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Page 1: SPIT THIS! - GVLIBRARIES.ORG Spit This.pdf · Spit thiS!the hazardS of SmokeleSS tobacco 2 human relationS media After viewing Spit This!The Hazards of Smokeless Tobacco and participating

8123DV

ISBN-13: 978-1-55548-810-9

SPIT THIS! The Hazards of Smokeless Tobacco

DVD Version

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Executive ProducerAnson W. Schloat

ProducerScott Sniffen

ConsultantsMargaret Drozowski Maule, DMD

Community Health Center, New Britain, CT

Maryellen Bolcer, Health Promotion Specialist St. Vincent’s Teen Smoke Stoppers

St. Vincent’s Medical Center, Bridgeport, CT

Teacher’s Resource BookElizabeth Hoover

Spit thiS! the hazardS of SmokeleSS tobacco

Credits

Copyright 2010 Human Relations Media, Inc.

human relationS media Spit thiS! the hazardS of SmokeleSS tobacco

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DVD Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Learning Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Program Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Student Activities

1. Pre/Post Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

2. The Power of Addiction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

3. Life Without Your Tongue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

4. To Spit or Not to Spit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

5. Macho Marketing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

6. Sean’s Story . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

7. You Versus Big Tobacco . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

8. Consequences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

9. Class Debate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Fact Sheets 1. Spit Tobacco FAQs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

2. Smokeless Tobacco and Nicotine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

3. What’s in Smokeless Tobacco? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

4. Oropharyngeal Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

5. Tricks of the Trade . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

6. Reasons Not to Use Smokeless Tobacco . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

7. Facing the Pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

8. Quit the Dip . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

9. Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

10. Internet Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

Other Programs from Human Relations Media . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Spit thiS! the hazardS of SmokeleSS tobacco

table of Contents

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MAIN MENU

➤ Play

➤ Chapter Selection

From here you can access many different paths of the DVD, beginning with the introduction and ending with the credits.

1. Introduction

2. Effects of Smokeless Tobacco

3. Oral Cancer

4. Andrew M. Weiner

5. Gruen Von Behrens

6. Snus

7. Wrap-Up

➤ Teacher’s Resource Book

A file of the accompanying Teacher’s Resource Book is available on the DVD. To open the file you need to load the DVD onto a computer that has a DVD-ROM and Adobe Acrobat Reader. Right click on the DVD icon and then double click on the file titled “Teacher’s Resource Book.”

i

Spit thiS! the hazardS of SmokeleSS tobacco

dVd Menu

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human relationS media Spit thiS! the hazardS of SmokeleSS tobacco1

As cigarette sales decline and no-smoking laws continue to expand across the nation, the tobacco industry is responding with new creative ways to lure new customers. Smokeless tobacco products are back in the spotlight these days, including many new products aimed at first-time users and young people.

Big Tobacco’s increase in marketing in this area seems to be paying off. A report from the U.S. Substance Abuse and Mental Health Services Administration suggests that between 2002 and 2007, smokeless tobacco use among adolescent boys increased 30 percent.1 Nearly one in eight boys in twelfth grade is a current user of smokeless tobacco.2

Spit tobacco is not the only product being hyped these days. Some of the new smokeless tobacco products involve spitless tobacco in the form of small pouches, pellets or toothpicks. Users may swallow tobacco juice rather than spitting it out. In the shadow of increasing public smoking bans, these products are sure to find a strong market, which is precisely what the tobacco companies are hoping.

Today, tobacco companies are promoting smokeless tobacco products in a new, insidious way: as a safer alternative to cigarettes. But studies show that the nicotine content in a can of dip or snuff is approximately the equivalent of four packs of cigarettes. Snuff is also known to have higher levels of cancer-causing nitrosamines than cigarette smoke—up to ten times higher in some cases. In terms of nicotine, one can of snuff or dip contains the equivalent nicotine content as four packs of cigarettes.3 In addition, recent data reveals that 85.8 percent of adolescents who had used smokeless tobacco products in the past month had also used cigarettes at some time in their lives.4

It is vital for educators to understand the risks associated with these new smokeless and spitless tobacco products. Like all tobacco products, they will be unregulated by the Food and Drug Administration. Although new legislation has been proposed to require all tobacco products to be treated as pharmaceuticals, the tobacco industry still has a great deal of power in Washington and in the American marketplace.

Spit This! The Hazards of Smokeless Tobacco provides a thorough overview of these dangerous new products, along with traditional smokeless tobacco products that continue to be popular—especially with young males. The program illustrates how smokeless tobacco products damage the body and stresses the importance of avoiding all use. Current users are encouraged to reclaim their lives by quitting. Students will learn that refusing tobacco in all its forms is one of the most important steps they can make toward a healthy life.

1 2007 National Survey on Drug Use & Health, <http://www.oas.samhsa.gov/nsduh.htm>

2 2008 Monitoring the Future Study, <http://monitoringthefuture.org/pubs/monographs/overview2008.pdf>

3 National Spit Tobacco Education Program <http://www.nstep.org/WhatYouNeedtoKnow.htm>

4 Study Finds Jump in Smokeless Tobacco Use Among Adolescent Boys, Robert Wood Johnson Foundation. <http://www.rwjf.org/publichealth/digest.jsp?id=9815>

Spit thiS! the hazardS of SmokeleSS tobacco

introduCtion

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After viewing Spit This! The Hazards of Smokeless Tobacco and participating in the class activities included in this Teacher’s Resource Book, your students will be able to:

➤ describe how nicotine affects the human brain and causes addiction

➤ identify several of the newer spitless, smokeless tobacco products that are currently being marketed as an alternative to smoking

➤ understand the serious physical risks of using any type of smokeless tobacco

➤ list some of the toxic chemicals found in smokeless tobacco

➤ describe how smokeless tobacco affects a user’s outward appearance

➤ detail how smokeless tobacco is linked to diseases like oral cancer, heart disease and stroke

➤ describe the short-term health consequences of smokeless tobacco use

➤ identify the ways that tobacco companies target young people as potential consumers

➤ confidently deal with peer pressure to use smokeless tobacco

➤ take steps to quit using smokeless tobacco or help a friend quit

Spit thiS! the hazardS of SmokeleSS tobacco

learning objeCtiVes

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As the program opens, we see facts and images related to chewing tobacco. Taylor, a former tobacco chewer and high school student, narrates. He explains that the use of chewing tobacco dates back to 1 BC. Today’s smokeless tobacco, he says, is growing in popularity because some people think it’s safer than cigarettes.

