Thursday, June 03, 2010

On Safer Cigarettes, Only Philip Morris is Making Any Sense

What an ironic, yet shameful moment for the tobacco control movement.

For today at least, only Philip Morris is making any sense on the issue of safer cigarettes.

For the tobacco control movement's part, it has sunk to the depths of pure speculation and unfortunately, deception of the American public: a place where the tobacco companies used to be.

And for Philip Morris' part, it has risen above the political, non-scientific rhetoric of the health groups to a new place: a place where the anti-smoking groups used to be.

This ironic twist, this nearly unfathomable switch in positions, comes as a direct result of the anti-smoking groups' ill-conceived plan to put the federal government in the business of approving and regulating cigarette ingredients and cigarette safety.

The Rest of the Story

The health groups, and even perhaps the CDC, have done their damage: The headline on ABC News reads: "American-Made Cigarettes May Be More Cancerous, CDC Finds." This is a very deceptive, very damaging, and completely unscientifically supported headline which implies that cigarettes made in Canada, Australia, and the UK are safer to smoke than those made in the United States.

There is absolutely no evidence to support such a contention. And if tobacco companies in Canada, Australia, or the UK were saying exactly the same thing, these very same anti-smoking groups and advocates which are making statements like the above would be taking those companies to court, attacking them, and accusing them of fraud and conspiracy.

Can you imagine? Suppose that Imperial Tobacco were to come out tomorrow with a statement declaring that its cigarettes are safer than brands like Marlboro, Camel, and Newport because they are made with lower levels of carcinogenic nitrosamines. The anti-smoking groups would have Imperial in court in no time. They would be attacked, accused of fraudulent deception of the public.

But ironically, it's now not the tobacco companies that are making such unsupported claims. It's the health groups!

The health groups would have us believe that by limiting certain constituents - like nitrosamines - in cigarettes, the product will be made safer. Some - like the Campaign for Tobacco-Free Kids - have stated to the public that cigarettes with lower nitrosamines would be safer.

To my mind, this is fraudulent deception. It's no different from what the tobacco companies did regarding low-tar cigarettes or no-additive cigarettes, and it is precisely what they were found guilty of in federal court when Judge Kessler issued her scathing opinion.

But in 2010, it is the health groups which are perpetuating the very myths that the DOJ lawsuit aimed to dispel. And most ironically, it is Philip Morris - a defendant in the DOJ lawsuit - which is the only group to tell it like it is and provide appropriate advice to the public: If you are concerned about your health, says Philip Morris, then quit smoking.

Not so, according to the anti-smoking groups. The implication of the Campaign for Tobacco-Free Kids' public statements is that it is only a matter of time before the FDA issues regulations that will mandate changes in cigarettes to make them safer. The Campaign's de facto advice to smokers: don't quit now, because if you wait a little bit, the FDA will be mandating a safer cigarette.

The rest of the story is that nitrosamines are only one of more than 40 recognized carcinogens in tobacco smoke. Thus, lowering levels of nitrosamines is not necessarily going to lower cancer risk. It also depends on what happens to the other 39. And it turns out that the most common methods used to reduce nitrosamines in cigarettes result in an increase in at least some of the other carcinogens in the cigarette. Moreover, we simply don't know which carcinogens, at what amounts, and in what combination, are responsible for the carcinogenic effects of cigarettes. Nor do we have biomarkers that accurately predict human risk. It would take a long-term epidemiologic study to determine whether mandating reduced TSNA levels in cigarettes would result in a safer product.

There is actually scientific plausibility behind the notion that mandating lower TSNA cigarettes could result in a more hazardous, not a less hazardous product. Such a mandate would almost certainly result in higher use of flue-cured, rather than burley tobacco in cigarettes because burley tobacco produces higher TSNA levels. Thus, such a mandate by the FDA would cause tobacco manufacturers to shift towards higher amounts of flue-cured tobacco.

However, there is scientific evidence that flue-cured tobacco yields higher levels of benzo[a]pyrene and tar than burley tobacco. Since tar and benzo[a]pyrene are associated with cancer risk, it is at least plausible that an FDA directive to reduce TSNA levels would increase the national burden of cancer.

Of all the organizations - including the CDC - that were quoted in the news articles on this new study, the only one which delivered a credible and responsible statement was Philip Morris, which was able to put aside the low-tar myth once and for all and to recommend that if people are concerned about their health, they should simply quit smoking.

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