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Health Canada looks at forcing tobacco companies to make cigarettes less addictive

Health Canada is studying the possibility of forcing companies to make their cigarettes less addictive, a controversial anti-smoking strategy that no other country has implemented.

The department issued a tender recently calling for an outside researcher to add to the government’s own extensive analysis of the idea and how it would affect public health.

Though not mentioned specifically in the document, reducing the nicotine level of cigarettes is the most-discussed means of lessening their addictiveness. But experts are divided on whether that makes any sense.

Proponents say early evidence indicates that a cut in the chemical could help wean smokers off the habit.

Critics argue that a mandated nicotine reduction would only prompt people to smoke more to get their desired hit of the drug — and suck in more of tobacco’s carcinogens in the process.

“It’s so wrong-headed,” said David Sweanor, an Ottawa lawyer and long-time anti-smoking advocate. “The unintended consequences are screaming out on this. … People adjust the way they smoke to get the nicotine they need or want.”

While other components of smoke account for cigarettes being the single-biggest cause of cancer, nicotine is what makes them addictive. No rule currently dictates how much of the drug they may contain.

Regulating changes to the chemical make-up of tobacco is one of the ideas being debated as part of the so-called smoking “endgame” – tactics to push smoking rates below the stubborn 15-20% they’ve hovered around for years.

Health Canada’s request for proposals asks for independent experts to expand and validate a model created by the department to assess the health benefits of an “addictiveness-reduction standard” for tobacco.

Officials have already considered how a cut in addictiveness would affect the rate of people starting and quitting smoking, as well as such possible consequences as a jump in the sales of contraband tobacco and rates of “compensatory” smoking — consuming more cigarettes or inhaling more intensely.

Sean Upton, a spokesman for Health Canada, said the project is not necessarily about reducing nicotine levels but “will help guide policy and be used to test different things and potential benefits.”

“It’s a policy development tool,” he said.

However, the document discusses exclusively addictiveness-reduction.

And in academic circles recently, cutting nicotine levels has garnered most of the attention as a way to make tobacco less addictive.

It’s so wrong-headed. The unintended consequences are screaming out on this.

The idea had earned a bad name because of what one anti-smoking campaigner calls the “disaster” of light cigarettes, an industry-led concept that aimed to lessen levels of tar and nicotine through special filters. The filters are perforated to vent off some of the chemicals before they are inhaled.

Studies have shown, however, that smokers essentially override the feature by covering the holes with their mouth or fingers, or smoking more cigarettes.

Some tobacco-control experts say there is more promise in tobacco that has been specially treated or genetically modified to lower nicotine content before the smoker even lights up.

A study published in the New England Journal of Medicine last fall found that smokers in a trial who were given experimental, reduced-nicotine cigarettes were smoking about 25% fewer of them per day by the end of the six-week study — and without “compensating” to get more of the drug.

But not everyone is convinced by the research, with one critic pointing to evidence that some participants may have augmented the low-nicotine cigarettes with regular ones outside the study.

Regardless, for the idea to really work, there needs to be another, safer nicotine-delivery tool readily available as a fallback for smokers, like electronic cigarettes or “snus,” smokeless tobacco, says Lynn Kozlowski, a health-behaviour professor at the University of Buffalo.

Addictiveness-reduction is a more dramatic step than it might sound, he argues.

“If you diminish the nicotine levels to such a point that it’s not addictive, that seems to me very much like prohibition of traditional cigarettes,” said Kozlowski, “a little bit like alcohol prohibition.”

It’s good that Health Canada is trying to learn more about tobacco and its effects, given industry is always way ahead of regulators in its knowledge level, said Rob Cunningham, a policy analyst with the Canadian Cancer Society.

But he suggested there are higher priorities for government, such as addressing the manufacturers’ new methods of promoting cigarettes, and bringing back anti-smoking ad campaigns that once were ubiquitous.

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