We move to a studio setting, where Taylor is delivering his information on camera. As fellow student Natasha gives him pointers, Jimmy enters. Jimmy is chewing tobacco and spitting the juice into a cup. Turned off by Jimmy’s nasty habit, Taylor and Natasha ask him to help with the video they’re producing.

When Natasha asks Jimmy to load a tape, Jimmy is horrified by what he sees on screen—graphic images of oral tumors and post-op surgeries of the mouth. Jimmy tries to leave, but Taylor and Natasha convince him to stay. More photos and clips of various mouths appear on screen. Jimmy calls the images “propaganda,” saying, “That’s not going to happen to me. I’m only going to be doing this for a few years.” In response, Natasha shows him a study proving that spit tobacco is just as addictive as cigarettes because both contain nicotine.

Later that day, the students work together to edit footage about oral cancer. Taylor’s narration explains that spit tobacco can cause cancers that permanently disfigure the face and cause tooth loss. Spit tobacco users face a higher risk of many forms of cancer, including lip, tongue, mouth, esophagus and stomach cancer.

Taylor’s narration goes on to explain why spit tobacco is so dangerous. He discusses many of the cancer-causing ingredients, including benzopyrene, uranium 235, polonium 210, formaldehyde and lead. Michael, a former spit tobacco user, says he thought it was safe because he wasn’t breathing smoke or swallowing the juice. “When you first start dipping,” he says, “you get this five minute buzz. When you starting doing it on a day-to-day basis, there’s no buzz. You’re just addicted, and you don’t even know why you’re doing it anymore.”

Dr. James Bauer, a dentist, and Ellen Eisenberg, an oral pathologist, explain how the juices in spit tobacco cause cancer. They describe how constant contact with mouth tissues causes irregular cell growth and white patches called leukoplakia. Susan R. Richards, Health Promotion Specialist, goes on to describe how blood vessels carry the ingredients in spit tobacco throughout the body. “The types of cancer this causes,” she says, “are some of the worst cancers to treat.” She mentions stomach and pancreatic cancer as two examples.

We also hear from Andrew M. Weimer, a pitcher for the Bridgeport Bluefish. He says many of his fellow players use spit tobacco. Andrew was offered spit tobacco by some teammates, but turned it down. He finds the habit disgusting, adding, “I never met a girl who liked it.”

Jennifer enters the editing room and Jimmy takes an interest in her. When Jennifer sees the spit cup, she runs out of the room—sick to her stomach. After this, Taylor finally convinces Jimmy to get rid of the tobacco in his mouth.

Spit thiS! the hazardS of SmokeleSS tobacco

PrograM suMMary

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Afterward, Natasha cues up footage of an interview with Gruen Von Berhen, a young man who developed cancer after using spit tobacco. His jaw, teeth and most of his tongue were removed—leaving him terribly disfigured. Gruen explains how his tongue was nearly split in half by the cancer, how he endured thirteen hours of surgery and hundreds of other treatments. He describes painful radiation therapy and being unable to eat for weeks.

As the interview continues, we see Jimmy’s horrified reaction. He finally takes the tobacco out of his pocket, throws it away and leaves the room.

Later that day, Jimmy returns to show Natasha and Taylor a smokeless tobacco product called snus. “It’s the perfect healthy alternative,” he says. In response, Taylor plays another part of the Gruen interview. Gruen explains that snus are no safer than other kinds of smokeless tobacco. We also hear the experts explain why snus are actually more dangerous than spit tobacco. Many users swallow the pouch, creating a completely new layer of health issues. Afterward, Natasha reminds Jimmy that Gruen was only seventeen when he was diagnosed with cancer.

Taylor explains that the tobacco industry spends hundreds of millions of dollars each year to promote their products. In efforts to replace users who quit or die, the tobacco makers develop new products. Snus, Taylor explains, is one of their latest attempts.

Taylor tells Jimmy that it was hard for him to quit spit tobacco, but he succeeded with the help and support of his friends. Experts offer thoughts on how to quit, including help from doctors, dentists, school staff and local community programs. They stress that the best way to prevent addiction is never to start. Gruen adds, “I haven’t had a dip in 13 years, but the cravings still come.” He says placing dip in his mouth was the biggest mistake of his life.

As the video is finally finished, Jimmy vows to chew only gum. He plans to join a tobacco support group and quit spit tobacco for good.

