Abstract
Background
Sales of smokeless tobacco products have increased in the USA. More
than one in eight males in the 12th grade are current
users of smokeless tobacco.
Surveillance data examining nicotine levels of smokeless tobacco
subsequent to 2006 have not been
reported in the literature.
Davidoff iD Blue cigarettes.
Methods
Data on nicotine levels and design features (eg, pH, moisture content,
leaf cut and flavour) of smokeless tobacco products
sold in Massachusetts were obtained
from manufacturers between 2003 and 2012. Design features, levels and
temporal trends
in unionised (free) nicotine and
nicotine content of smokeless tobacco products were analysed overall and
by manufacturer
and product type.
Results
The annual total number of moist snuff products increased from 99 in
2003 to 127 in 2012. The annual total number of reported
snus products increased from 4 in
2003 to the highest level of 62 in 2011, before decreasing to 26 in
2012. Overall, mean
unionised (free) nicotine remained
relatively stable (β=0.018 (95% CI −0.014 to 0.050) mg/g dry
weight/year) from 2003 to
2012. However, both levels and
temporal trends of mean free nicotine varied significantly among
manufacturers (p<0.001). Since
2003, the free nicotine content of
snus has increased at an overall rate of 0.192 (95% CI 0.138 to 0.246)
mg/g dry weight/year,
but varied by manufacturer
(p<0.001).
Conclusions
The number of smokeless tobacco products increased in the Massachusetts
market. Further, mean unionised (free) nicotine levels
in smokeless tobacco products of
several manufacturers continued to rise despite decreasing levels from
other manufacturers.
The current success in tobacco
control is very likely undermined without government surveillance,
regulation and widespread
public disclosure of nicotine levels
in these products.
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