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November, 2001:

Light, Low-Tar Cigarettes Do Not Reduce Smokers’ Health Risks

Landmark Report Concludes “Light,” “Low-Tar” Cigarettes Do Not Reduce Smokers’ Health Risks

Public Health Leaders Tell Smokers that Quitting Is Their Only Healthy Choice

November 27,2001

Washington, DC – Responding to a comprehensive new National Cancer Institute (NCI) report that concluded “light” and “low-tar” cigarettes do not reduce smokers’ health risks, the nation’s leading public health organizations today delivered a strong new message to smokers: If you are concerned about your health, quitting is your only choice. Low-tar and light cigarettes are not safer than other cigarettes on the market.

This advice to smokers was issued in a joint statement by the nation’s leading public health organizations, including the American Cancer Society, American Heart Association, American Lung Association and the Campaign for Tobacco-Free Kids (full statement and list of organizations are attached). They were joined at a press conference by former Surgeon General C. Everett Koop and handgun control advocate Sarah Brady, a “lights” smoker who is suffering from lung cancer.

The public health groups also called for the immediate elimination of the terms “light”, “ultra-light” and “low tar” based on the NCI report’s conclusion that many consumers are using products labeled as such in the false belief they are safer. To accomplish this goal, the groups called on Congress and the Bush Administration to grant the U.S. Food and Drug Administration (FDA) effective authority over tobacco products, including the authority to ban the terms “light,” “ultra-light” and “low-tar.” Until Congress acts, the groups called on the tobacco industry to voluntarily stop using those terms. Effective, bipartisan legislation has been introduced in the Senate by Senators Harkin (D-IA), Chafee (R-RI) and Graham (D-FL) and in the House by Representatives Ganske (R-IA), Dingell (D-MI) and Waxman (D-CA). The groups will issue letters to Congress, Health and Human Services Secretary Tommy Thompson and the tobacco industry calling on them to take the appropriate action.

The NCI report, released today, concludes, “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” (p. 10 of report). The report further concludes that the marketing of these products as delivering less tar and reducing risk is “deceptive” and smokers’ choice of these products as an alternative to quitting makes this deception an “urgent public health issue” (p. 1).

Currently, 87 percent of cigarettes sold in the United States are low-tar brands marketed with descriptions such as “light” and “ultra-light”, according to the Federal Trade Commission. According to the NCI report, “Many smokers switch to lower yield cigarettes out of concerns for their health believing these cigarettes to be less risky or to be a step toward quitting.” However, “current evidence does not support either claims of reduced harm or policy recommendations to switch to these products” (both quotes from p. 10).

Based on similar findings, several countries have already taken action within the past year to ban terms such as “light” and “low-tar” that imply a particular tobacco product is less harmful than others. On June 5, 2001, the European Union (EU) passed legislation that bans “texts, names, trademarks and figurative or other signs suggesting that a particular tobacco product is less harmful than others.” On May 31, 2001, the government of Canada called on the tobacco industry to voluntarily stop the use of misleading descriptions such as “light” and “low-tar.” On November 1, 2001, Canada’s health minister released the report and findings of an expert panel that recommended a total ban on such terms and announced he would develop a means to do so.

The 235-page government report, entitled “Risks Associated with Smoking Cigarettes with Low Machine-Measured Yields of Tar and Nicotine,” is the most definitive to date on the impact of low-tar cigarettes on the public health. It is based on a comprehensive review of all epidemiological and other scientific evidence and is the first government review to include evidence from internal tobacco industry documents revealing the industry’s knowledge about and deceptive marketing of low-tar cigarettes.

The report’s key findings are as follows:

# While changes in cigarette design have reduced the amount of tar and nicotine measured by smoking machines, these machine measurements do not accurately show how much tar and nicotine is actually received by the smoker. There is in fact no meaningful difference in exposure from smoking low-tar and regular brands, and therefore no difference in disease risk. That is because smokers smoke low-tar brands differently to obtain the same amount of nicotine. Smokers block ventilation holes; inhale more deeply; take larger, more rapid, or more frequent puffs; or increase the number of cigarettes smoked per day.

# Internal tobacco industry documents show the industry deliberately designed cigarettes that would produce low yields of tar when tested by machines, but would be smoked differently by actual smokers seeking to maintain nicotine levels. Despite knowing that low-tar cigarettes delivered the same amount of tar to smokers, the cigarette companies marketed them as reduced risk by using terms such as “light”, “ultra-light” and “mild”. Many smokers smoked or switched to these brands in a false belief they were reducing their disease risk. The report finds that the cigarette companies especially marketed the “illusion of risk reduction” to smokers who were thinking of quitting, with the likely effect of discouraging them from taking action that truly would have improved their health.

# As a result, people who smoke low-tar cigarettes are exposed to the same amount of dangerous toxins and have not reduced their risk of developing lung cancer, emphysema, heart disease and other smoking-caused diseases. The study finds that there is no convincing evidence that changes in cigarette design, including the introduction of low-tar cigarettes, have reduced disease either for smokers as a group or for the whole population.

Public Health Implications of Changes in Cigarette Design and Marketing

Cigarettes have changed dramatically over the last 50 years, but the data contained in this volume make it clear that the disease risks associated with smoking have not. Following the demonstration that cigarettes could cause cancer in the 1950s (Wynder and Graham, 1950; Doll and Hill, 1952, 1954; Hammond and Horn, 1958), cigarette manufacturers added filters to their products. They also embarked on an effort to lower the machine-measured tar and nicotine yields produced by their cigarettes when tested under a protocol specified by the Federal Trade Commission (FTC) (Pillsbury, 1996). These changes led to more than a 60-percent reduction in machine-measured tar yields of U.S. cigarettes over the last 50 years (see Figure 1-1).

However, it appears that many of the same changes in cigarette design that reduced machine-measured tar yields also led to a disassociation
between the machine-measured yield of the cigarette and the amount of tar and nicotine actually received by the smoker (see Chapters 2 and 3). As a result, tar and nicotine measurements made by the FTC method for current cigarettes have little meaning for the smoker, either for how much he or she will receive from a given cigarette or for differences in the amount of tar and nicotine received when he or she smokes different brands of cigarettes.

The absence of meaningful differences in smoke exposure when different brands of cigarettes are smoked (see Chapter 3) and the resultant
absence of meaningful differences in risk (see Chapter 4) make the marketing of these cigarettes as lower-delivery and lower-risk products deceptive for the smoker (see Chapters 6 and 7). The reality that many smokers chose these products as an alternative to cessation—a change that would produce real reductions in disease risks—makes this deception an urgent public health issue.

Read the entire document on the Public Health Implications of Changes in Cigarette Design and Marketing here (251 pages).