Spit thiS! the hazardS of SmokeleSS tobacco

PrograM suMMary Continued

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STUDENT ACTIVITIES

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activity 1a

Pre/Post test

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Name: _____________________________________

1. ___________ are small teabag-like pouches of smokeless tobacco that have recently been introduced to the U.S. market.

a) snus b) lozenges c) plugs d) chaw

2. White, leathery patches that most often occur where tobacco is placed in the mouth are called:

a) carcinogens b) nitrosamines c) leukoplakia d) mutagens

3. Oral cancer is cancer of the: a) mouth b) gums c) tongue d) all of the above

4. Of those diagnosed with oral cancer, only ___________ will survive five years. a) 10 percent b) 25 percent c) 50 percent d) 75 percent

5. Spit tobacco can cause the gums to recede and bleed, eventually leading to: a) severe headaches b) indigestion c) tooth loss d) irregular cell growth

6. For smokeless tobacco users, the risk of cancer to the cheek and gum is nearly ___________ times greater than non-users.

a) 10 b) 20 c) 25 d) 50

7. People who consume eight to 10 dips per day are getting as much nicotine as a smoker who smokes ___________ cigarettes per day.

a) five to 10 b) 10 to 20 c) 30 to 40 d) 50 to 100

8. Oral cancer can happen to people in their: a) teens b) 20s c) 30s d) 40s

9. Smokeless tobacco contains polonium 210, which is found in: a) car batteries b) embalming fluid c) nuclear waste d) rat poison

10. The _______________ system carries the ingredients of spit tobacco throughout the body, where they can cause cancer in organs like the stomach and pancreas.

a) nervous b) circulatory c) endocrine d) immune

The Answer Key appears on the next page.

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activity 1b

Pre/Post test

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Answer Key

1. a

2. c

3. d

4. c

5. c

6. d

7. a

8. a

9. c

10. b

Name: _____________________________________

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Nicotine is more addictive than heroin or cocaine.1 Yet for decades, tobacco executives have said that nicotine is no more addictive than foods like candy, potato chips or hamburgers.2 In 1997, a tobacco executive said cigarettes are no more addictive than gummy bears!3 Of course, that’s ridiculous, but it might help you to understand a few things about the tobacco industry’s efforts to keep consumers from knowing the truth about their products. It may also shed some light on the power of addiction in human beings. For people who have never been addicted to tobacco, try this experiment as a way to approximate what a tobacco user might feel, related to addiction.

PART ONE: Think of your favorite food. Close your eyes and imagine this food as vividly as you can. What does it look like? What does it smell like? What is the texture like when you take a bite? How does it taste? Imagine you can take only one bite of your favorite food, but you have to look at it and smell it for an hour. Now imagine this feeling multiplied by 100! Remember, nicotine in all its forms has been determined to be more addictive than cocaine or heroin. Describe how this might feel.

PART TWO: Now imagine that a company discovered an addictive chemical in your favorite food. What if the company used laboratory experiments to increase this addictive chemical? What if they did this, even though they knew the food contained dozens of deadly ingredients that could shorten your life? Would you buy or eat the food? Explain your answer.

1 <http://whyquit.com/whyquit/LinksAAddiction.html>

2 The Verdict Is In: Findings from the United States vs. Philip Morris, Tobacco Control Legal Consortium, page 3.

3 Legacy Tobacco Documents Library. Philip Morris Collection. April 17, 1997. page 78. <http://legacy.library.ucsf.edu/tid/hkd38d00>

activity 2

the Power of addiCtion

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Name: _____________________________________

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activity 3

life without your tongue

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Name: _____________________________________

Many famous people have been diagnosed with oral cancer—for instance, Grover Cleveland, General Ulysses S. Grant, Babe Ruth, Sigmund Freud, All-Star outfielder Brett Butler, NASCAR driver Bobby Hamilton, legendary rock guitarist Eddie Van Halen. Many of these men had to endure radiation as well as extensive surgeries to remove a portion—or all—of their tongues. (Consult <http://www.oralcancerfoundation.org/people/arts_entertainment_people.htm> for more details.)

Most of us don’t spend much time appreciating our tongues. But what would life be like without them? Smokeless tobacco users have a much higher risk of getting cancers of the mouth and gums than nonusers. Sadly, many patients lose large portions of their tongue, jaws and cheeks in an attempt to remove the fast-growing, deadly tumors.

NOTE: The first activity should be done in class with a partner. The others can be done at home.

1. Start by washing your hands or cleaning them with a waterless hand sanitizer. Choose a random sentence from a book, but don’t show the sentence to your partner. Read the sentence aloud to your partner while firmly holding your tongue between your fingers.

Was your partner able to understand what you were saying? How did it feel to communicate without the benefit of your entire tongue?

2. Choose a simple snack food, such as a cracker. Make sure the snack is something you enjoy eating. Before taking a bite, firmly pinch your nostrils closed. Keep your nose pinched as you take a bite and chew the food. Do not release your nose until you have swallowed the bite.

How did the food taste? What would eating be like without the benefit of your taste buds? What if everything you ate, day after day, tasted like nothing?

3. A tongue amputation often includes the loss of certain muscles that keep the mouth closed and help us with facial expressions such as smiling. What would your face look like if these muscles were removed? Imagine going on a job interview or a big date.

What would it be like to be unable to show emotions? How would you feel about your appearance?

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activity 4

to sPit or not to sPit

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Form small groups with your classmates. After you have read the Facing the Pressure fact sheet, choose one of the scenes below to act out for your classmates. Discuss what the characters in your scene might do or say. Talk about the possible consequences of these choices. Write dialogue for each character and practice it. Perform your scene for the class. Ask your classmates for feedback. Which responses worked well? Which did not? Which ones would you use?

Scene OneYour younger brother is a great baseball pitcher. This season, he moved up to the varsity team. He has some new friends and he spends a lot of time with them. At a game, you notice that your brother’s lower lip is bulging out in a strange way. When you ask him about it, he says it’s just bubble gum. Later you find a spit cup in his room. It stinks like tobacco juice. Your uncle died of throat cancer after using spit tobacco, and you’re worried your brother will become hooked on it, too. What do you do?

