SACTob Conclusions on Health Claims Derived from ISO/FTC Method to Measure Cigarette Yield
烟草制品管制科学咨询委员会关于以国际标准化组织/美国联邦贸易委员会测定香烟含量的方法 所标示的健康说明的结论
Background
背 景
The United States Federal Trade Commission [FTC] adopted standardized testing methods for the measurement of tar and nicotine yields of cigarette smoke in the 1960s and for carbon monoxide in 1981, mandating the disclosure of these ratings in cigarette advertising (1). Under the International Organization for Standardisation [ISO] method, similar testing methods were adopted in Europe and many other countries.
美国联邦贸易委员会于1960年代对测定香烟烟雾的烟碱和尼古丁含量以及于1981年对一氧化碳通过了标准化检测方法，指令在香烟广告中披露这些分级(1)。在国际标准化组织的方法之下，类似检测方法已在欧洲和许多其它国家采用。
For nearly three decades, the ISO / FTC methods were relied upon as meaningful predictors of the differences in exposure to tar, nicotine and carbon monoxide received by smokers of brands with different machine measured yields. This difference in exposure was expected to result in substantive differences in the health effects of smoking various types (low/high yield) of cigarettes (2). Since the 1980s, however, there has been growing concern among health authorities and scientists alike about the validity of the health claims based on these methods (3, 4, 5, 6, 7).
在约30年里，依靠国际标准化组织/美国联邦贸易委员会的方法，作为各品牌在吸烟者对烟碱、尼古丁和一氧化碳接触方面与不同机器测定的含量差别的有意义预测。预期接触方面的这种差别造成了吸各种类型香烟（含量低/高）的健康效应方面的实质性差别(2)。但是，自1980年代以来，卫生当局和科学家都日益关注以这些方法为基础的健康说明的有效性(3,4,5,6,7)。
Even in the early 1980’s, it was understood that measurements made using the ISO/FTC protocol did not quantify the actual delivery of toxins to the smoker since individual smokers smoked with a variety of puff profiles that differed from those used in the machine testing. Today, with a better understanding of the modern cigarette designs and the concept of compensatory smoking of the low yield cigarettes (2), the limitations of the ISO/FTC measurements, even for comparisons of smoker exposures between brands of cigarettes have become more evident (8, 9). The validity of communications made to consumers on the basis of the ISO/FTC methods regarding the delivery of carcinogens and other toxins from different types of cigarettes are now being questioned (8,10,11). Considerable concern exists about the misuse of test results by tobacco companies to support their marketing claims, which imply that cigarettes with lower yield ratings are ‘safer’ than those with higher ratings (12,13,14, 15).
即使在1980年代初期，也认为采用国际标准化组织/美国联邦贸易委员会的方案所作的测定不能量化毒素对吸烟者的实际提供，因为各吸烟者以各种吸烟方式吸烟，与机器检测中使用的吸烟方式是不同的。今天，随着对现代香烟设计以及低含量香烟补偿性吸烟概念的更好了解(2)，即使用于比较香烟品牌之间吸烟者的接触，国际标准化组织/美国联邦贸易委员会测定的局限性已变得更加明显(8,9)。现在正在对以国际标准化组织/美国联邦贸易委员会的方法为基础就不同类型香烟释放的致癌物和其它毒素向消费者传递的信息的有效性提出质疑(8,10,11)。对于烟草公司滥用检测结果以支持其市场营销宣传存在着相当多的担忧，这些宣传暗示低含量等级的香烟比高等级的香烟“更为安全”(12,13,14,15)。
The ISO/FTC protocols were never designed to accommodate the variations in human smoking habits as opposed to the standard machine smoking methods (1,16,17). It is now clear that the combination of compensatory changes in smoking patterns by smokers and cigarette design changes (particularly ventilation holes in filters) which increase the yield of smoke can restore the smoke delivery of the so-called low-yield cigarettes to that of full flavour cigarettes with much higher machine measured yields (18, 19, 20, 21). However, as a consequence of the conventional format for conveying tar and nicotine information, the consumer believes that the ‘low yield’ cigarettes provide an alternative to smoking cessation (22,23). This belief persists even though it is now accepted that “low yield” cigarettes do not offer any proven health benefit in comparison to higher yield cigarettes (2,4,5,24,25).
