Exotic smoking:clove cigarettes, bidis, and hookahs

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Several forms of flavored tobacco have become popular in recent years, especially among younger people. Clove cigarettes (kreteks), bidis, and, more recently, hookahs, often appeal to those who want something a little different. They also provide young people with another way to experiment with tobacco. The false image of these products as clean, natural, and safer than conventional cigarettes seems to attract some young people who may otherwise not start smoking. But these products carry many of the same risks of cigarettes and other tobacco products and each has its own additional problems associated with it.

Clove cigarettes, also called kreteks, are imported mainly from Indonesia and contain 60% to 70% tobacco and 30% to 40% ground cloves, clove oil, and other additives. The chemicals in cloves have been implicated in cases of asthma and other lung diseases. Users often have the mistaken notion that smoking clove cigarettes is a safe alternative to smoking tobacco. But they are a tobacco product with the same health risks as cigarettes and, in fact, have been shown to deliver more nicotine, carbon monoxide, and tar than conventional cigarettes.

Bidis or "beedies" are flavored cigarettes imported mainly from India. They are hand-rolled in an unprocessed tobacco leaf and tied with colorful strings on the ends. Their popularity has grown in recent years in part because they come in a variety of candy-like flavors such as strawberry, vanilla, and grape, they are usually less expensive than regular cigarettes, and they often give the smoker an immediate buzz.

Even though bidis contain less tobacco than regular cigarettes, they have higher levels of nicotine (the addictive chemical in tobacco) and other harmful substances such as tar and carbon monoxide. Because they are thinner than regular cigarettes, they require about 3 times as many puffs per cigarette. They are also unfiltered. Bidis appear to have all of the same health risks of regular cigarettes, if not more. Bidi smokers have much higher risks of heart attacks, chronic bronchitis, and some cancers than nonsmokers.

Hookah (or narghile) smoking, which started in the Middle East, involves burning flavored tobacco in a water pipe and inhaling the smoke through a long hose. It has recently become popular among young people, especially around college campuses. Hookah smoking is usually a social event that allows conversation to take place among the smokers as they pass the shared pipe around. It is marketed as being a safe alternative to cigarettes because the percent of tobacco in the product smoked is low. This claim for safety is false. The water does not filter out many of the toxins, and hookah smoke contains varying amounts of nicotine, carbon monoxide, and other hazardous substances. Several types of cancer have been linked to hookah smoking. Hookah is also linked to other unique risks not associated with cigarette smoking. For example, infectious diseases can be spread by pipe sharing or the uncontrolled, manual preparation of the tobacco used.

All forms of tobacco are dangerous. Even if the health risks were smaller for some tobacco products as opposed to others, all tobacco products contain nicotine, which can lead to increased use and addiction. Tobacco cannot be considered safe in any amount or form.

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