheek and gum. Snuff and chewing tobacco are commonly available in tins or pouches; popular brand names include Skoal and Copenhagen. Snus (pronounced like "snoose") is a finely ground form of snuff that originated in Norway and Sweden that comes in small tins. The amount of snuff placed in the mouth is referred to as a pinch, dip, lipper, or quid. A portion of chewing tobacco is referred to as a plug, wad, or chew.

Chewing tobacco is known to contain at least 28 cancer-causing chemicals, medically known as carcinogens. The main carcinogens in chewing tobacco are tobacco-specific nitrosamines (TSNAs). Some of the other cancer-causing agents found in chewing tobacco are formaldehyde, acetaldehyde, arsenic, benzopyrene, nickel, and cadmium. Many people mistakenly believe that snus is a safe form of chewing tobacco because it is steam-heated rather than fermented when produced in Norway or Sweden, causing it to have fewer nitrosamines. However, snus still contains several cancer-causing chemicals. Snus made in America is not necessarily processed in the same way as in Norway or Sweden.

Nicotine is also found in snuff and chewing tobacco, like all tobacco products. Although nicotine is absorbed more slowly from chewing tobacco than from cigarettes, 3 to 4 times more nicotine is absorbed from chewing tobacco than from a cigarette, and the nicotine from chewing tobacco remains longer in the bloodstream. Nicotine is the substance responsible for tobacco addiction.

Chewing tobacco is not the same thing as chewing cigarettes. Chewing cigarettes (also termed e-cigarettes) are designed to provide nicotine in vapor to the user without burning tobacco. However, smokeless cigarettes still provide addictive nicotine to the user and secondhand nicotine to others.

What are the health risks of chewing tobacco?

Several significant health risks are associated with the use of chewing tobacco.

Cancer risk and chewing tobacco

Users of snuff and chewing tobacco are at an increased risk for certain types of cancer, most notably cancer of the oral cavity including cancers of the following:

Some studies have suggested a link between the use of chewing tobacco and the development of the following:

Other health risks of chewing tobacco

Those who use chewing tobacco have an increased risk of the following:

Developing gum diseases and gum recession (pulling away of the gum tissue from the teeth)

Leukoplakia (whitish patches inside the mouth that can become cancerous)

Abrasion (wearing down) of teeth

Staining of teeth

Tooth decay

Tooth loss

All of the above have been linked to chewing tobacco use.

Some studies have shown a link between an increased risk of cardiovascular disease (including heart attacks and stroke) in users of snuff and chewing tobacco, although these risks are not as great as those observed in smokers. Further research is needed to determine whether or not chewing tobacco use presents a significant risk of heart disease and stroke.

SLIDESHOW
See Slideshow

Is chewing tobacco safer than cigarette smoking?

Chewing tobacco has been widely marketed as a way for cigarette smokers to use tobacco in smoke-free areas, so it is safer for other people because they are not exposed to secondhand smoke. However, in 1986, a statement from the U.S. Surgeon General concluded that users of chewing tobacco should know that chewing tobacco "is not a safe substitute for smoking cigarettes." Chewing tobacco contains nicotine, which is highly addictive, as well as several known cancer-causing chemicals. Any form of tobacco use poses an increased risk of developing cancer, and no level is considered safe.

While the risks of getting cancer from chewing tobacco are lower than those associated with smoking cigarettes, the health risks of chewing tobacco are very real and potentially fatal. Chewing tobacco use also is not helpful for smokers who want to quit smoking.

What is being done to reduce the use of chewing tobacco?

Parents are encouraged by healthcare professionals, school authorities, and public health officials to include the topic of chewing tobacco use when they discuss the hazards of tobacco use with their children, especially teenage children. It is better never to start than try to stop the addictive tobacco (nicotine) habit in any form.

Legislation has been enacted to help reduce the number of people who use tobacco products and reduce adverse health risks associated with tobacco use. The Family Smoking Prevention and Tobacco Control Act of 2009 gives the Food and Drug Administration (FDA) the power to regulate tobacco products in the U.S., which will allow for increased regulation of the marketing and advertising of tobacco products, including chewing tobacco.

In 2015, San Francisco became the first U.S. city to ban the use of smokeless tobacco at sporting events, including AT&T Park, home of the city's Major League Baseball team, the Giants.

What treatments are available to help people quit using chewing tobacco?

Chewing tobacco is an addiction that can be overcome. As with cigarette smoking, various support systems, programs, and even prescription medications are available to help people quit using chewing tobacco.

Examples of products available used to wean a person from nicotine addiction from chewing tobacco include:

Prescription medicines such as bupropion SR ( Zyban and Wellbutrin SR) and varenicline tartrate ( Chantix) have been effective in some patients who are trying to quit nicotine.
Medically Reviewed on 6/5/2023
American Cancer Society. "Smokeless Tobacco." <http://www.cancer.org/cancer/cancercauses/tobaccocancer/smokeless-tobacco>.

American Cancer Society. "Smokeless tobacco and how to quit." <http://www.cancer.org/docroot/PED/content/PED_10_13X_Quitting_Smokeless_Tobacco.asp>.

Boffeta P, Hecht S, Gray N, Gupta P, Straif K. "Smokeless tobacco and Cancer." Lancet Oncol 2008 Jul;9(7):667-75.

eMedicine.com. "Smokeless tobacco lesions." <http://emedicine.medscape.com/article/1077117-overview>.

Gupta R, Gurm H, Bartholomew JR. "Smokeless tobacco and cardiovascular risk." Arch Intern Med 2004 Sept;164(17):1845-9.

U.S. National Cancer Institute (NCI). "Smokeless tobacco and cancer, questions and answers." <http://www.cancer.gov/cancertopics/factsheet/Tobacco/smokeless>.