国际标准化组织/美国联邦贸易委员会的方案从未预定适应相对于标准的机器吸烟方法而言人的吸烟习惯方面的变化(1,16,17)。现已明显的是，吸烟者吸烟模式方面补偿改变与增加烟雾含量的香烟设计改变（特别是过滤嘴的通气孔）相结合，可将所谓低含量香烟的烟雾释放恢复到浓味香烟的水平，比机器测定的含量要高得多(18,19,20,21)。但是，由于传递烟碱和尼古丁信息的常规形式，消费者认为，“低含量”香烟提供了一种戒烟的替代方法(22,23)。即使现已相信“低含量”香烟与较高含量香烟相比不提供任何经证实的健康效益，这种信念仍继续存在(2,4,5,24,25)。
The United States F.T.C stated in 1998 that: “new data suggests that the limited health benefits, previously believed to be associated with lower tar and nicotine cigarettes may not exist.” (26). Also, a 1999 quotation reads: “They (the ratings) are not intended to reflect what any individual consumer would get from any particular cigarette”(27).
美国联邦贸易委员会1998年指出：“新的数据表明，可能不存在以前认为与烟碱和尼古丁含量较低香烟有关的有限健康效益”(26)。而且，1999年一条引文写明：“它们（分级）并不预定反映任何消费者个人会从任何特定香烟中摄入的一切”(27)。
In 2001, the U.S. National Cancer Institute completed its evaluation of the scientific basis for the relationship between the FTC methods and the health effects of smoking, as well as the effects of marketing claims (e.g., “reduced tar” and “light”) that are supported by the information derived from these methods (15).
2001年，美国国立癌症研究所就联邦贸易委员会的方法与吸烟的健康效应以及这些方法产生的信息所支持的市场营销宣传（如“烟碱减少”和“淡味”）的效应之间的关系完成了对科学基础的评价(15)。
The NCI Monograph (Number 13, 2001) “Risks Associated with Smoking Cigarettes with Low Machine-Measured Yields of Tar and Nicotine” presented the following five main conclusions:
- “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 fifty years.”
- “For spontaneous brand switchers, there appears to be complete compensation for nicotine delivery, reflecting more intensive smoking of lower-yield cigarettes.”
- “Widespread adoption of lower yield cigarettes in the United States has not prevented the sustained increase in lung cancer among older smokers.”
- “Many smokers switch to lower yield cigarettes out of concern for their health, believing these cigarettes to be less risky or to be a step toward quitting. Advertising and marketing of lower yield cigarettes may promote initiation and impede cessation, more important determinants of smoking-related diseases.”
- “Measurements of tar and nicotine yields using the FTC method do not offer smokers meaningful information on the amount of tar and nicotine they will receive from a cigarette. The measurements also do not offer meaningful information on the relative amounts of tar and nicotine exposure likely to be received from smoking different brands of cigarettes.”
国立癌症研究所专著（第13期，2001年）“与吸经机器测定的烟碱和尼古丁含量低的香烟有关的风险”提出了下列5项主要结论：
- “流行病学和其它科学证据，包括由吸烟引起的疾病的死亡模式，并不表明在过去50年期间香烟设计和生产方面的改变对公共卫生带来利益。”
- “对自发的品牌转换者而言，看来对尼古丁释放获得充分的补偿，反映更强烈地吸含量较低的香烟。”
- “在美国普遍采用含量较低的香烟并未在老年吸烟者中间制止肺癌的持续增加。”
- “许多吸烟者由于担忧自己的健康而转向含量较低的香烟，相信这些香烟风险较小或是朝着戒烟迈进一步。含量较低的香烟广告和市场营销可促进开始吸烟和阻碍戒烟，它们是吸烟相关疾病的较重要决定因素。”
- “采用美国联邦贸易委员会的方法测定烟碱和尼古丁并不向吸烟者提供关于从一支香烟中所摄入烟碱和尼古丁量的有意义信息。这些测定也不提供从吸不同品牌香烟中可能获得的烟碱和尼古丁接触量的有意义信息。”
Currently, there are two major issues of concern about the health claims based on the ISO/FTC methods: one, machine-measurements are not valid estimates of the exposure to smoke or nicotine received by smokers when they smoke different brands of cigarettes (4,16) and two, many smokers currently believe that lower yield or light cigarettes deliver less tar, produce lower rates of disease and are therefore ‘safer’ (17,22,28,29). Because of these misconceptions, smokers believe those cigarettes marked as lower yield or light and ultra light are a reasonable intermediate step or alternative to cessation and may defer or avoid the one change in smoking behaviour proven to actually reduce their disease risk-cessation.
