Abstract background paper The paper provides an overview of novel marketed and test-marketed products and products with emerging use, including oral tobacco products, modified or alternative cigarettes, waterpipes and notable alterations to traditional products.
New technologies in development, such as substituting traditional burning of tobacco by heating, changing tobacco processing and alterations to filter structure are also discussed. Analysis of published research on these products brought us to the conclusion that the impact of the newest tobacco products on public health is not clear. Potential unrecognized toxicity, increased or sustained prevalence of tobacco use by recruitment of new users, relapse of ex-smokers or maintenance of tobacco use by current smokers who might otherwise have quit, dual use of a novel tobacco product and cigarettes and potential initiation with a novel product followed by switching to cigarette smoking are major concerns voiced.
During the past decade, a range of new tobacco products and product types has been introduced onto markets worldwide. Some of the new products, such as dissolvable tobacco products and “snus” manufactured in the UnSA, are designed for oral use. Other innovations are in essence modified cigarettes that contain specially treated tobacco or novel filters or deliver inhaled tobacco in novel ways, such as at a lower burning temperature or by heating instead or burning the tobacco. Some of these products may be the result of attempts by the tobacco industry to manufacture and market products that decrease exposure to harmful tobacco constituents, and some have been or are being marketed with corresponding implicit or explicit health claims.
While the general concept of exposure reduction is constructive, use of such products or misperception of the health benefit of using a “reduced exposure” product could have unintended health consequences. For instance, marketing of “light” cigarettes raised false expectations of reduced exposure, and they have not decreased health risks. Cigarettes with reduced nicotine content are another innovation in tobacco products; such cigarettes could be less addictive and lead to a decrease in smoking prevalence. Other innovations, such as menthol capsules in cigarette filters, are not associated with reduced risk. Further alterations to or processing of tobacco plants and new tobacco delivery products may be developed. The emerging use of some tobacco products in countries where those products have not been used previously, with potential unrecognized consequences, is another concern.