Dr. Ebbert form the Mayo Clinic in Rochester MN PowerPoint presentation about the negative health effects of smoking.

1. What You Need to Know about Smokeless Tobacco Jon O. Ebbert, MD, MSc Assistant Professor of Medicine Mayo Clinic College of Medicine Rochester, MN

5. Chewing Tobacco

6. Snuff

7. Type of ST Used in U.S. National Survey on Drug Use and Health, 2003

8. Preferred Snuff Products National Survey on Drug Use and Health, 2003

9. Preferred Chewing Tobacco National Survey on Drug Use and Health, 2003

10. RJ Reynold’s

11. Phillip Morris (Altria)

12. Other ST Products USSTC Swedish Match, NA BAT

14. Results from the 2006 National Survey on Drug Use and Health: National Findings Past Month Tobacco Use among Persons Aged 12 or Older: 2002-2006

16. Health Impact of Smokeless Tobacco

21. Tobacco-Related Oral Disease

22. Smokeless Tobacco Dependence

24. Volkow et al. J. Pharmacol. Exp. Ther. 291:409-415, 1999 The intensity of the &quot;high&quot; induced by methylphenidate is significantly correlated with the levels of released dopamine (r = 0.78, p <.001) . “ High” Intensity & Dopamine Release

25. Smokeless Tobacco Pharmacology Blood nicotine concentration (ng/ml) Benowitz, NL et al. Nicotine absorption and cardiovascular effects with smokeless tobacco use: comparison with cigarettes and nicotine gum. Clin Pharmacol Ther 1988; 44: 23-8. Benowitz NL, et al. Clin Pharmacol Ther. 1988 Jul;44(1):23-8. Figure Used with Permission from Elsevier.

27. CDC, 1999. Free Nicotine as a Function of pH

29. Frequency of Withdrawal Symptoms in 162 ST Users Ebbert JO, et al. Journal of Substance Abuse Treatment, 26 (4), 261-267.

30. Marketing Messages http://www.trinketsandtrash.org

31. Cowboy/Rodeo http://www.trinketsandtrash.org

32. Active Lifestyle http://www.trinketsandtrash.org

33. “ Social” Lifestyle http://www.trinketsandtrash.org

34. Individuality “ Not everybody understands it. Which is exactly why you do it.” http://www.trinketsandtrash.org

35. Brave New World – What’s a Smoker To Do? http://www.trinketsandtrash.org

36. Brave New World – What’s a Smoker To Do? http://www.trinketsandtrash.org

37. http://www.trinketsandtrash.org

38. Appeals to Females? http://www.trinketsandtrash.org

39. Methods of Treating Smokeless Tobacco Use Behavioral Pharmacologic

40. Methods of Treating Smokeless Tobacco Use Behavioral Pharmacologic

46. Methods of Treating Smokeless Tobacco Use Behavioral Pharmacologic

51. Proper Lozenge Placement 4 NL