目前关于以国际标准化组织/美国联邦贸易委员会的方法为基础的健康说明存在着两个有利害关系的重要问题：一个问题是，当吸烟者吸不同品牌的香烟时，机器测定的量度并不是他们接受的接触烟雾或尼古丁的有效估计数(4,16)，以及第二个问题是，许多吸烟者目前相信，含量较低或淡味香烟释放烟碱少，发病率较低，因此“更为安全”(17,22,28,29)。由于这些误解，吸烟者认为，这些标明含量较低或淡味和极淡味的香烟是戒烟的一个合理中间步骤或替代选择，并可推迟或避免吸烟行为方面经证明可实际减少其疾病风险的唯一改变—戒烟。
The Health Education Authority in the UK (30) and several other studies have revealed that the tar and nicotine ratings as they are displayed by the industry are not clearly understood by the consumers (28,31). Due to the advertising and packaging methods adopted by the industry, smokers see these terms not as technical descriptors but as implying health benefits (13,32,33). These advertising and marketing approaches have contributed to consumers’ using low yield cigarettes in an attempt to reduce their health risks, or as a step towards or an alternative to smoking cessation (34,35). A number of reputed bodies have therefore recommended banning terms such as ‘light’, ‘mild, etc (25,36)
联合王国健康教育当局(30)和若干其它研究表明，工业界所显示的烟碱和尼古丁分级尚未为消费者所明确理解(28,31)。由于工业界采用的广告和包装方法，吸烟者不是将这些词语看作为技术描述词，而是看作为暗示健康效益(13,32,33)。这些广告和市场营销作法已促进消费者使用低含量香烟，以试图减少其健康风险，或作为朝着戒烟迈进一步或作为其替代选择(34,35)。一些知名机构已建议禁止使用“淡味”、“柔和”等词语(25,36)。
Additionally, awareness levels among the general public about the limitations of the ISO/FTC test methods and the ratings based upon them (37,38,39) are very low. The regulatory measures undertaken for the disclosure of this information have clearly proven ineffective (40,41).
此外，公众对国际标准化组织/美国联邦贸易委员会检测方法的局限性和以这些方法为基础的等级(37,38,39)的认识水平很低。为披露这一信息所采取的管制措施已清楚地证明不起作用(40,41)。
The message that there is no such thing as a safe cigarette still has not been effectively communicated to the smoking public…
不存在安全的香烟这一信息仍尚未有效地向吸烟的公众传播…
Based on the existing science, SACTob makes the following conclusions and recommendations:
- Tar, nicotine, and CO numerical ratings based upon current ISO/FTC methods and presented on cigarette packages and in advertising as single numerical values are misleading and should not be displayed.*
- All misleading health and exposure claims should be banned.
- The ban should apply to packaging, brand names, advertising and other promotional activities
- Banned terms should include light, ultra-light, mild and low tar, and may be extended to other misleading terms The ban should include not only misleading terms and claims but also, names, trademarks, imagery and other means to conveying the impression that the product provides a health benefit.
以现有科学为基础，烟草制品管制科学咨询委员会 提出下列结论和建议：
- 以国际标准化组织/美国联邦贸易委员会目前方法为基础并在香烟包装和广告中作为单一数值出现的烟碱、尼古丁和一氧化碳数字分级是误导的，不应予以显示。∗
- 应禁止所有误导性健康和接触说明。
- 禁止应适用于包装、品牌名称、广告和其它促销活动。
- 禁止的词语应包括淡味、极淡味、柔和和低烟碱，并可扩大到其它误导性词语。禁止不仅应包括误导性词语和说明，而且应包括名称、商标、图象和传递该制品提供健康效益的印象的其它手段。
http://www.who.int/tobacco/sactob/recommendations/en/iso_ftc_en.pdf
http://www.who.int/tobacco/sactob/recommendations/en/iso_ftc_ch.pdf