Types of Tobacco Products

E-cigarettes and other electronic nicotine delivery systems (ENDS) are tobacco products that allow a user to inhale an aerosol containing nicotine and other substances. They are not FDA-approved quit-smoking devices.

For more information, visit our MDHHS All About E-Cigarettes webpage (www.michigan.gov/e-cigarettes).

The IQOS was introduced in June 2014 by Philip Morris.The IQOS is an electronic device, touted as a "heat-not-burn" product.

Heat-not-burn tobacco products heat tobacco and produce an inhalable aerosol, instead of burning tobacco like traditional cigarettes. Heat-not-burn products use real tobacco, not the flavored liquid nicotine typically found in e-cigarettes. "Heatsticks," which look like mini cigarettes, are inserted inside.

The Food and Drug Administration recently authorized this product for sale in the United States. While this action permits the product to be sold, it does not mean these products are safe or "FDA approved" — there are no safe tobacco products.

Spit tobacco and snuff are readily available throughout Michigan in candy flavors including mint, cinnamon, apple, berry, citrus, cherry, and peach.

Snus, a moist form of smokeless tobacco, typically is offered in small pouches similar to tea bags and is held in the mouth, either behind the upper lip or between the cheek or teeth and the gums.

First developed in Sweden, snus are a "spit-free" form of tobacco and have been marketed aggressively in the United States as an alternative nicotine-delivery system in smoke-free environments. American snus are available in a variety of flavors, including spearmint, wintergreen, vanilla, and various fruits.

The fact that snus and, indeed all of today's smokeless tobacco products, can be purchased in a range of flavors helps make these products more attractive to youth who might otherwise not use them.

Despite the marketing campaigns, though, it is important to remember that all smokeless tobacco — no matter what form it takes — poses health risks and has been associated with oral, esophageal, stomach, and pancreatic cancers.

Hookah smoking involves using a water pipe or shisha to pass tobacco smoke through water or a distilled alcoholic beverage, such as vodka, before it is inhaled. Different flavors, such as apple, mint, cherry, chocolate, coconut, licorice, cappuccino, and watermelon, are available.

In an hour-long hookah session, a smoker can inhale 100-200 times the volume of smoke inhaled from a single cigarette. The charcoal used to heat the shisha also can increase health risks by exposing the user to high levels of carbon monoxide, metals, and cancer-causing chemicals and by exposing both users and non-users to the carcinogens in secondhand smoke that remains in the area.

Because hookah smoking is typically done in groups, passing the same mouthpiece from person to person in the group, there are special concerns related to hookah use, including the risk of transmitting tuberculosis, herpes, and/or hepatitis and other infectious diseases.

Research shows that hookah smokers are at risk for oral, stomach, lung, and esophageal cancers, reduced lung function, and decreased fertility.

Read more about hookah in the MDHHS Position Statement on Hookah Use.

Large cigars, cigarillos, and little cigars are readily available, come in a vast array of fruit and candy flavors, and are sold individually, often for as little as 25 cents each. All those factors can make them attractive to youth.

Large cigars, which do not include a filter, can deliver as much as 10 times the nicotine, twice the tar, and more than five times the carbon monoxide than a filtered cigarette. Cigarillos, wihch are three to four inches long and more narrow, may or may not include a filter. Little cigars, which are about the size of a cigarette, typically do have a filter.

Dissolvable products are made either of nicotine gel, such as Nicospan, or of finely ground tobacco pressed into a lozenges, sticks, strips, orbs. They can look like candy or small mints and are marketed in a variety of flavors.

The fact that they are made to dissolve slowly in the mouth means they are more easily concealed, because the user does not have to spit or dispose of any leftover portion of the product after use.

Because they are used orally and involve swallowing tobacco juice, there is increased concern about the possibility of oral, esophageal and stomach cancers arising among long-term users.