# data[].attributes.attachment_link.title
Chewing Tobacco Health Side Effects, Risks, Tips on Quitting

# data[].attributes.attachment_link.description
Using chewing tobacco, snuff, or smokeless tobacco can cause oral cancers, gum disease, tooth decay (cavities), tooth loss, and bad breath. Learn how to quit chewing tobacco, the side effects of chewing tobacco, and how mouth cancer can arise from chewing tobacco.

# data[].attributes.body
- unsafe for teens and adults
- harmful substances besides nicotine
- nicotine is highly addictive harm brain development

# data[].attributes.attachment_link.provider_name
Centers for Disease Control and Prevention

# data[].attributes.attachment_link.readable_text
The use of e-cigarettes is unsafe for kids, teens, and young adults.

Most e-cigarettes contain nicotine. Nicotine is highly addictive and can harm adolescent brain development, which continues into the early to mid-20s.1

E-cigarettes can contain other harmful substances besides nicotine.

Young people who use e-cigarettes may be more likely to smoke cigarettes in the future.

Find Data on E-cigarette Use Among Youth

E-cigarettes are electronic devices that heat a liquid and produce an aerosol, or mix of small particles in the air.

E-cigarettes come in many shapes and sizes. Most have a battery, a heating element, and a place to hold a liquid.

Some e-cigarettes look like regular cigarettes, cigars, or pipes. Some look like USB flash drives, pens, and other everyday items. Larger devices such as tank systems, or "mods," do not look like other tobacco products.

E-cigarettes are known by many different names. They are sometimes called "e-cigs," "e-hookahs," "mods," "vape pens," "vapes," "tank systems," and "electronic nicotine delivery systems (ENDS)."

Using an e-cigarette is sometimes called "vaping."

Some e-cigarettes look like regular cigarettes, cigars, or pipes.
Some look like USB flash drives, pens, and other everyday items.

E-cigarettes produce an aerosol by heating a liquid that usually contains nicotine, flavorings, and other chemicals that help to make the aerosol.

The liquid used in e-cigarettes often contains nicotine and flavorings. This liquid is sometimes called "e-juice," "e-liquid," "vape juice," or "vape liquid."

Users inhale e-cigarette aerosol into their lungs. Bystanders can also breathe in this aerosol when the user exhales it into the air.

E-cigarette devices can be used to deliver marijuana and other drugs.

News outlets and social media sites report widespread use of JUUL by students in schools, including classrooms and bathrooms.

JUUL is a brand of e-cigarette that is shaped like a USB flash drive. Like other e-cigarettes, JUUL is a battery-powered device that heats a nicotine-containing liquid to produce an aerosol that is inhaled.

All JUUL e-cigarettes have a high level of nicotine. According to the manufacturer, a single JUUL pod contains as much nicotine as a pack of 20 regular cigarettes.2

JUUL is one of a few e-cigarettes that use nicotine salts, which allow particularly high levels of nicotine to be inhaled more easily and with less irritation than the free-base nicotine that has traditionally been used in tobacco products, including e-cigarettes.

News outlets and social media sites report widespread use of JUUL by students in schools, including classrooms and bathrooms.

Approximately two-thirds of JUUL users aged 15 - 24 do not know that JUUL always contains nicotine.

Although JUUL is currently the top-selling e-cigarette brand in the United States, other companies sell e-cigarettes that look like USB flash drives. Examples include the MarkTen Elite, a nicotine delivery device, and the PAX Era, a marijuana delivery device that looks like JUUL.

Additional information about USB-shaped e-cigarettes and actions that parents, educators, and health care providers can take to protect kids is available at CDC's Infographic [PDF - 1.2MB]

Most e-cigarettes (vapes) contain nicotine-the addictive drug in regular cigarettes, cigars, and other tobacco products.

A CDC study found that 99% of the e-cigarettes sold in assessed venues in the United States contained nicotine.1

Some vape product labels do not disclose that they contain nicotine, and some vape liquids marketed as containing 0% nicotine have been found to contain nicotine.

Nicotine can harm the developing adolescent brain.2 The brain keeps developing until about age 25.

Using nicotine in adolescence can harm the parts of the brain that control attention, learning, mood, and impulse control.2

Each time a new memory is created or a new skill is learned, stronger connections - or synapses - are built between brain cells. Young people's brains build synapses faster than adult brains. Nicotine changes the way these synapses are formed.

Using nicotine in adolescence may also increase risk for future addiction to other drugs.2

When a person is dependent on (or addicted to) nicotine and stops using it, their body and brain have to get used to not having nicotine. This can result in temporary symptoms of nicotine withdrawal.

Nicotine withdrawal symptoms include irritability, restlessness, feeling anxious or depressed, trouble sleeping, problems concentrating, and craving nicotine.3 People may keep using tobacco products to help relieve these symptoms.4

Youth may turn to vaping to try to deal with stress or anxiety, creating a cycle of nicotine dependence. But nicotine addiction can be a source of stress.

What may start as social experimentation can become an addiction.

The most common reason U.S. middle and high school students give for trying an e-cigarette is "a friend used them." 5

The most common reason youth give for continuing to use e-cigarettes is "I am feeling anxious, stressed, or depressed." 5

Youth e-cigarette and cigarette use have been associated with mental health symptoms such as depression.9, 10

Yes. As long as a person stays quit, withdrawal symptoms will fade over time as the brain gets used to not having nicotine.

Scientists are still learning about the effects of quitting vaping on mental health. Quitting smoking cigarettes is associated with lower levels of anxiety, depression, and stress, as well as improved positive mood and quality of life.9

Scientists are still learning about the long-term health effects of e-cigarettes.

Some of the ingredients in e-cigarette aerosol could also be harmful to the lungs in the long-term. For example, some e-cigarette flavorings may be safe to eat but not to inhale because the gut can process more substances than the lungs.1

Defective e-cigarette batteries have caused some fires and explosions, a few of which have resulted in serious injuries.

