NEW YORK, Jan 18 (Reuters Health) -- Because smokers take more frequent and larger puffs when they smoke low- and medium-yield cigarettes, the amounts of tar and nicotine that they inhale are double or more than double estimates published by the Federal T

The study results suggest that the 80% of smokers in the United States who commonly choose to smoke ``light'' cigarette brands are being exposed to higher doses of nicotine and lung carcinogens than those indicated by FTC figures. ``The FTC list of numbers are very poor guides for consumers, and over the years people on their own and with perhaps the sly encouragement of the tobacco industry have come to rely on lower tar and nicotine yield numbers as indications of safety,'' said Steven Stellman, study co-author and the chief of the division of epidemiology at the American Health Foundation in Valhalla, New York. Stellman suggested that the study findings might push smokers to ``think more seriously about quitting. Maybe this will nudge people who are on the verge of quitting to seek out some of the many available resources out there to help them stop.'' But the researchers also warn that the doses of nicotine medications, such as the nicotine patch, used to help smokers trying to kick the habit may need revision because they are often based on official estimates of the nicotine content of cigarettes. Researchers interviewed 133 healthy smokers between the ages of 18 and 50 in Westchester County, New York, who smoked only medium- or low-yield cigarettes, giving them a 4-day supply of their brand and examining the remaining butts to establish the amount smoked and the exact manner the cigarettes were held and handled. Factors examined to determine the levels of tar and nicotine actually inhaled included the length of each individual puff, the number of puffs taken, the total number of cigarettes smoked, and the flow of the smoke. When these indicators were established, a piston-type smoking machine was used to ``machine smoke'' each smokers' brand and analyze the resulting amounts of tar, nicotine, and carbon monoxide -- as well as other carcinogens such as the nitrosamine NNK, which is found only in tobacco. Stellman and his team found that when compared with the method the FTC has used since 1936 to calculate cigarette carcinogen levels, the low- and medium-yield cigarette smokers inhaled, respectively, 2.5 and 2.2 times more nicotine and 2.6 and 1.9 times more tar than the government listings indicate. The investigators also found that smokers generally took longer puffs with shorter intervals between puffs than the FTC's own machine-based protocol assumes is the case. Their report is published in the January 19th issue of the Journal of the National Cancer Institute. In an interview with Reuters Health, Stellman emphasized that the importance of this finding is that it points out how the smoking public is being misled when making choices about cigarettes. ``Although the FTC is very careful about not making health claims, everyone knows that tar and nicotine are bad for you -- so many smokers are encouraged to choose low-yield cigarettes with an eye to possible health consequences,'' said Stellman. ``The smoking habit is extraordinarily difficult to shake once you have it, and for many years many in the health community had hoped that we would find safer lower-yield cigarettes -- but these facts are mitigated by the way that people smoke,'' said Stellman. Stellman pointed out that discrepancies in the reported figures have arisen because the FTC estimates ``have very little relevance to the way people actually smoke.... One of the principal characteristics of the FTC calculation method has been that all of the numbers come from smoking all of these different cigarettes in exactly the same way. So we have abandoned these settings and reset the smoking machines to the way that people actually smoke their cigarettes. When we did that, we found that the tar and nicotine intake levels are approximately twice as high than in the FTC reports... And so someone who thinks that switching from a medium-yield brand to a low-yield brand would give them a 50% or more cut in nicotine and tar intake as suggested by the FTC would actually only be cutting intake by about 25,'' said Stellman. He added that this miscalculation has given smokers a false sense of security since ``by the time a person gets lung cancer a smoker has generally been smoking about 40 years. And in that time he or she has generally changed brands about four or five times, and because the tobacco industry has been lowering its tar and nicotine brands over time everyone has experienced the change'' and assumed that their carcinogen intake has been similarly lowered when in fact their manner of smoking has changed to compensate for the brand changes. But Stellman cautioned that for those who do decide to quit, the study results indicate that the commonly used nicotine patch therapy, in particular, can fall victim to the FTC number reporting problem. ``People who use this method set the dosage based on the FTC numbers, and in our opinion they're setting their doses up too low and therefore setting themselves up for a failure,'' said Stellman, suggesting that smokers who try this route should realistically understand their intake levels if they want to succeed in quitting. In an editorial, Judith Wilkenfeld of the Washington DC-based Committee on Tobacco Product Change and colleagues note that the study findings suggest that the Food and Drug Administration (FDA), not the FTC, should be responsible for regulating tobacco products. ``The FDA would have the authority and expertise necessary to make tobacco product manufacturers accountable for clearly and accurately describing the toxicity and addictiveness of their products to their customers,'' Wilkenfeld's team writes. SOURCE: Journal of the National Cancer Institute 2000;92:90-91, 106-111.

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