Building a better butt
It's every smoker's dream: Keep the sweet consolation that cigarettes give, but avoid the threat of death. So far that dream has remained an illusion. Smoking is the largest preventable cause of death in the United States, claiming more than 400,000 victi
The question is fraught with peril. Harm reduction is a time-honored principle of public health, exemplified by mundane items like seat belts and sunscreen, but also by methadone and needle-exchange programs for drug addicts. Cigarettes are the equivalent of a dirty needle. Yet public-health advocates have largely balked at cleaning them up, fearing that less toxic smokes would encourage teens to indulge and quitters to light up once again. "The name 'safer cigarettes' is a misnomer," says Ron Todd, director of tobacco control for the American Cancer Society. "The best thing to do is not to smoke."
New understanding of the science of nicotine addiction, coupled with revelations on the sophisticated chemical engineering of the modern cigarette, is feeding interest in reducing the habit's harm, from the surgeon general and the Institute of Medicine to manufacturers eager to turn a new leaf. At the end of the month, Star Scientific Inc., of Chester, Va., will start test-marketing a cigarette with a charcoal filter and tobacco cured to reduce nitrosamine, a potent carcinogen. The mission, says Star President Paul Perito, is to prove "the commercial viability of less hazardous tobacco products."
Thousands of chemicals. Hazards abound. More than 4,000 chemicals swirl in tobacco smokeâ€“born of the weed itself, the curing process, numerous additives, and combustion. Nicotine is the most addictive. But the carnage cancer, heart disease, and emphysema is wreaked by gases like carbon monoxide, formaldehyde, nitrosamines, benzopyrene, and nitrous oxides, plus radioactive elements like polonium and toxic substances including hydrogen cyanide and lead.
Cigarette manufacturers have long known of their product's noxious cargo. Starting in the 1960s, they launched major research efforts to render cigarettes less toxic and filed dozens of patents for designs and devices to reduce key offenders. But sanitizing the cigarette proved to be tougher than expected, and their work never saw the supermarket shelf. Unveiling a safer cigarette, industry executives said in internal memos, would imply that the current product was unsafe and expose the firms to liability. The depth of the research and its suppression have come to light only recently, as tobacco-liability lawsuits have pried loose a cascade of industry documents.
Consumers, however, remain in the dark. Tobacco products are exempt from the content labeling required for millions of products, from bran muffins to flu tablets, and manufacturers have fiercely fought efforts to disclose ingredients. Indeed, most of what public-health officials know about the guts of a cigarette comes from tobacco litigation documents and whistle-blowers. Last month, Surgeon General David Satcher called for disclosure of cigarette ingredients as part of a new initiative to cut smoking in half by 2010.
Public-health officials and advocates are greeting the industry's latest efforts with deep distrust, born of decades of experiences with new cigarettes that delivered hefty sales increases but no discernible health benefits. Filters were promoted in the 1950s as "the greatest health protection in cigarette history" but didn't appreciably reduce toxics. The 1970s saw the advent of "light" cigarettes, which promised to reduce tar and nicotine by blending tobacco and increasing ventilation. But smokers compensated by blocking vent holes with their fingers and taking longer drags to maintain a constant dose of nicotine. Since the 1950s, the typical lung cancer that Americans get has shifted dramatically, from squamous cell carcinoma found in the large bronchi to once rare adenocarcinoma, which strikes the lungs' periphery. Epidemiologists say the shift is due to smokers' inhaling the smoother cigarettes more deeply and to higher-nitrate tobacco blends. "We were deceived," says John Slade, director of the addictions program at the New Jersey School of Medicine and Dentistry. "The products gave false assurances without providing any genuine health benefit."
Smokeless smokes. Still, the tobacco companies keep trying. Philip Morris has been test-marketing Accord, a low-smoke cigarette inserted in a battery-powered lighter, since 1997. But the company avoids making health claims, saying instead that it reduces secondhand smoke. In April, R.J. Reynolds Tobacco Co. started selling Eclipse as the "next best choice" in the Dallas-Fort Worth area. Eclipse builds on the technology of Premier, a product Reynolds tested and abandoned in the late 1980s, by producing fewer toxics because it largely heats, rather than burns, tobacco. "Eclipse may present less risk of cancer, chronic bronchitis, and possibly emphysema," says Dave Iauco, senior vice president of marketing for R.J. Reynolds. But nicotine-addiction scientists say that Reynolds is far from proving health benefits and that Eclipse's filter can release glass fibers into the lungs. "I just think it's silly," says Stanton Glantz, a professor of medicine at the University of California-San Francisco and tobacco-control advocate. "You could basically eliminate tobacco use in 10 years. Why screw around with the cigarette?"
Others say, why not do both? Gregory Connolly, who leads a Massachusetts campaign that has reduced cigarette consumption by 33 percent since 1993, says cigarettes should be made less toxicâ€“but only if these products disclose their contents and are coupled with strong treatment programs. "What happens in the marketplace?" Connolly asks. "Will former smokers start again?"
Figuring out a way to judge risk, in cigarettes and any potential substitutes, would go a long way toward easing the impasse between the industry and no-smokeniks and finally give consumers the chance to make an informed choice. The Institute of Medicine is finishing work on a plan for testing standards to evaluate the potential health benefits of cigarette substitutes, standards that could then serve as the basis for Food and Drug Administration regulation of all nicotine-delivery devices. "We need those standards to force competition," Connolly says. Without it, he says, the tobacco industry will once again use science to create products that entice and ultimately kill.
Today's engineered cigarette is a far cry from the humble hand-rolled cylinder of a century ago.
R.J. Reynolds unveils Camel, a blended-tobacco cigarette. Camel becomes the first nationally popular brand.
Lorillard introduces Kent, with the "Micronite" filter: "the greatest health protection in cigarette history." But filters fail to deliver health benefits.
Marlboro Lights debut, promising lower tar and nicotine. Smokers compensate by dragging more deeply.
Premier, a "smokeless" cigarette that heats tobacco, is offered by R.J. Reynolds. Consumers reject its taste.
Reynolds markets Eclipse, which largely heats, rather than burns, tobacco. Star Scientific debuts a cigarette processed to reduce a carcinogen.