Children and adults have been poisoned by swallowing, breathing, or absorbing e-cigarette liquid through their skin or eyes. Nationally, approximately 50% of calls to poison control centers for e-cigarettes are for kids 5 years of age or younger.

E-cigarette aerosol is NOT harmless "water vapor."

The e-cigarette aerosol that users breathe from the device and exhale can contain harmful and potentially harmful substances, including:

Nicotine

Ultrafine particles that can be inhaled deep into the lungs

Flavorings such as diacetyl, a chemical linked to a serious lung disease

Volatile organic compounds

Cancer-causing chemicals

Heavy metals such as nickel, tin, and lead1

The aerosol that users inhale and exhale from e-cigarettes can expose both themselves and bystanders to harmful substances.

It is difficult for consumers to know what e-cigarette products contain. For example, some e-cigarettes marketed as containing zero percent nicotine have been found to contain nicotine.3

E-cigarettes come in various flavors, including fruit, candy, mint, and menthol.

A study from 2013-2014 showed that most youth who use e-cigarettes first start with a flavored variety, and flavors are the primary reason youth report using e-cigarettes.⁶

In 2023, most youth who reported using e-cigarettes used flavored varieties (89.4%). Among middle and high school students who currently used any type of flavored e-cigarette in 2023, the most commonly used flavors were fruit (63.4%), candy, desserts, or other sweets (35%), mint (27.8%), and menthol (20.1%).¹¹

On January 2, 2020, the U.S. Food and Drug Administration (FDA) finalized an enforcement policy that prohibits the sale of prefilled cartridge e-cigarettes in any flavor other than tobacco or menthol, unless authorized by FDA. FDA has since taken additional steps to prohibit certain companies from selling youth-appealing, flavored disposable e-cigarettes and flavored e-liquids without authorization.⁷

Several states and communities have restricted the sale of flavored tobacco products, including menthol-flavored products.⁸

E-cigarettes are also advertised using the same themes and tactics that have been shown to increase youth initiation of other tobacco products, including cigarettes. In 2021, approximately 76% of students reported exposure to tobacco product marketing through traditional sources and approximately 74% of students who used social media had seen e-cigarette-related posts or content.¹²

Widespread advertising for e-cigarettes, including via media for which advertising for conventional tobacco products is prohibited (e.g., TV), and the lower costs of some e-cigarettes relative to regular cigarettes has contributed to use among youth.¹

Many youth also report using e-cigarettes because they are curious about these products.¹

Many young people who use e-cigarettes also smoke cigarettes.1 There is some evidence that young people who use e-cigarettes may be more likely to smoke cigarettes in the future.

Specifically, a 2018 National Academy of Medicine report found that there was some evidence that e-cigarette use increases the frequency and amount of cigarette smoking in the future.4

E-cigarettes also can be used to deliver other drugs, including marijuana; in 2016, approximately one-third of U.S. middle and high school students who have ever used an e-cigarette reported using marijuana in the device.

But e-cigarette use among young people is still unsafe, even if they do not progress to future cigarette smoking.

E-cigarettes expose users to fewer harmful chemicals than burned cigarettes.1

But burned cigarettes are very dangerous, killing half of all people who smoke long-term.

The use of any tobacco product, including e-cigarettes, is unsafe for young people.

Yes. In August 2016, the regulatory authority of the FDA was extended to cover e-cigarettes through the agency's "deeming rule."

Through authority granted by the Family Smoking Prevention and Tobacco Control Act (FSPTCA), FDA has authority to develop regulations that address the manufacturing, marketing, and sale of e-cigarettes.

There are some strategies that the FDA does not have authority to implement, such as including e-cigarettes in smoke-free policies or increasing the minimum legal sales age for these products, unless directed to do so by Congress. However, the FSPTCA does not prevent states and communities from including e-cigarettes in smoke-free policies or from regulating the sale and distribution of e-cigarettes. These types of strategies can include further raising the minimum legal sales age, licensing retailers, implementing price policies, and restricting or prohibiting the sale of tobacco products.

Yes. In 2018, the FDA expanded its successful youth tobacco prevention campaign, "The Real Cost," to reach the more than 10 million youth aged 12-17 who have used e-cigarettes or are open to trying them. The campaign educates youth about the potential risks of using e-cigarettes.

The "Real Cost" reaches teens where they spend most of their time: in school and online. The campaign is also placing e-cigarette prevention materials in high schools across the nation, both in school bathrooms and on educational digital platforms accessed by students during the school day.

Heated tobacco products (HTPs) like IQOS and Eclipse, sometimes marketed as "heat-not-burn" technology, represent a diverse class of products that heat the tobacco leaf to produce an inhaled aerosol. They are different from e-cigarettes, which heat a liquid that can contain nicotine derived from tobacco.

HTPs are available in at least 40 countries and several have been authorized for sale in the United States by the FDA. In 2018, few U.S. adults (2.4% of all surveyed, including 6.7% of people who currently smoke surveyed) had ever used HTPs. In 2023, 1.0% of U.S. middle and high school students, combined, reported having used heated tobacco products in the past 30 days.¹¹

Scientists are still learning about the short-term and long-term health effects of HTPs, but the available science shows they contain harmful and potentially harmful ingredients. Youth use of any tobacco products, including heated products, is unsafe.

It is important that we continue to modernize proven tobacco prevention and control strategies to include newer products entering the market such as HTPs.

Talk to your child or teen about why e-cigarettes are harmful for them. It's never too late.

Set a good example by being tobacco-free and ensure that your kid is not exposed to the secondhand emissions from any tobacco products, including e-cigarettes.

If you use tobacco, it's never too late to quit. For free help, visit smokefree.gov or call 1-800-QUIT-NOW.

Talk to your child or teen about why e-cigarettes are harmful for them. It's never too late.

