In an article published in the current issue of Cancer Epidemiology, Biomarkers & Prevention, researchers from the Centers for Disease Control and Prevention (CDC) have demonstrated that the health protection strategy in the proposed FDA tobacco legislation is severely flawed, as a chemical-by-chemical approach to trying to reduce the harms of cigarette smoking is foolish (see: Ding YS, et al. Levels of tobacco-specific nitrosamines and polycyclic aromatic hydrocarbons in mainstream smoke from different tobacco varieties. Cancer Epidemiology Biomarkers & Prevention 2008; 17: 3366-3371).
The researchers attempted to reduce the levels of nitrosamines and polycyclic aromatic hydrocarbons - two of the known categories of carcinogens in cigarettes - in tobacco smoke by altering the tobacco blends used. Unfortunately, they found that when changes are made to reduce the levels of one type of carcinogen, the levels of the other type increase: "Our results tend to indicate an inverse relation exists between NNK and PAH deliveries when considering different tobacco blends."
Most importantly, the researchers concluded that even if one could reduce levels of both of these types of carcinogens - nitrosamines and polycyclic aromatic hydrocarbons - it is unknown whether this would have any protective impact on the health of smokers. As the authors explain: "There are more than 60 known carcinogens in cigarette smoke and at least 16 in unburned obacco. Among these, tobacco-specific nitrosamines (TSNA), polycyclic aromatic hydrocarbons PAH), and aromatic amines likely play important roles in causing cancer. The IARC lists 10 PAHs, 8 TSNAs, and at least 45 other compounds or substances as potential human carcinogens."
Ultimately, the authors conclude that even if levels of both nitrosamines and polycyclic aromatic hydrocarbons could be reduced in cigarettes, it is unknown what effect this would have on health: "Whether such reductions [in both the TSNAs and PAHs] would reduce the health risk associated with smoking is unknown."
The Rest of the Story
As the new year approaches, I think this is an ideal time for anti-smoking groups to take a step back and to realize that the entire approach underlying the FDA tobacco legislation is ludicrous.
As this research and much other work like it demonstrates, a chemical-by-chemical approach to regulating the safety of cigarettes - as taken by the FDA tobacco legislation - is absurd.
Not only do strategies that reduce the levels of one tobacco smoke constituent tend to increase the levels of other constituents, but it is widely acknowledged in the first place that reducing the levels of a wide range of tobacco smoke constituents is not known to reduce the hazards associated with cigarette smoking. Thus, there is simply no science base to support the approach taken by the current FDA tobacco legislation.
Claims by anti-smoking groups - like the Campaign for Tobacco-Free Kids, American Cancer Society, and American Medical Association - that the proposed legislation would save countless lives are pure propaganda.
The New Year's resolution taken by anti-smoking groups should be to somehow lose their obsession with the FDA legislation over the holidays and to come back in the new year behind a new approach to federal tobacco legislation, one that is based on science rather than propaganda.
Such an approach would be based on the two strategies which have actually been shown to work: raising cigarette prices and running aggressive anti-smoking media campaigns. The legislation would pair these two approaches. A series of graduated fines would be levied on cigarette companies based on the number of youths smoking their cigarette brands. The allowable levels of youth smokers would decrease over time so that fines would only be levied if companies failed to reduce youth smoking of their brands to specified levels over time. The money raised would be allocated to establish a national anti-smoking media campaign as well as similar campaigns in all 50 states, for the first time in history. In addition, a substantial proportion of funds would be used to support programs specifically for smokers, including research into smoking-related diseases, treatment of such diseases, and smoking cessation programs. The bill introduced last year by Senator Enzi contains many elements of such an approach.
Unfortunately, I don't think that the anti-smoking groups will seriously consider promoting an effective approach. Why? Because they are being driven largely by propaganda and ego, rather than by science and a pure concern for protecting the public's health. While only an idealist (which I no longer am) might expect that anti-smoking groups would be driven by a pure concern for public health protection and not affected by the desires for money and power, the public has the right to expect that these groups' actions will be driven by science, rather than propaganda.