Scene TwoYou’re at a party with the guy (or girl) you really like. You’ve been waiting for a chance to hang out together all year. You notice two other couples at the party sharing a tin of chew. Yuck, you can’t stand that stuff! You are shocked when your dream date offers to share some chew with you. You can’t imagine what it would be like to kiss someone with a mouth full of that smelly black stuff. Maybe it would be easier if both people were chewing. Is that why the other couples are sharing? How bad could it be to try it just once? After all, you don’t want to ruin your chances of having another date. What do you do?

Scene ThreeAfter many long and hard tryouts, you finally make the school baseball team. At practice, you notice some of the other guys chewing tobacco. They say it helps them concentrate and relax. You really want to do well on the team. Maybe chewing could help you focus, too. And it’s not like smoking cigarettes. You’d never do that to your lungs. What do you do?

Scene FourKyle and his older brother invite you to a professional car race. They pay for your ticket, your soda, everything! When you arrive at the stands, Kyle’s older brother takes out some snus pouches. He offers you one, joking that it’s part of a grand initiation into their family. You love hanging out with them, and you don’t want to seem ungrateful after they have been so generous with you. But you really don’t want one. What do you do?

Name: _____________________________________

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activity 5

MaCho Marketing

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Despite the historic 1998 tobacco settlements that required tobacco companies to drastically change the way they promote their products to consumers, little has changed for the spit tobacco business. The main producers of smokeless tobacco continue to be promotional sponsors of professional motor sports, rodeos and bull-riding competitions. In addition, scores of tobacco-chewing baseball players continue to act as unpaid advertisements for spit tobacco each time they appear in a televised game.

PART ONE: Read the fake taglines below. On the back of this page, answer the questions that follow each tagline.

1. Introducing Cyan-Ara, the new spitless cyanide pouch. It delivers more of what you want. Quickly. Privately.

Tobacco companies certainly don’t want to advertise that cyanide is an ingredient in their product. But they are advertising new products that allow people to suck on pouches of smokeless tobacco without spitting. In a world where cigarette smoking is becoming more restricted, how would this kind of marketing be profitable for tobacco companies? Do you think this kind of product might help someone stop smoking? How might it increase users’ health problems?

2. Hydrazine Silver Cup Finals, brought to you by Hydrazine Snus. Only a tough guy would suck on rocket fuel!

Would you attend an event sponsored by a deadly product? How would you feel about cheering on a racing team sponsored by a serial killer? How do you feel about events sponsored by Big Tobacco, an industry whose product kills half a million people in the U.S. every year?

3. “Nitrosamine Nuggets help me get through the big games. I just chew on a few for pure cancer-causing enjoyment. I’m not afraid of a little chemo!” Marty “Big Man” Connor, Catcher for the Redhill Roadkills

Do you think being tough is related to the decision to use smokeless tobacco? Explain your answer.

PART TWO: With your classmates, come up with your own twisted ad campaign for an imaginary smokeless tobacco product. Consult the What’s in Smokeless Tobacco? fact sheetfor ideas.

Name: _____________________________________

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PART ONE: Read the true story below, then proceed to Part Two.

PART TWO: Choose one of these topics and write a two-page essay about Sean Marsee.

1. Imagine that Sean refused the chew that he was offered when he was 12. What would his life have been like seven years later, in college? Write a brief article that might have appeared in his college newspaper’s sports section after one of Sean’s track meets.

2. Imagine you were Sean’s best friend in the eighth grade. At that time, he had only been using spit tobacco for a few months. Write a letter to Sean, telling him why he should stop.

3. Imagine Sean’s adult life without smokeless tobacco. Write a new ending to his story. Include information about his career, hobbies, family and home.

NOTE: A more extensive version of Sean’s story—and photos of him before and after surgery—can be found at <www.whyquit.com/whyquit/SeanMarsee.html>

activity 6

sean’s story

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Name: _____________________________________

Sean Marsee was a high school athlete who enjoyed playing many sports. He was an exceptional runner, winning 28 medals in track and field. When he was 12, a teammate offered Sean some spit tobacco. Sean had seen some of his sports idols using spit tobacco on television, so he decided to try it.

Within a few weeks, Sean was using tobacco at every track meet. By junior high, he was using it every day. Sean knew that smoking or drinking alcohol was unhealthy, but he didn’t see anything wrong with using spit tobacco. After all, many professional athletes had been using it for years.

Sean’s mother begged him to stop using spit tobacco, but he didn’t listen. When he was 17, Sean developed a painful sore on his tongue.

Doctors performed a biopsy and discovered a large, cancerous tumor beneath the sore. Despite chemotherapy treatments and surgeries, Sean’s cancer continued to spread. He endured more surgeries as doctors removed his tongue, jawbone and muscles in his neck—all of which were riddled with cancer.

Sean was disfigured and in enormous pain. Shortly before his death, he became unable to speak. A friend asked Sean if there was anything he wanted to share with other young athletes. With pencil in hand Sean wrote, “Don’t dip snuff.” Soon after, at the age of 19, Sean Marsee died.

Before picture

After picture

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activity 7

you Versus big tobaCCo

human relationS media Spit thiS! the hazardS of SmokeleSS tobacco12

From 1998 to 2005, the top five smokeless tobacco companies in the United States increased their advertising budgets by 72.4 percent.1 In 2005, these smokeless tobacco companies spent more than $250.7 million to advertise and market their products.

In more recent years, producers of smokeless tobacco products have become even more aggressive in their efforts to attract a new generation of customers. New types of smokeless—and even spitless—tobacco continue to flood the market. There are snus (oral tobacco pouches banned all over Europe except for Sweden), nicotine strips, nicotine pellets and even nicotine toothpicks!