Get the Talk With Your Teen About E-cigarettes [PDF - 5.2MB] tip sheet for parents. Start the conversation early with children about why e-cigarettes are harmful for them.

Let your child know that you want them to stay away from all tobacco products, including e-cigarettes, because they are not safe for them. Seek help and get involved.

Set up an appointment with your child's health care provider so that they can hear from a medical professional about the health risks of tobacco products, including e-cigarettes.

Speak with your child's teacher and school administrator about enforcement of tobacco-free school grounds policies and tobacco prevention curriculum.

Encourage your child to learn the facts and get tips for quitting tobacco products at Teen.smokefree.gov.

Fact Sheet for Educators:

Conversation Card for Educators:

1. U.S. Department of Health and Human Services. Smoking Cessation: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2020 [accessed 2022 April 4].

2. Truth Initiative Mental Health x Vaping Headline Survey Internal Data - August 2021.

3. Gentzke AS, Wang TW, Cornelius M, et al. Tobacco Product Use and Associated Factors Among Middle and High School Students - National Youth Tobacco Survey, United States, 2021. MMWR Surveill Summ 2022;71(No. SS-5):1-29. DOI: http://dx.doi.org/10.15585/mmwr.ss7105a1.

4. U.S. Department of Health and Human Services. The Health Consequences of Smoking-50 years of Progress: A Report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.

5. Birdsey J, Cornelius M, Jamal A, et al. Tobacco Product Use Among U.S. Middle and High School Students - National Youth Tobacco Survey, 2023. MMWR Morb Mortal Wkly Rep 2023; 72(44);1173-1182.

6. Cooper M, Park-Lee E, Ren C, Cornelius M, Jamal A, Cullen KA. Notes from the Field: E-cigarette Use Among Middle and High School Students - United States, 2022. MMWR Morb Mortal Wkly Rep 2022;71:1283-1285. DOI: http://dx.doi.org/10.15585/mmwr.mm7140a3

# data[].attributes.attachment_link.title
Quick Facts on the Risks of E-cigarettes for Young People

# data[].attributes.attachment_link.description
Learn quick facts on the risks of e-cigarettes for kids, teens, and young adults, including how they work, why nicotine is unsafe, what is in e-cigarette aerosol, and resources for parents to prevent their child from using e-cigarettes or help them stop.

# data[].attributes.body
- make your blood thicker and increase your chances of clot formation
- more likely to have a stroke than someone who doesn't smoke
- narrow your arteries reducing the amount of oxygen.

# data[].attributes.attachment_link.readable_text
Whether you want to start breathing easier, feel the energy boost or even have a little more money to spend, there has never been a better time to stop smoking. Remember, it's never too late to join the thousands of people quitting smoking this October.

Check out our tips and tools.

You've got what it takes to quit this Stoptober!

# data[].attributes.attachment_link.description
Whether you want to start breathing easier, feel the energy boost or even have a little more money to spend, there has never been a better time to stop smoking. Remember, it's never too late to join the thousands of people quitting smoking this October. Check out our tips and tools.

# data[].attributes.body
- more nicotine is absorbed by chewing tobacco use that by smoking a cigarette
- chewing tobacco is a risk factor for the development of oral cancer and precancers
- products that are desighned to help smokers quit can also be used to help quit chewing tobacco use

# data[].attributes.attachment_link.readable_text
What is chewing tobacco?

Chewing tobacco contains nicotine and many known cancer-causing substances.

Chewing tobacco is sometimes known as smokeless tobacco or spitting tobacco. It is available in two forms, snuff, and chewing tobacco. Both types of chewing tobacco are held in the mouth inside the cheek or between the cheek and gum. Snuff and chewing tobacco are commonly available in tins or pouches; popular brand names include Skoal and Copenhagen. Snus (pronounced like "snoose") is a finely ground form of snuff that originated in Norway and Sweden that comes in small tins. The amount of snuff placed in the mouth is referred to as a pinch, dip, lipper, or quid. A portion of chewing tobacco is referred to as a plug, wad, or chew.

Chewing tobacco is known to contain at least 28 cancer-causing chemicals, medically known as carcinogens. The main carcinogens in chewing tobacco are tobacco-specific nitrosamines (TSNAs). Some of the other cancer-causing agents found in chewing tobacco are formaldehyde, acetaldehyde, arsenic, benzopyrene, nickel, and cadmium. Many people mistakenly believe that snus is a safe form of chewing tobacco because it is steam-heated rather than fermented when produced in Norway or Sweden, causing it to have fewer nitrosamines. However, snus still contains several cancer-causing chemicals. Snus made in America is not necessarily processed in the same way as in Norway or Sweden.

Nicotine is also found in snuff and chewing tobacco, like all tobacco products. Although nicotine is absorbed more slowly from chewing tobacco than from cigarettes, 3 to 4 times more nicotine is absorbed from chewing tobacco than from a cigarette, and the nicotine from chewing tobacco remains longer in the bloodstream. Nicotine is the substance responsible for tobacco addiction.

Chewing tobacco is not the same thing as chewing cigarettes. Chewing cigarettes (also termed e-cigarettes) are designed to provide nicotine in vapor to the user without burning tobacco. However, smokeless cigarettes still provide addictive nicotine to the user and secondhand nicotine to others.

What are the health risks of chewing tobacco?

Several significant health risks are associated with the use of chewing tobacco.

Cancer risk and chewing tobacco

Users of snuff and chewing tobacco are at an increased risk for certain types of cancer, most notably cancer of the oral cavity including cancers of the following:

Some studies have suggested a link between the use of chewing tobacco and the development of the following:

Other health risks of chewing tobacco

Those who use chewing tobacco have an increased risk of the following:

Developing gum diseases and gum recession (pulling away of the gum tissue from the teeth)

Leukoplakia (whitish patches inside the mouth that can become cancerous)

Abrasion (wearing down) of teeth

Staining of teeth

Tooth decay

Tooth loss

All of the above have been linked to chewing tobacco use.

