Evidence does not indicate that "low-tar" or "light" cigarettes are better for smokers health, according to a recent monograph from the National Cancer Institute.
The reports authorspublic health experts and smoking researchers from around the countryconcluded that, "Epidemiological and other scientific evidence, including patterns of mortality from smoking-caused diseases, does not indicate a benefit to public health from changes in cigarette design and manufacturing over the last 50 years."
According to former Surgeon General C. Everett Koop, the reports conclusions are "a wake-up call for smokers and policy-makers."
The authors of the monograph found that, among the estimated 47 million smokers in the United States, people who are most concerned about smoking risks or are most interested in quitting use brands labeled "light" or "ultra-light," believing those cigarettes are less risky or a step toward quitting.
The authors found that choosing lower-yield cigarettes is not likely to reduce tar intake and the resulting disease risks. Furthermore, marketing and promotion of reduced-yield products may delay or prevent attempts to quit. The authors found no evidence that switching to light or ultra-light cigarettes actually assists smokers in smoking cessation.
"The take-home message of this report is that the only proven way to reduce the disease risks associated with smoking is to quit," said David Burns, M.D., senior scientific editor of the monograph and a professor at the University of California, San Diego, School of Medicine.
The monograph examined other issues regarding low-tar cigarettes, including the way in which the nicotine and tar outputs of cigarettes are measured. The only information available to smokers on the levels of tar, nicotine, and carbon monoxide in cigarette smoke is obtained in the laboratory using the current Federal Trade Commission method.
In this method, machines are programmed using specific settings to generate smoke for analysis of smoke components. Studies have shown, however, that the current FTC method does not mimic real-life smoking behaviors and, thus, measurements of tar and nicotine generated using this protocol do not offer meaningful information on the amount of tar and nicotine smokers receive from a cigarette. The measurements also do not allow meaningful comparisons between different brands of cigarettes, according to the monograph.
Those same studies have also noted that people who switch to lower-yield cigarettes "compensate" for nicotine delivery in various ways. One of the most substantial changes in cigarette design over the past 50 years has been the addition of filters to many cigarettes, designed to allow air to enter ventilation holes to dilute the smoke.
The FTC has asked the Department of Health and Human Services for guidance to improve its testing method. NCI and other DHHS agencies will convene a working group in 2002 to determine what changes should be made to the method to correct the limitations identified in the monograph.
The discrepancy between the FTC machine-measured yields of tar and nicotine and what the smoker actually inhales should not be a surprise to the tobacco industry. The monograph includes industry documents from the past few decades that reveal companies early knowledge of the inaccuracy of the machines.
These documents demonstrate that cigarette manufacturers recognized the inherent deception of advertising that offered cigarettes as "light" or "ultra-light," or as having the lowest tar and nicotine yields. The monograph concluded that these promotional strategies were intended to reassure smokers and to prevent them from quitting and that they led consumers to perceive filtered and low-tar products as safer alternatives to regular cigarettes.
Many advocacy organizations have seen this report as a call for regulatory action. "For the American Heart Association, the need for, and importance of, FDA authority over tobacco products is clear and irrefutable, as this report so aptly demonstrates," said M. Cass Wheeler, chief executive officer of the American Heart Association. "Tobacco is the only product sold in the United States that, when used as instructed, regularly kills millions."
According to Matthew Myers, J.D., president of the Campaign for Tobacco-Free Kids, "We just want regulation of tobacco to be as strong as it is for macaroni and cheese."
The report, Risks Associated with Smoking Cigarettes with Low Machine-Measured Yields of Tar and Nicotine, is available at http://cancercontrol.cancer.gov/tcrb/nci_monographs/.
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