Version May 2024
| Alternate names | Description | Comments | |
| Smoked tobacco | |||
| Cigar | Cigarillo, figurado | Depending on size, nicotine content may be up to 4 times that of a cigarette. | |
| Hookah | Pipes, waterpipe, hubble bubble, narghile, shisha | Lit tobacco bubbles through water and inhaled through a shared mouthpiece. | Use of black "air-cured" tobacco has higher risk of esophageal cancer. The filtering effect of water does not make it less dangerous. |
| Bidi | Hand-rolled, leaf-wrapped cigarette, often with sweet flavors such as chocolate or cherry. | Nicotine content is 3 to 5 times that of a cigarette. | |
| Kretek | Clove cigarette | Rolled mixture of tobacco, cloves, and other additives. | |
| Noncombustible forms of nicotine | |||
| Electronic nicotine delivery devices (ENDS; including e-cigarettes) | E-cigarette, vapor cigarette, personal vaporizer, vape pipe/pen/stick, hookah pen, e-hookah, mod, pod-mod, tank system, Juul (and other brand names) | Battery-powered device that provides doses of nicotine for inhalation. A nicotine-containing liquid is put into the device in a cartridge or in drops. Available in a variety of flavors. | E-cigarettes and other ENDS devices are widely available from internet sources. These forms of nicotine are not harmless. Nicotine exposure during adolescence can cause addiction and harm the developing brain[1]. Patients may not report that they "smoke" if they use ENDS devices or are "juuling," so specific screening questions should be used. E-cigarettes are often used to vaporize cannabis or other substances. Refer to UpToDate content on e-cigarettes. |
| Nontobacco oral nicotine products | Synthetic or "tobacco-free" oral nicotine; because these are not approved as cessation aids, they are sometimes known as "nontherapeutic" nicotine products | Available as gum, lozenges, gummies, and pouches, in appealing flavors (fruits and sweets). | Relatively new form of nicotine product. Aspects that may particularly appeal to youth include availability in appealing flavors, forms that are easily concealed, and marketing messages that suggest minimal harm[2]. |
| Tobacco-derived oral nicotine | Contains nicotine derived from tobacco but not unrefined tobacco. | The FDA has authorized the marketing of some of these products, with the rationale that they are less harmful than other forms of smokeless tobacco. | |
| Heat-not-burn (HNB) tobacco products | HNB tobacco | Electric blade heats tobacco stick to much lower temperature compared with a tobacco cigarette. | Nicotine content is approximately 85% that of a traditional tobacco cigarette. In addition, HNB products contain lower amounts of some other harmful constituents compared with the smoke of a traditional cigarette[3]. |
| Chewing tobacco | Chew, spit tobacco | Shredded tobacco leaves, often sweetened, and available as loose leaf, "plug," or "twist." It is used by holding it in the mouth between the gum and cheek. | Chewing tobacco is associated with substantial risks for gum disease, mouth cancer, and oral sores; it also causes stained teeth, bad breath, and loss of taste. |
| Snuff | Pinch, dip | Finely ground tobacco, either dry or moist. Dry snuff is usually inhaled through the nostrils; moist snuff is usually held in the mouth for absorption, similar to chewing tobacco. | Similar to chewing tobacco above. |
| Snus | A form of moist snuff, dispensed in packets or sachets. These are held in the mouth for absorption, similar to chewing tobacco, but designed so that spitting is not required. | Nicotine content is 2 to 6 times that of a cigarette. | |
| Dissolvable tobacco | Dissolvable tobacco strips, sticks, or orbs (pellets similar to Tic Tac candies). | Delivers between 0.5 and 2 times the nicotine of a cigarette. Allows for covert use of tobacco; risk of inadvertent toxic ingestion by young children. High content of un-ionized nicotine leads to rapid absorption and potentially increases nicotine toxicity. | |
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