Some studies have shown a link between an increased risk of cardiovascular disease (including heart attacks and stroke) in users of snuff and chewing tobacco, although these risks are not as great as those observed in smokers. Further research is needed to determine whether or not chewing tobacco use presents a significant risk of heart disease and stroke.

SLIDESHOW
See Slideshow

Is chewing tobacco safer than cigarette smoking?

Chewing tobacco has been widely marketed as a way for cigarette smokers to use tobacco in smoke-free areas, so it is safer for other people because they are not exposed to secondhand smoke. However, in 1986, a statement from the U.S. Surgeon General concluded that users of chewing tobacco should know that chewing tobacco "is not a safe substitute for smoking cigarettes." Chewing tobacco contains nicotine, which is highly addictive, as well as several known cancer-causing chemicals. Any form of tobacco use poses an increased risk of developing cancer, and no level is considered safe.

While the risks of getting cancer from chewing tobacco are lower than those associated with smoking cigarettes, the health risks of chewing tobacco are very real and potentially fatal. Chewing tobacco use also is not helpful for smokers who want to quit smoking.

What is being done to reduce the use of chewing tobacco?

Parents are encouraged by healthcare professionals, school authorities, and public health officials to include the topic of chewing tobacco use when they discuss the hazards of tobacco use with their children, especially teenage children. It is better never to start than try to stop the addictive tobacco (nicotine) habit in any form.

Legislation has been enacted to help reduce the number of people who use tobacco products and reduce adverse health risks associated with tobacco use. The Family Smoking Prevention and Tobacco Control Act of 2009 gives the Food and Drug Administration (FDA) the power to regulate tobacco products in the U.S., which will allow for increased regulation of the marketing and advertising of tobacco products, including chewing tobacco.

In 2015, San Francisco became the first U.S. city to ban the use of smokeless tobacco at sporting events, including AT&T Park, home of the city's Major League Baseball team, the Giants.

What treatments are available to help people quit using chewing tobacco?

Chewing tobacco is an addiction that can be overcome. As with cigarette smoking, various support systems, programs, and even prescription medications are available to help people quit using chewing tobacco.

Examples of products available used to wean a person from nicotine addiction from chewing tobacco include:

Prescription medicines such as bupropion SR ( Zyban and Wellbutrin SR) and varenicline tartrate ( Chantix) have been effective in some patients who are trying to quit nicotine.
Medically Reviewed on 6/5/2023
American Cancer Society. "Smokeless Tobacco." <http://www.cancer.org/cancer/cancercauses/tobaccocancer/smokeless-tobacco>.

American Cancer Society. "Smokeless tobacco and how to quit." <http://www.cancer.org/docroot/PED/content/PED_10_13X_Quitting_Smokeless_Tobacco.asp>.

Boffeta P, Hecht S, Gray N, Gupta P, Straif K. "Smokeless tobacco and Cancer." Lancet Oncol 2008 Jul;9(7):667-75.

eMedicine.com. "Smokeless tobacco lesions." <http://emedicine.medscape.com/article/1077117-overview>.

Gupta R, Gurm H, Bartholomew JR. "Smokeless tobacco and cardiovascular risk." Arch Intern Med 2004 Sept;164(17):1845-9.

U.S. National Cancer Institute (NCI). "Smokeless tobacco and cancer, questions and answers." <http://www.cancer.gov/cancertopics/factsheet/Tobacco/smokeless>.

# data[].attributes.attachment_link.title
Chewing Tobacco Health Side Effects, Risks, Tips on Quitting

# data[].attributes.attachment_link.description
Using chewing tobacco, snuff, or smokeless tobacco can cause oral cancers, gum disease, tooth decay (cavities), tooth loss, and bad breath. Learn how to quit chewing tobacco, the side effects of chewing tobacco, and how mouth cancer can arise from chewing tobacco.

# data[].attributes.attachment_link.provider_name
Centers for Disease Control and Prevention

# data[].attributes.attachment_link.readable_text
The use of e-cigarettes is unsafe for kids, teens, and young adults.

Most e-cigarettes contain nicotine. Nicotine is highly addictive and can harm adolescent brain development, which continues into the early to mid-20s.1

E-cigarettes can contain other harmful substances besides nicotine.

Young people who use e-cigarettes may be more likely to smoke cigarettes in the future.

Find Data on E-cigarette Use Among Youth

E-cigarettes are electronic devices that heat a liquid and produce an aerosol, or mix of small particles in the air.

E-cigarettes come in many shapes and sizes. Most have a battery, a heating element, and a place to hold a liquid.

Some e-cigarettes look like regular cigarettes, cigars, or pipes. Some look like USB flash drives, pens, and other everyday items. Larger devices such as tank systems, or "mods," do not look like other tobacco products.

E-cigarettes are known by many different names. They are sometimes called "e-cigs," "e-hookahs," "mods," "vape pens," "vapes," "tank systems," and "electronic nicotine delivery systems (ENDS)."

Using an e-cigarette is sometimes called "vaping."

Some e-cigarettes look like regular cigarettes, cigars, or pipes.
Some look like USB flash drives, pens, and other everyday items.

E-cigarettes produce an aerosol by heating a liquid that usually contains nicotine, flavorings, and other chemicals that help to make the aerosol.

The liquid used in e-cigarettes often contains nicotine and flavorings. This liquid is sometimes called "e-juice," "e-liquid," "vape juice," or "vape liquid."

Users inhale e-cigarette aerosol into their lungs. Bystanders can also breathe in this aerosol when the user exhales it into the air.

E-cigarette devices can be used to deliver marijuana and other drugs.

News outlets and social media sites report widespread use of JUUL by students in schools, including classrooms and bathrooms.

JUUL is a brand of e-cigarette that is shaped like a USB flash drive. Like other e-cigarettes, JUUL is a battery-powered device that heats a nicotine-containing liquid to produce an aerosol that is inhaled.