What does this mean? It means that you, your peers and even those who are younger than you are going to be the next targets of Big Tobacco. Now’s your chance to help others avoid being hooked on a habit that could cost them their lives. What would you say to a friend or family member who has just started using smokeless tobacco? How would you express your feelings about the person’s habit? Could you say things that show your support, while making it clear that you want the person to stop?

Use this space to write a letter to someone you know who uses smokeless tobacco. If you don’t know someone who uses it, imagine you do. Use the tips on the Quit the Dip fact sheet for guidance. Remember to use respectful, honest thoughts.

1 Federal Trade Commission (FTC), Federal Trade Commission Smokeless Tobacco Report for the Years 2002- 2005, 2007, <http://www.ftc.gov/reports/tobacco/02-05smokeless0623105.pdf>

Name: _____________________________________

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activity 8

ConsequenCes

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Addiction is an up-and-down cycle of physical and emotional changes. It’s well documented that nicotine is more addictive than heroin or cocaine.1 Check out the Smokeless Tobacco and Nicotine fact sheet to learn more. Use what you know about addiction to write an ending for each story below. Be sure to consider the emotional, social, legal and physical consequences for the people using smokeless tobacco.

1.

At night, Cory started sneaking smokeless tobacco from his dad’s dresser. Before long, he was craving it during the day, too. One morning, Cory stole some money from his dad’s dresser so he could buy some smokeless tobacco. His dad walked in just as Cory was shoving the money into his pocket.

What happens next? What are the consequences?

2.

Gabe was the best center that his school’s basketball team ever had. He set lots of new records and helped his team go to the state finals. On the court, Gabe also had a secret habit of using snus. A single pouch could take him through a whole game. At the state championship, Gabe was heading out of the locker room when he realized his container of snus was missing. He didn’t have time to find more. Gabe panicked, his mind racing with doubt and anxiety about playing the big game without his usual dose of tobacco.

What happens next? What are the consequences?

3.

Toby had been hooked on spit tobacco for three years. His girlfriend Kara told him he had to quit. She threw away every container of tobacco she could find. Toby cared about Kara, but his addiction was making him have terrible mood swings. When he met Kara after school, his hands were shaking and his head was pounding. Withdrawal from tobacco was making him want to smash everything he saw. He told her he was going to the store to buy more spit tobacco. She threatened to break up with him if he did.

What happens next? What are the consequences?

4.

Kate had a crush on Sid, an older teen who worked on a horse farm. To impress Sid, Kate learned how to ride a horse and use a lasso. Some of the guys at the farm used spit tobacco, so she decided to try that, too. She thought Sid would be impressed with her new cowboy skills. When they saw each other one afternoon, Sid said, “What’s that gross stuff in your mouth? You’re not dipping, are you?”

What happens next? What are the consequences?

1 <http://whyquit.com/whyquit/LinksAAddiction.html>

Name: _____________________________________

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activity 9

Class debate

human relationS media Spit thiS! the hazardS of SmokeleSS tobacco14

Divide the class into two equal groups. One group must argue yes, and the other group must argue no. Each side must support its position with facts and valid arguments.

Choose one of the following debate topics, or create one of your own in the space below.

1.Considering that the FCC has outlawed all tobacco commercials on television, should auto races, rodeos and other televised sports events be prohibited from showing any tobacco logos? Why or why not?

2.Spit tobacco is extremely addictive and harmful for anyone who uses it. But unlike smoking, there are no physical dangers for others in the vicinity of the tobacco user. There’s no such thing as “secondhand spit,” after all. Should chewing tobacco in public places be outlawed? Why or why not?

3.

Tobacco companies are becoming more aggressive about creating and marketing certain “nicotine delivery systems” that provide users with a jolt of nicotine without any sidestream smoke or messy spit juice to offend others. The manufacturers claim that these products can be used safely by people who want to cut down or quit smoking. Is this legitimate and reasonable? Why or why not?

Name: _____________________________________

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FACTSHEETS

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fact Sheet 1

sPit tobaCCo faqs

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What is smokeless tobacco? Smokeless tobacco comes in two basic forms, snuff and chewing tobacco. Several other alternative forms of smokeless tobacco are also on the market, and more will likely be developed in the future.

Snuff is finely-ground tobacco packaged in cans or pouches. It is sold in two forms: dry and moist. Moist snuff is used by placing a “pinch” or “dip” between the lower lip or cheek and gum. Nicotine is absorbed through the tissues of the mouth. Moist snuff is also available in small, teabag-like pouches or sachets that can be placed between the cheek and gum. Dry snuff is sold in a powdered form and is used by sniffing or inhaling the dry snuff powder up the nose.

Chewing tobacco comes in the form of long strands of loose leaves, plugs or twists of tobacco. Portions of this, commonly called “plugs,” “wads,” or “chew,” are chewed or placed between the cheek and gum or teeth. Nicotine is absorbed through the mouth tissues. The user spits out the brown juice—saliva that soaked through the tobacco.

Alternative smokeless tobacco products come in many forms. Snus (sounds like “snoose”) is a form of moist snuff commonly used in Sweden but banned in the rest of the European Union. It is now being marketed in the United States. It is made of air-cured tobacco, water, salt and other flavorings. It has less tobacco-specific nitrosamines than most smokeless products used in the U.S. because the tobacco is not fermented. (Tobacco-specific nitrosamines are chemicals known to cause cancer.) Snus is most commonly packaged in small pouches, but can also be used like loose moist snuff.

Other smokeless products are being developed and marketed in the United States. These are designed to be both “smoke-free” and “spit-free” and are marketed as a discreet way to use tobacco. These include tobacco lozenges and dissolvable products (shaped like toothpicks, pellets or strips) that melt in a user’s mouth and deliver a strong dose of nicotine.

