Letter: All tobacco a menace, not just cigarettes

EDITOR,
Dr. Terry Hollenbeck’s column on cigarette smoking (“Cigarette smoking drops to record low in California,” Page 14, July 29) was a welcome and useful reminder of the consequences of nicotine use. I would only add that other nicotine delivery systems have equally dire results.
The use of spit tobacco by young people — a particularly pernicious habit — has declined since the 1990s, but recent upticks in use are troubling. Spit tobacco use can lead to gum disease, throat and mouth cancer, and other health problems, and it puts two to three times more nicotine into the body than a single cigarette. While mostly a male and rural drug of choice, it is not uncommon among high school athletes in any area.
Another delivery system, and a growing fad, is the hookah or water pipe. Hookah use increases the negative consequences of smoking by the extended periods of time young people spend using the hookah, ordinarily in group social settings, as well as the dangers of secondhand smoke in such situations. About 20 percent of 12th-graders in the U.S. report use of a hookah in the past 30 days, and about 15 percent of females report the same.
Regardless of delivery system — cigarette, spit tobacco, hookah, cigar — nicotine is a major public health problem. “Generational forgetting”— the tendency of succeeding generations to lose sight of previously identified dangers of certain drugs — may be at work with these recent increases in nicotine use by young people. Continued education and prevention efforts must be sustained in the face of the rigorous marketing efforts of tobacco companies in the U.S.
Bill Brigham, Scotts Valley