All JUUL e-cigarettes have a high level of nicotine. According to the manufacturer, a single JUUL pod contains as much nicotine as a pack of 20 regular cigarettes.2

JUUL is one of a few e-cigarettes that use nicotine salts, which allow particularly high levels of nicotine to be inhaled more easily and with less irritation than the free-base nicotine that has traditionally been used in tobacco products, including e-cigarettes.

News outlets and social media sites report widespread use of JUUL by students in schools, including classrooms and bathrooms.

Approximately two-thirds of JUUL users aged 15 - 24 do not know that JUUL always contains nicotine.

Although JUUL is currently the top-selling e-cigarette brand in the United States, other companies sell e-cigarettes that look like USB flash drives. Examples include the MarkTen Elite, a nicotine delivery device, and the PAX Era, a marijuana delivery device that looks like JUUL.

Additional information about USB-shaped e-cigarettes and actions that parents, educators, and health care providers can take to protect kids is available at CDC's Infographic [PDF - 1.2MB]

Most e-cigarettes (vapes) contain nicotine-the addictive drug in regular cigarettes, cigars, and other tobacco products.

A CDC study found that 99% of the e-cigarettes sold in assessed venues in the United States contained nicotine.1

Some vape product labels do not disclose that they contain nicotine, and some vape liquids marketed as containing 0% nicotine have been found to contain nicotine.

Nicotine can harm the developing adolescent brain.2 The brain keeps developing until about age 25.

Using nicotine in adolescence can harm the parts of the brain that control attention, learning, mood, and impulse control.2

Each time a new memory is created or a new skill is learned, stronger connections - or synapses - are built between brain cells. Young people's brains build synapses faster than adult brains. Nicotine changes the way these synapses are formed.

Using nicotine in adolescence may also increase risk for future addiction to other drugs.2

When a person is dependent on (or addicted to) nicotine and stops using it, their body and brain have to get used to not having nicotine. This can result in temporary symptoms of nicotine withdrawal.

Nicotine withdrawal symptoms include irritability, restlessness, feeling anxious or depressed, trouble sleeping, problems concentrating, and craving nicotine.3 People may keep using tobacco products to help relieve these symptoms.4

Youth may turn to vaping to try to deal with stress or anxiety, creating a cycle of nicotine dependence. But nicotine addiction can be a source of stress.

What may start as social experimentation can become an addiction.

The most common reason U.S. middle and high school students give for trying an e-cigarette is "a friend used them." 5

The most common reason youth give for continuing to use e-cigarettes is "I am feeling anxious, stressed, or depressed." 5

Youth e-cigarette and cigarette use have been associated with mental health symptoms such as depression.9, 10

Yes. As long as a person stays quit, withdrawal symptoms will fade over time as the brain gets used to not having nicotine.

Scientists are still learning about the effects of quitting vaping on mental health. Quitting smoking cigarettes is associated with lower levels of anxiety, depression, and stress, as well as improved positive mood and quality of life.9

Scientists are still learning about the long-term health effects of e-cigarettes.

Some of the ingredients in e-cigarette aerosol could also be harmful to the lungs in the long-term. For example, some e-cigarette flavorings may be safe to eat but not to inhale because the gut can process more substances than the lungs.1

Defective e-cigarette batteries have caused some fires and explosions, a few of which have resulted in serious injuries.

Children and adults have been poisoned by swallowing, breathing, or absorbing e-cigarette liquid through their skin or eyes. Nationally, approximately 50% of calls to poison control centers for e-cigarettes are for kids 5 years of age or younger.

E-cigarette aerosol is NOT harmless "water vapor."

The e-cigarette aerosol that users breathe from the device and exhale can contain harmful and potentially harmful substances, including:

Nicotine

Ultrafine particles that can be inhaled deep into the lungs

Flavorings such as diacetyl, a chemical linked to a serious lung disease

Volatile organic compounds

Cancer-causing chemicals

Heavy metals such as nickel, tin, and lead1

The aerosol that users inhale and exhale from e-cigarettes can expose both themselves and bystanders to harmful substances.

It is difficult for consumers to know what e-cigarette products contain. For example, some e-cigarettes marketed as containing zero percent nicotine have been found to contain nicotine.3

E-cigarettes come in various flavors, including fruit, candy, mint, and menthol.

A study from 2013-2014 showed that most youth who use e-cigarettes first start with a flavored variety, and flavors are the primary reason youth report using e-cigarettes.⁶

In 2023, most youth who reported using e-cigarettes used flavored varieties (89.4%). Among middle and high school students who currently used any type of flavored e-cigarette in 2023, the most commonly used flavors were fruit (63.4%), candy, desserts, or other sweets (35%), mint (27.8%), and menthol (20.1%).¹¹

On January 2, 2020, the U.S. Food and Drug Administration (FDA) finalized an enforcement policy that prohibits the sale of prefilled cartridge e-cigarettes in any flavor other than tobacco or menthol, unless authorized by FDA. FDA has since taken additional steps to prohibit certain companies from selling youth-appealing, flavored disposable e-cigarettes and flavored e-liquids without authorization.⁷

Several states and communities have restricted the sale of flavored tobacco products, including menthol-flavored products.⁸

E-cigarettes are also advertised using the same themes and tactics that have been shown to increase youth initiation of other tobacco products, including cigarettes. In 2021, approximately 76% of students reported exposure to tobacco product marketing through traditional sources and approximately 74% of students who used social media had seen e-cigarette-related posts or content.¹²

Widespread advertising for e-cigarettes, including via media for which advertising for conventional tobacco products is prohibited (e.g., TV), and the lower costs of some e-cigarettes relative to regular cigarettes has contributed to use among youth.¹

Many youth also report using e-cigarettes because they are curious about these products.¹

Many young people who use e-cigarettes also smoke cigarettes.1 There is some evidence that young people who use e-cigarettes may be more likely to smoke cigarettes in the future.