What are the dangers?About 70 percent of smokeless tobacco users get leukoplakia—white, leathery patches that are sometimes, but not always, painful. Leukoplakia is a pre-cancerous condition that occurs in the spots where tobacco is placed in the mouth.

Leukoplakia can develop into oral cancer. According to the Centers for Disease Control, about 30,000 Americans are diagnosed with oral cancer every year. Oral cancer can include cancer of the mouth, lips, tongue, cheeks or gums. Compared to some other types of cancer, oral cancer can spread quickly. One in three people diagnosed with oral cancer will die from it.1 The longer you use oral tobacco, the more likely you are to have leukoplakia.

The toxic ingredients in the tobacco also increase the risk of cancer in the stomach, esophagus, pancreas and bladder.

Other side effects of smokeless tobacco include a lowered sense of taste and smell, bleeding lips and gums, tooth loss, increased heart rate, higher blood pressure and a greater risk of heart attacks and stroke. 1 The Health Consequences of Using Smokeless Tobacco: A Report of the Surgeon General. United States Public Health Service, Bureau of Maternal and Child Health and Resources Development, Office of Maternal and Child Health, NIH Publication No. 86-2874, April 2006.

Name: _____________________________________

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fact Sheet 2

sMokeless tobaCCo and niCotine

human relationS media Spit thiS! the hazardS of SmokeleSS tobacco16

Name: _____________________________________

Nicotine is a highly addictive drug found naturally in all forms of tobacco. When a person uses smokeless tobacco, nicotine enters the bloodstream from the tissues inside the mouth. From there, the nicotine is carried throughout the body. Within seconds, it affects the heart, blood vessels, hormones, metabolism, brain and nervous system.

Nicotine causes pleasurable feelings that make the tobacco user want to use more. As the body adapts to nicotine, the user must ingest higher levels of nicotine to get the same effect. This is called tolerance.

Many spit tobacco products include added sweeteners that are attractive to young users. Beginning users eventually graduate to products that contain higher doses of nicotine once they have become regular users.

Smokeless tobacco delivers a high dose of nicotine. An average dose of snuff delivers 3.6 milligrams and an average dose of chewing tobacco delivers 4.5 mg. This is compared to 1.5 mg delivered by smoking one cigarette. According to the National Institutes for Health, holding an average-size dip in the mouth for just 30 minutes can deliver as much nicotine as smoking three cigarettes.

WithdrawalIf a smokeless tobacco user stops or uses less, nicotine withdrawal begins. This withdrawal can be just as difficult to manage as withdrawal from smoking cigarettes. Withdrawal from nicotine is both physical and mental.

Withdrawal can happen to someone who has only been using smokeless tobacco for a few weeks. Symptoms usually start within a few hours of the last dip or chew and peak about two to three days later. Withdrawal symptoms can last from a few days to up to several weeks. Symptoms can include:

➤ nervousness ➤ feelings of frustration or anger ➤ trouble concentrating ➤ headache ➤ sweating ➤ trouble sleeping ➤ pounding heart ➤ shakiness ➤ loss of energy ➤ depression ➤ excessive hunger ➤ nausea ➤ digestive problems

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fact Sheet 3

what’s in sMokeless tobaCCo?

human relationS media Spit thiS! the hazardS of SmokeleSS tobacco17

Smokeless tobacco contains 28 carcinogens (cancer-causing ingredients) and dozens of other harmful chemicals. This is just a partial list.

➤ Abrasives—materials that can wear down the surfaces of the teeth. If the abrasives rub against the soft tissues of the mouth, an even larger amount of nicotine is passed directly into the bloodstream.

➤ Ammonia—added by tobacco companies to increase the addictive qualities of nicotine

➤ Arsenic—a lethal poison

➤ Cadmium—a carcinogen used in car batteries

➤ Cyanide—a lethal poison

➤ Formaldehyde—a chemical found in embalming fluid, which is used to preserve dead bodies

➤ Lead—a nerve poison

➤ Nicotine—a drug that alters the brain and causes addiction. Holding an average-size dip in the mouth for just 30 minutes can deliver as much nicotine as smoking three cigarettes.

➤ Nitrosamines—carcinogens formed during the growing, fermenting and aging of tobacco. Levels of nitrosamines in snuff are ten times greater than those found in cigarettes and 100 times greater than the Food and Drug Administration allows in food products.

➤ Polonium 210—a carcinogen found in nuclear waste

➤ Salt—added to improve the taste of tobacco. Salt can damage the kidneys and cause high blood pressure.

➤ Sweeteners—used to improve tobacco’s bitter taste. Sweeteners can increase the rate of tooth decay caused by smokeless tobacco.

Name: _____________________________________

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fact Sheet 4

oroPharyngeal CanCer

human relationS media Spit thiS! the hazardS of SmokeleSS tobacco18

Spit tobacco users do not inhale carbon monoxide and tar the way smokers do, but they still swallow nicotine and many toxic cancer-causing chemicals. When you consider that spit tobacco introduces ten times more cancer-causing agents into the bloodstream than cigarettes, it’s clear that chewing tobacco users are putting their health on the line with each dip.

In fact, the rate of oral cancer in spit tobacco users is four times higher than in nonusers. The risk of oral cancer among those who use spit tobacco increases 50 percent with cases of long-term use. One in three people diagnosed with oral cancer die from it.

Below are some of the physical warning signs that your body is being damaged by spit tobacco. If you have any of these symptoms, see a doctor as soon as possible.

