‘Safer’ Cigarettes Appeal to Some, but Appall Others
If a smoker can’t or won’t kick the habit, is puffing on a less hazardous cigarette the next best alternative? Consumers may have to decide for themselves.
One product advertised as “the first reduced carcinogen cigarette” is already on the market; another brand, which its makers say contains “less toxins,” is being test-marketed. And this summer a nicotine-free, reduced-carcinogen product aimed at smokers who are trying to quit will arrive on store shelves.
But the very notion of a safer cigarette appalls many tobacco-control advocates. Saying there is no evidence that smoking can be made safer, they charge that such products could cause people to avoid quitting or even to take up smoking.
Other experts have adopted a wait-and-see attitude. They maintain that independent research should be done on the new cigarettes to determine if they actually could reduce harm to smokers or work as a bridge to help the most addicted smokers quit. The new cigarettes contain fewer nitrosamines and polycyclic aromatic hydrocarbons, or PAHs, carcinogens found in cigarette smoke, than premium cigarettes.
“I don’t think the majority of [health professionals] would advise smokers to use these products just yet,” says Dr. David Burns, a tobacco researcher at UC San Diego. “But I think there are people who are interested in seeing research on whether they work.”
Although Vector Tobacco, the maker of the already available Omni, concedes that sales are slow thus far, the potential market for the products is vast. Nearly 50 million Americans smoke; many of them would like to quit and are desperate for a way to do so.
“The people who could quit smoking without a great deal of difficulty have probably already done so,” says John Banzhof, executive director of Action on Smoking and Health, a Washington, D.C., anti-tobacco health organization. “Most of us in the [tobacco control] movement today believe most of the smokers are hard-core addicts. They find it incredibly hard to quit.”
The idea of a less harmful smoke appears to make sense to people. In a recent poll of smokers and nonsmokers in Indianapolis, 74% said they think tobacco companies should work toward the development of a safer cigarette. The poll was commissioned by Brown & Williamson, which is test-marketing Advance Lights in Indianapolis.
Advance Lights are made with a special tobacco-curing process and a filter that reduce nitrosamines and PAHs. Omni also uses tobacco processed to reduce nitrosamines and PAHs.
“It’s nice to say that everyone should stop smoking, and we are pushing toward that,” says Bennett LeBow, chief executive of Vector, which also owns Liggett Group, maker of discount cigarettes. “In the meantime we really believe you can do something to reduce the long-term risks of cigarette smoking.” But with as many as 4,000 chemicals in cigarette smoke, the risks to smokers are many and varied. Besides elevating the risk of at least nine forms of cancer, smoking is linked to heart disease, emphysema and pulmonary disorders. Smoking also increases the risk of birth defects.
There is no proof that reducing PAHs or nitrosamines translates to a decreased risk to smokers. And the advertising surrounding Omni and Advance Lights may mislead people into thinking there is a safe way to smoke, says Ken Warner, director of the University of Michigan Tobacco Research Network, which studies smoking and health.
“Smokers who are always trying to avoid quitting may believe that they are now eliminating their risk of lung cancer,” he says. “Former smokers may say, ‘Thank God, they have created a smoke that doesn’t cause lung cancer; I can start up again.’ And kids could be persuaded to start if they think it doesn’t cause lung cancer. We could end up with a substantial increase in the disease burden associated with smoking.”
Being able to reduce PAHs “offers promise, but that promise has not been studied, even in animals,” Burns says. “We know very little about the actual carcinogens people receive from this product.”
Warner says lowering the nitrosamines doesn’t compromise taste. But he says, “Nitrosamines are not the only carcinogens in tobacco smoke. And anything combusted still has too much risk to be promoted as [less harmful]. You’re still left with heart disease, chronic obstructive pulmonary disease and emphysema caused by smoking.”
A Brown & Williamson spokesman says the company is not claiming that Advance Lights reduce disease risk. The company will await the results of test-marketing before deciding whether to market the product nationwide.
“We cannot make any claim on the health effects because you are still smoking a cigarette,” says Mark Smith, a spokesman for Brown & Williamson. “But those smokers who are concerned with the health consequences of smoking would see this as a step in the right direction.”
However, several public health experts say they fear the lower-toxin billing will give smokers a false sense of safety, much the way the marketing of “light” or “low tar” cigarettes has done. In November, the National Cancer Institute released a report on “light” cigarettes saying that such cigarettes do nothing to lower smokers’ health risks. Smokers using “light” cigarettes inhale more deeply and smoke more to compensate for the lower-yield cigarettes, thereby doing nothing to reduce health risks, the report said. It called on Congress to enact legislation barring use of the terms “light” or “ultra-light,” saying they are deceptive.
The newer products take a somewhat different tack. Quest, due out this summer, is of particular interest to cessation experts--who are divided about the product’s value, says Burns, senior scientific editor of the National Cancer Institute report. Unlike Omni and Advance Lights, Quest is made from genetically modified tobacco that contains no nicotine--which is meant to both lower smokers’ health risks and promote cessation, says Vector’s LeBow.
Research on Quest’s ability to promote cessation is underway. Duke University researcher Jed Rose is comparing a group of smokers using Quest and the nicotine patch with a group using Quest alone.
“The question is whether you can give up the nicotine first while continuing the habit,” says Rose, the co-inventor of the nicotine patch, who is now director of Duke’s Nicotine Research Program. “Maybe some people would find it easier to relinquish the smoking habit if they first deal with the dependency on the drug.”
But the product will be available to consumers well before research has determined its usefulness. Initially, Quest will be marketed as a product to help with nicotine cessation. Vector is working toward submitting data to the FDA to market Quest as a smoking cessation product, LeBow adds.
The emergence of Quest and the reduced-carcinogen cigarettes has renewed the call for FDA regulation of all tobacco products--an idea that, so far, has been spurned by the federal government.
“The nicotine patch is regulated; so is the gum. But it seems like the cigarette industry always comes out with something new that makes health claims, and there is no governing body to follow up on it,” says Diane Maple, a spokeswoman for the American Lung Assn. “Cigarette manufacturers have changed their formulas before, switched ingredients around. Until the FDA gets the authority to look at these products, we may never know the risks.”