Specifically, a 2018 National Academy of Medicine report found that there was some evidence that e-cigarette use increases the frequency and amount of cigarette smoking in the future.4

E-cigarettes also can be used to deliver other drugs, including marijuana; in 2016, approximately one-third of U.S. middle and high school students who have ever used an e-cigarette reported using marijuana in the device.

But e-cigarette use among young people is still unsafe, even if they do not progress to future cigarette smoking.

E-cigarettes expose users to fewer harmful chemicals than burned cigarettes.1

But burned cigarettes are very dangerous, killing half of all people who smoke long-term.

The use of any tobacco product, including e-cigarettes, is unsafe for young people.

Yes. In August 2016, the regulatory authority of the FDA was extended to cover e-cigarettes through the agency's "deeming rule."

Through authority granted by the Family Smoking Prevention and Tobacco Control Act (FSPTCA), FDA has authority to develop regulations that address the manufacturing, marketing, and sale of e-cigarettes.

There are some strategies that the FDA does not have authority to implement, such as including e-cigarettes in smoke-free policies or increasing the minimum legal sales age for these products, unless directed to do so by Congress. However, the FSPTCA does not prevent states and communities from including e-cigarettes in smoke-free policies or from regulating the sale and distribution of e-cigarettes. These types of strategies can include further raising the minimum legal sales age, licensing retailers, implementing price policies, and restricting or prohibiting the sale of tobacco products.

Yes. In 2018, the FDA expanded its successful youth tobacco prevention campaign, "The Real Cost," to reach the more than 10 million youth aged 12-17 who have used e-cigarettes or are open to trying them. The campaign educates youth about the potential risks of using e-cigarettes.

The "Real Cost" reaches teens where they spend most of their time: in school and online. The campaign is also placing e-cigarette prevention materials in high schools across the nation, both in school bathrooms and on educational digital platforms accessed by students during the school day.

Heated tobacco products (HTPs) like IQOS and Eclipse, sometimes marketed as "heat-not-burn" technology, represent a diverse class of products that heat the tobacco leaf to produce an inhaled aerosol. They are different from e-cigarettes, which heat a liquid that can contain nicotine derived from tobacco.

HTPs are available in at least 40 countries and several have been authorized for sale in the United States by the FDA. In 2018, few U.S. adults (2.4% of all surveyed, including 6.7% of people who currently smoke surveyed) had ever used HTPs. In 2023, 1.0% of U.S. middle and high school students, combined, reported having used heated tobacco products in the past 30 days.¹¹

Scientists are still learning about the short-term and long-term health effects of HTPs, but the available science shows they contain harmful and potentially harmful ingredients. Youth use of any tobacco products, including heated products, is unsafe.

It is important that we continue to modernize proven tobacco prevention and control strategies to include newer products entering the market such as HTPs.

Talk to your child or teen about why e-cigarettes are harmful for them. It's never too late.

Set a good example by being tobacco-free and ensure that your kid is not exposed to the secondhand emissions from any tobacco products, including e-cigarettes.

If you use tobacco, it's never too late to quit. For free help, visit smokefree.gov or call 1-800-QUIT-NOW.

Talk to your child or teen about why e-cigarettes are harmful for them. It's never too late.

Get the Talk With Your Teen About E-cigarettes [PDF - 5.2MB] tip sheet for parents. Start the conversation early with children about why e-cigarettes are harmful for them.

Let your child know that you want them to stay away from all tobacco products, including e-cigarettes, because they are not safe for them. Seek help and get involved.

Set up an appointment with your child's health care provider so that they can hear from a medical professional about the health risks of tobacco products, including e-cigarettes.

Speak with your child's teacher and school administrator about enforcement of tobacco-free school grounds policies and tobacco prevention curriculum.

Encourage your child to learn the facts and get tips for quitting tobacco products at Teen.smokefree.gov.

Fact Sheet for Educators:

Conversation Card for Educators:

1. U.S. Department of Health and Human Services. Smoking Cessation: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2020 [accessed 2022 April 4].

2. Truth Initiative Mental Health x Vaping Headline Survey Internal Data - August 2021.

3. Gentzke AS, Wang TW, Cornelius M, et al. Tobacco Product Use and Associated Factors Among Middle and High School Students - National Youth Tobacco Survey, United States, 2021. MMWR Surveill Summ 2022;71(No. SS-5):1-29. DOI: http://dx.doi.org/10.15585/mmwr.ss7105a1.

4. U.S. Department of Health and Human Services. The Health Consequences of Smoking-50 years of Progress: A Report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.

5. Birdsey J, Cornelius M, Jamal A, et al. Tobacco Product Use Among U.S. Middle and High School Students - National Youth Tobacco Survey, 2023. MMWR Morb Mortal Wkly Rep 2023; 72(44);1173-1182.

6. Cooper M, Park-Lee E, Ren C, Cornelius M, Jamal A, Cullen KA. Notes from the Field: E-cigarette Use Among Middle and High School Students - United States, 2022. MMWR Morb Mortal Wkly Rep 2022;71:1283-1285. DOI: http://dx.doi.org/10.15585/mmwr.mm7140a3

# data[].attributes.attachment_link.title
Quick Facts on the Risks of E-cigarettes for Young People

# data[].attributes.attachment_link.description
Learn quick facts on the risks of e-cigarettes for kids, teens, and young adults, including how they work, why nicotine is unsafe, what is in e-cigarette aerosol, and resources for parents to prevent their child from using e-cigarettes or help them stop.