➤ Lumps in jaw or neck area

➤ Color changes on the inside of the lips

➤ Lumps inside lips

➤ White, smooth or scaly patches in the mouth or on the neck, lips, or tongue

➤ A red spot or sore on the tongue, lips or gums or inside the mouth that hasn’t healed after two weeks

➤ Repeated bleeding in the mouth

➤ Difficulty or abnormality in speaking or swallowing

Name: _____________________________________

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fact Sheet 5

triCks of the trade

human relationS media Spit thiS! the hazardS of SmokeleSS tobacco19

Name: _____________________________________

New laws have restricted the tobacco industry’s power, making it illegal to smoke in many public places and encouraging thousands of people to quit smoking for good. This spells trouble for Big Tobacco, but they certainly aren’t giving up. Instead, the tobacco industry is spending millions of dollars to promote new smokeless tobacco products. Many of these products are aimed right at you—young users who could potentially become lifetime customers.

Check out these facts: ➤ The tobacco industry is promoting new smokeless tobacco products in the form of small spitless pouches or even candy-like tablets. They say these are to help smokers stop using tobacco. In truth, these products are designed to help smokers get a nicotine fix in places where they can’t smoke. They’re also designed to lure young new users who are turned off by the idea of spitting in a cup.

➤ Like all tobacco products, these new smokeless products are unregulated by the Food and Drug Administration (FDA). In other words, because of their money and power, Big Tobacco can put anything they want in these products. A stick of chewing gum has to undergo many tests to make sure it’s safe. But smokeless tobacco products get no tests, even though they contain dozens of poisonous, cancer-causing ingredients.

➤ Without the FDA lurking over them, tobacco makers are free to control the amount of nicotine in their products. Many studies have proven that the tobacco companies adjust nicotine levels to maximize addiction. Smokeless tobacco products also use salt, sugar and flavorings to make their products taste better— especially to kids. One kind of snuff was even grape flavored!

➤ Many tobacco companies offer coupons or free samples by mail. They claim that offering these new smokeless tobacco products will prevent people from smoking or help them quit. But one study showed that over 85 percent of young people who used smokeless tobacco had also smoked cigarettes.

➤ Products truly meant to help people break their nicotine addiction—like nicotine replacement products, antidepressants and nicotine receptor blockers—have been carefully tested by the FDA. They are proven effective in helping people quit smoking.

➤ The last time the tobacco companies aggressively promoted smokeless products, there was a big rise in the use of smokeless tobacco among teenagers, especially male teens. Don’t let this happen again! When Big Tobacco tries to push their new marketing your way, show them you refuse to spend your money on a deadly, addictive product!

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fact Sheet 6

reasons not to use sMokeless tobaCCo

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1. I will have better breath and whiter teeth.

2. I won’t have to hide a nasty spitting or dipping habit.

3. I’ll save money. A person who uses just one can of smokeless tobacco per day can spend over $100,000 during his or her lifetime.

4. I will set an example. I can be a good role model for younger kids and encourage them not to use tobacco of any kind.

5. I’ll be less likely to develop cancer, heart disease and stroke.

6. I’ll have greater control over my moods and emotions. My personality will not be affected or controlled by addiction.

7. I won’t worry the people who care about me.

8. I’ll be more able to taste, smell and enjoy food.

9. My true love won’t gag when he/she kisses me.

10. I’ll be around to see my kids grow up.

11. (women) My baby will be at lower risk for premature birth and lower birth weight.

12. (men) I won’t have to worry about impotence when I get older.

13. My friends will know that I have the courage to stand by my beliefs and refuse things that are unhealthy.

14. I will avoid giving my money to a tobacco company that doesn’t care if I live or die.

15. I will be a healthy person and a strong, independent thinker.

Name: _____________________________________

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fact Sheet 7

faCing the Pressure

human relationS media Spit thiS! the hazardS of SmokeleSS tobacco21

Peer pressure is one of the primary reasons that teens begin to use smokeless tobacco. Knowing different ways to refuse peer pressure can help you resist offers.

POINT OUT CONSEQUENCES

“No thanks, I’d get in trouble if my parents found out.”

“I don’t want to get cancer.”

GIVE A REASON

“No thanks, I don’t like the way it makes my breath smell.”

“I don’t like the way it makes me feel.”

SUGGEST AN ALTERNATIVE

“I have the munchies. Let’s get a snack instead.”

“Let’s get a smoothie at that new place down the street.”

CHANGE THE SUBJECT

“Hey, did you see that new movie…”

“Are you going to the dance next week?”

MAKE AN EXCUSE

“I’ve got to get home.”

“I’m working Saturday night.”

WALK AWAY!

Name: _____________________________________

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fact Sheet 8

quit the diP

human relationS media Spit thiS! the hazardS of SmokeleSS tobacco22

Here are some steps that can make quitting smokeless tobacco easier. Remember that everyone is different. What works for one person may not work for another.

1. Decide to quit. Only you can make this decision and stick to it.

2. Set a quit date in the next month or so. Decide how to lower your daily smokeless tobacco use until it reaches zero.

3. Ask your friends and family for support. Suggest ways for them to help you before and after your quit date. Groups like Nicotine Anonymous can also offer support. Consult <www.nicotine-anonymous.org> online to find a meeting near you.

4. List your reasons for quitting. Put the list where you can see it if you feel tempted.

5. Plan ahead. While cutting down, leave your smokeless tobacco at home. Carry substitutes instead—like sugarless gum, hard candy, beef jerky, sunflower seeds, shredded coconut or dried fruit. Some stores and websites also carry tobacco-free snuff made from mint leaves.

6. Get involved in a healthy activity like running, lifting weights, basketball or swimming. Be sure to drink plenty of water or juice, especially after exercising.

