Are Low Tar and Nicotine Cigarettes Healthful?
Many people believe that if they smoke low tar, "Lite" or "mild" cigarettes they will be reducing the tar and nicotine that enters their lungs. Smoking machines have measured tar and nicotine in these "Lite" cigarettes to be often much less than one-tenth that of regular cigarettes.
The tobacco companies promote low tar and nicotine cigarettes as a more healthy alternative for people concerned about their health. They are happy to use the tar and nicotine levels smoking machines find in their cigarettes.
Dr. Neal Benowitz described the smoking machines as follows:
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"The FTC method consists of placing a cigarette into a syringe-like device which withdraws exactly 35 milliliters of smoke over two seconds, once every sixty seconds, until the cigarette is smoked to a given distance above the filter, or the filter over-wrap. "This [machine measured yield] is the amount of nicotine, tar, carbon monoxide, or other chemicals that are generated in the smoke of a cigarette that is smoked in a standardized fashion. The standard machine measured yields of tar and nicotine measured using the FTC method are reported in cigarette advertising." |
Knowing the "standard fashion" by which the government measures tar and nicotine content of cigarettes, the tobacco companies modify their cigarettes to produce low readings in the machines. By manipulating the construction of cigarettes, tobacco companies can produce almost any reading they want.
Low tar and nicotine cigarettes normally are constructed with vent holes near the edge of the filter. They may also use more porous paper to allow air leakage along the entire length of the cigarette. These construction techniques allow clean air to mix with the tobacco smoke as it is sucked into the smoking machine. The smoking machine measures the concentrations of tar and nicotine, made lower by the ventilation "leaks" in the filter.
For example, The Federal Trade Commission report for 1998 (issued in 2000) shows Carlton King size Ultra-Lite cigarettes produce less and half a milligram of tar and less than half a milligram of nicotine. The Command king size cigarettes, on the other hand, produce 27 milligrams of tar and 1.7 milligrams of nicotine. Certainly, there is quite a range of values to choose from.
If people smoked in the "stander fashion", exactly like the cigarette machines, they would be inhaling less tar and nicotine in these "lite" cigarettes. But, people do not smoke like the government's cigarette machines.
The same FTC report that lists the tar and nicotine levels for cigarettes warns consumers that how a person smokes a cigarette is important in determining the amount of tar and nicotine they get from the cigarette. The FTC report indicates that this different between the machine measure values and what a smoker could actual get was primarily due to "compensation."
The changes in cigarette design have caused people to compensate, or change their smoking behavior (called "smoking topography"). Smokers take larger, stronger, and more frequent puffs in order to get the same amount of nicotine from a "lite" cigarette as they did from a regular cigarette. They may also hold the cigarette so as to block the vent holes so they get a stronger stream of smoke. These compensating behaviors result in getting the same amount of nicotine as they would get from a regular cigarette.
Dr. Neal Benowitz's research indicates that most smokers engage in compensation to get their required amount of nicotine:
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The vast majority of smokers engage in compensation. If one looks at the broad population of smokers, there is a high degree of compensation that is seen from the range of machine-determined nicotine yields of about 0.3 milligram to 1.5 milligrams of nicotine. Across this range, there is only about a ten percent difference in nicotine intake from the lowest to the highest yield cigarette. When one switches to the ultra-low yield cigarettes with machine measured yields of 0.1 or 0.2 milligram of nicotine, then there is an approximately thirty percent reduction of nicotine exposure. It is more difficult for smokers to fully compensate for ultra-low yield cigarettes. However, very few smokers (less than 5 percent) smoke ultra-low yield cigarettes. This is most likely because they cannot adequately compensate and do not get enough nicotine for these cigarettes to be satisfying. |
The words from the FTC report provide a good warning to smokers who think that by switching to a "lite" cigarette they are smoking more healthy cigarettes. The report indicates:
- "Tar" and nicotine ratings were never intended to reflect what any individual consumer would get from any particular cigarette;
- How much "tar" and nicotine an individual gets from a cigarette depends on how he or she smokes it – smokers of cigarette brands with lower "tar" and nicotine ratings who take larger or more frequent puffs may get as much "tar" and nicotine as smokers of higher rated brands;
- Many cigarettes have ventilation holes that, when blocked, substantially increase exposure to the harmful constituents in smoke;
- There is no such thing as a safe smoke, no matter what the "tar" and nicotine ratings are; and
- People who are concerned about the health effects of smoking should quit.
A number of research studies have confirmed that many people compensate to get the required amount of nicotine from cigarettes. A Japanese study (Nakazawa, et.al.), for example, examined 458 Japanese male smokers confirmed compensation. They measured urinary concentrations of cotinine (nicotine is broken down to cotinine in the body) in the morning to gage how much nicotine was obtained the previous day.
By knowing the number of cigarettes smoked, the cotinine levels would allow evaluation of the amount of nicotine the smoker got from each cigarette. As you can see from the following graph, the amount of nicotine obtained from each cigarette was almost constant across extremely low (0.1 mg nicotine) cigarettes to more normal cigarettes (1.1 mg nicotine).
The Japanese study concludes that the smoking machine determined nicotine yield cannot reliably predict that amount of nicotine a smoker actually gets from low tar and nicotine cigarettes. In fact, the study indicates that "current labeling practices are misleading for two-third of smokers who are moderately or highly dependent on nicotine."
Another study (Hammond, et. al.) showed that when smokers change from regular to "lite" cigarettes their smoke intake from each cigarette jumped by 40%. This increase in smoke volume was accomplished primarily by higher puff volumes rather than by more frequent puffing. They also smoked an extra cigarette or two to help compensate.
So, if you are dependent on nicotine in cigarettes, you should not expect to receive health benefits from low tar and nicotine cigarettes. You will most likely puff harder, puff more frequently, or cover the vent holes in order to get the full amount of nicotine you need.
Resources:
- Atsuko Nakazawa, Masako Shigeta and Kotaro Ozasa, Smoking cigarettes of low nicotine yield does not reduce nicotine intake as expected: a study of nicotine dependency in Japanese males, BMC Public Health 2004, 4:28
- Unites States' Written Direct Examination of Neal Benowitz, M.D., United States of America v. Philip Morris USA Inc, Civil No. 99-CV-02496 (GK)
- Federal Trade Commission, Tar, Nicotine, and Carbon Monoxide of the Smoke of 1294 Varieties of Domestic Cigarettes for the Year 1998.
- David Hammond, Geoffrey T. Fong, K. Michael Cummings and Andrew Hyland, Smoking Topography, Brand Switching, and Nicotine Delivery: Results from an In vivo Study, Cancer Epidemiology, Biomarkers & Prevention, 14(4) 1370-1375.
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