# data[].attributes.headline
facts about juul, vape ,and e cigarette use 

# data[].attributes.subject
facts about juul, vape ,and e cigarette use 

# data[].attributes.body
- juul pods contains 20 cigarettes worth of nicotine
-almost one fifth of middle and highshool students have seen juul used in school
- juuls comes in sweet and fruity flavors
-minors are getting juuls in stores online through friends
- people are copying the juul type
- Fda has taken some action
- E cigarettes can contain other harmful substances besides nicotine
- young people who use e cigarettes are likley to smoke later on in life
- the use of e cigarettes is unsafe for kids

# data[].attributes.attachment_link.readable_text
The amount of nicotine in one JUUL cartridge is roughly equal to the amount of nicotine in a pack of cigarettes, or about 200 puffs, according to the product website.

While less toxic than combustible cigarettes, e-cigarettes can make youth more likely to use cigarettes and still contain toxins and the addictive chemical nicotine, which is harmful to adolescent brain development.

JUUL is easy to hide because it looks like a flash drive and can be charged in a USB port. It also does not produce a strong odor.

These characteristics enable discreet use, especially in schools. Almost one-fifth of middle and high school students have seen JUUL used in school, according to an April 2018 Truth Initiative® survey of more than 1,000 youth between 12 and 17 years old.

JUUL comes in a variety of flavors, such as fruit medley, mango, cool cucumber and creme brulee. Flavors in tobacco products, including e-cigarettes, have been proven to appeal to young people. Flavored e-cigarettes are especially dangerous, not only because they attract youth, but because their young users are likely to be misinformed about the harmfulness of the products.

Many youth e-cigarette users incorrectly believe they aren't consuming nicotine when they vape. The majority of youth e-cigarette users think they vaped only flavoring, not nicotine, the last time they used a product, according to an annual national survey of more than 40,000 students from the University of Michigan 2016 Monitoring the Future study.

By law, people under the age of 18 (or 21 in some areas) should not be able to purchase any tobacco products, including JUUL. So, how are so many young people getting their hands on JUUL?

Truth Initiative surveyed a national sample of more than 1,000 12- to 17-year-olds in April 2018 and found that nearly three quarters - 74 percent - of youth said that they obtained JUUL at a store or retail outlet. Just over half - 52 percent - reported that they received JUUL from a social source, such as a friend or family member. Although the internet was not the most common way youth obtained JUUL - only 6 percent reported that they received the product through an online transaction - nearly all youth who tried to buy the product online were successful.

Many companies are producing look-alike products to try to cash in on the profits of the top-selling e-cigarette. There are so many new devices that a social media account dedicated to e-cigarettes and vaping devices, Salt Porn, posted in May, "It feels like there is a new pod system released every day and we receive tons of them ... So many in fact that there is no way we can review them all." These products are not only putting a generation of youth at risk of nicotine addiction, but they appear to be breaking the law.

In recent months, the Food and Drug Administration has taken some actions regarding JUUL, including issuing warning letters to retailers for selling the product to minors. The FDA also asked the maker, JUUL Labs, to turn over documents related to marketing, health effects and use among youth. While these actions are encouraging, problems with tobacco products like JUUL won't be addressed until the FDA fully regulates e-cigarettes and establishes a strong pre-market review process to prevent these kinds of products from being sold in the first place.

Truth Initiative and five other public health and medical groups called on the FDA to take action on JUUL in April. The groups specified five actions, including removing certain JUUL flavors, suspending internet sales and prohibiting branded merchandise.

# data[].attributes.attachment_link.description
The amount of nicotine in one JUUL cartridge is roughly equal to the amount of nicotine in a pack of cigarettes, or about 200 puffs, according to the product website. While less toxic than combustible cigarettes, e-cigarettes can make youth more likely to use cigarettes and still contain toxins and the addictive chemical nicotine, which is harmful to adolescent brain development.

# data[].attributes.headline
3 facts of cigarette use: - an average life expectancy of  a smokers is 10 years less than a nonsmoker 

# data[].attributes.subject
3 facts of cigarette use: - an average life expectancy of  a smokers is 10 years less than a nonsmoker 

# data[].attributes.body
- cigarettes smoke contains more than 7,000 chemicals
- nearly 9 out of 10 smokers start before the age of 18

# data[].attributes.attachment_link.readable_text
Facts about Smoking & Using Tobacco

Today we know a lot about the dangers of smoking thanks to decades years of research about tobacco addiction. Here we've listed some of the major statistics about the effects of smoking and using tobacco. Read them and then judge for yourself.

10 Tobacco and Addiction Facts

On average, the life expectancy of a smoker is 10 years less than a nonsmoker.

Cigarette smoke contains more than 7,000 chemicals, 70 of which are known to cause cancer.

Nearly 9 out of 10 smokers start before the age of 18 and almost all start smoking by age 26.

Every day, more than 3,200 children and teens under 18 years old smoke their first cigarette. (There are also 2,100 young adults who turn into daily smokers each day.)

For every person who dies from a smoking-related disease, 20 more people suffer from a smoking-related illness.

Smoking and tobacco use causes more than 5 million deaths per year worldwide. Current trends show that this will increase to more than 8 million deaths annually by 2030.

Smoking is responsible for about 1 in 5 deaths annually in the United States. (That means tobacco causes about 480,000 deaths per year-and 41,000 of those deaths are because of exposure to secondhand smoke).

Smoking causes cancer, heart disease, stroke, diabetes and lung diseases (including emphysema, bronchitis and chronic airway obstruction).

Smokers typically inhale about 1 milligram (mg) of nicotine in a single cigarette.4 For some, that's all it takes to become addicted.

Tobacco is the leading cause of preventable death in the world.

# data[].attributes.attachment_link.title
Smoking & Tobacco Facts and Statistics | The CIGNAL

# data[].attributes.attachment_link.description
Today we know a lot about the dangers of smoking thanks to decades years of research about tobacco addiction. Here we've listed some of the major statistics about the effects of smoking and using tobacco. Read them and then judge for yourself. On average, the life expectancy of a smoker is 10 years less than a nonsmoker.