7. If you have a craving, put off using tobacco for at least 10 minutes. Try putting it off longer and longer as you near your quit date.

8. Learn to recognize triggers that make you crave tobacco. These can include activities, places or feelings. Do everything you can to avoid these triggers. When you cannot avoid them, be prepared to work through them.

9. Reward yourself. Put the money you would have spent on tobacco in a jar every day and buy yourself a weekly treat.

10. If you have had trouble quitting in the past, talk to a doctor about using nicotine gum or a patch.

Name: _____________________________________

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fact Sheet 9a

glossary

human relationS media Spit thiS! the hazardS of SmokeleSS tobacco23

ABUSE: Any use of a legal or illicit drug that is detrimental to a person’s health.

ADDICTION: A strong physical or psychological craving for a substance despite its harmful effects; a behavior that is dangerous, progressive and destructive. Characterized by

physical dependence, increased tolerance for the drug and compulsive use.

CANCER: A serious, often deadly, disease caused when the body’s cells mutate and begin to grow out of control. Many cancers are caused by poisonous substances such as those

found in smokeless tobacco.

CARCINOGEN: A cancer-causing agent. Tobacco and other drugs contain many carcinogens.

CHAW: A slang word for chewing tobacco.

CHEWING TOBACCO: A shredded tobacco leaf product, usually placed between the cheek and teeth by the user.

CRAVING: A strong need or compulsion for an activity or a substance, such as a drug.

DIPPING: Placing moist snuff or chewing tobacco between the inside of the cheek and the gum.

DRUG WITHDRAWAL: The uncomfortable, at times toxic, response of the body as it attempts to regain balance after the absence of a drug; the reactions experienced by an addict

who stops using drugs.

GATEWAY DRUG: A substance—legal or illegal—that is typically the first drug a young person uses. Frequently leads to the use of other drugs. Alcohol and tobacco are considered

gateway drugs.

GUM RECESSION: The gum shrinks away from the teeth. As a result, the roots have less gum protecting them and become vulnerable to infection. The technical term is

“gingival recession.”

HEART DISEASE: A serious health problem related to the heart, such as stroke and heart attack. Smoking is the leading cause of heart disease in the United States.

HYPERTENSION: A serious condition also known as “high blood pressure.” Nicotine causes the heart to beat faster and the blood vessels to narrow. These two factors work

together to raise the blood pressure of a tobacco user.

This fact sheet is continued on the next page.

Name: _____________________________________

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fact Sheet 9b

glossary

human relationS media Spit thiS! the hazardS of SmokeleSS tobacco24

LEUKOPLAKIA: A pre-cancerous condition characterized by leathery white patches that occur in the mouth where smokeless tobacco is placed.

NICOTINE: A dangerous, addictive drug found in all tobacco products, including cigarettes, cigars, pipe tobacco and spit tobacco.

NITROSAMINES: A group of chemicals known to cause cancer in both animals and humans. Most of the nitrosamines in tobacco are formed after the tobacco is harvested during

curing, fermentation, aging, flavoring and packaging of the tobacco. The levels of nitrosamines in snuff are ten times greater than those found in cigarettes and 100 times greater than the Food and Drug Administration allows in food products.

PEER PRESSURE: The strong influence that others in the same age group can have upon an individual. This influence can be positive or negative.

POLONIUM 210: A radioactive metal that is picked up by tobacco leaves and is known to cause cancer. It appears that Polonium-210 in tobacco leaves comes partially from

certain types of fertilizers and airborne particles that are taken up by the glandular hair (trichomes) of the tobacco leaf.

SNUFF: A finely ground or finely shredded form of tobacco that is held between the lips or cheek and gums. Snuff may also contain additives such as mint or wintergreen.

SNUS: A kind of moist snuff made of air-cured tobacco, water, salt and flavorings. Can be purchased in loose form or in teabag-like containers.

SOLVENT: A substance used to dissolve other substances. Usually evaporates quickly. Many solvents give off vapors that can be inhaled.

SPIT TOBACCO: A general term used to describe both snuff and chewing tobacco. They are both called “spit tobacco” because they are held in the mouth instead of being burned

like cigarettes, cigars or pipes.

STROKE: A lack of blood flow to the brain caused by the blockage of a blood vessel; can cause severe disability or death. Smoking is related to high blood pressure and

hardening of the arteries, both of which can cause a stroke.

TOBACCO: A plant whose leaves are used to make cigarettes and spit tobacco; contains nicotine and many carcinogens or cancer-causing chemicals.

TOLERANCE: The ability of the body to become accustomed to a certain dosage of a drug. Over time, the body begins to need more of the drug to gain the same effect.

Name: _____________________________________

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fact Sheet 10

internet resourCes

human relationS media Spit thiS! the hazardS of SmokeleSS tobacco25

American Cancer Society <www.cancer.org>

American Lung Association <http://www.lungusa.org/>

Campaign for Tobacco-Free Kids <www.tobaccofreekids.org>

Centers for Disease Control and Prevention <www.cdc.gov>

Join Together <www.jointogether.org>

National Clearinghouse for Alcohol and Drug Information (NCADI) <www.health.org>

National Institute on Alcoholism and Alcohol Abuse <www.niaaa.nih.gov>

National Institute on Drug Abuse (NIDA) <www.nida.nih.gov>

National Youth Anti-Drug Media Campaign <www.theantidrug.com>

Office of National Drug Control Policy <www.whitehousedrugpolicy.gov>

Partnership for a Drug-Free America <www.drugfreeamerica.org>

Substance Abuse and Mental Health Services Administration <www.samhsa.gov>

Name: _____________________________________

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human relationS media Spit thiS! the hazardS of SmokeleSS tobacco26

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