Emerging and Alternative Products

Tobacco comes in many different forms, especially when compared to just a few years ago. Learn the basics about these alternative forms beyond the cigarettes that everyone is familiar with. For basic information on tobacco, see our Tobacco 101 on our Resources and Links page. Because the tobacco industry is always coming up with new products, this page is a constant work in progress. To share or request additional resources, please email richmondcenter@aap.org.


  • Chewing tobacco: Also referred to as spit or chew, chewing tobacco can come in loose-leaf strips of shredded tobacco leaves, or in the form of a plug, where the tobacco is pressed together, wrapped in a tobacco leaf, then twisted to resemble a rope. Chewing tobacco is placed between the gum and the cheek.

  • Cigars: A cigar is a large, tightly rolled bundle of tobacco wrapped in leaf tobacco (or another substance containing tobacco) that is smoked. Cigars contain the same carcinogens as cigarettes, so that even if cigar smoke is not inhaled, cigar smokers are still at risk from the carcinogens in the smoke they produce. The U.S. Food and Drug Administration (FDA) does not yet regulate cigars.

  • Dissolvable tobacco: Tobacco that is meant to dissolve in the user's mouth is given the broad term 'dissolvable tobacco.' This can incorporate the orbs (which resemble tic tac candies), strips (resembling breath strips that you place on your tongue to freshen your breath), and sticks (resembling slightly larger toothpicks) that are currently in some markets around the U.S. These items resemble candy or mints, and are easy to mistake for candy or mint packaging, making it a danger to children. These dissolvable forms of tobacco typically dissolve in anywhere from three minutes (for a strip) to 30 minutes (for a stick), and the nicotine content in each differs- some contain more nicotine than a typical cigarette, some contain less.

  • E-Cigarette: Also called Electronic Nicotine Delivery Systems (ENDS), these devices are battery-powered and provide nicotine through use of a cartridge. A nicotine vapor is exhaled from the end, mimicking the behavior of a regular cigarette. E-cigarettes are available in many flavors. The FDA intends to develop regulation for these devices.


  • Hookah: Hookahs, or waterpipes, are largely a social use for tobacco. Groups of people sit around a hookah, and tobacco- usually flavored- is heated, filtered by water, and passed through a hose to a mouthpiece, where it is inhaled, then passed to the next person in the group. Hookah use carries the same health risks for tobacco use and SHS exposure, and additionally carries a risk of communicable disease (herpes, tuberculosis, etc.) through use of the shared mouthpiece, which may not be properly sterilized between uses. Hookah use is especially popular with younger populations, and hookah bars can often be found near college campuses.

    Hookah poster (courtesy of South Florida Area Health Education Center [AHEC])

  • Little cigars and cigarillos: Little cigars are sold in larger packs, and typically come with filtered tips, indicating that they are meant to be inhaled like cigarettes. Little cigars usually contain 1 gram of tobacco, whereas cigarillos are a little larger than little cigars, and typically contain 3 grams of tobacco. The FDA does not yet regulate cigars.

  • Menthol cigarettes: Providing a cool, minty sensation, menthol cigarettes mask the harshness of smoking. Menthol's cooling, numbing properties may permit larger puffs, deeper inhalation or allow smoke to stay in the lungs for a longer period of time, and is used as a local anesthetic to relieve throat irritation. Menthol cigarettes are popular with African American smokers- 83% of African American smokers smoke mentholated cigarettes, compared to only 24% of White smokers. The FDA’s Tobacco Products Scientific Advisory Committee has concluded that removing menthol cigarettes from the market will improve the public health of the U.S., and the FDA is determining whether regulatory actions should be taken.

  • Snuff: Also known as pinch, or dip, snuff is a loose, finely-ground form of tobacco that can be dry or moist, and can be placed between gum and cheek.

  • Snus: A spitless tobacco contained in small, teabag-like pouches, snus is a type of moist snuff. Snus is designed so that there's no need to spit the juices out, as is the case with snuff, so it may be attractive to those who are in smoke-free settings.