Wednesday, September 06, 2006

Misrepresentation of Nicotine Report Leading to Confusion

The misrepresentation of the Massachusetts Department of Public Health (MDPH) report demonstrating that nicotine yields have increased by about 10% over the past seven years is leading to widespread confusion about the health and policy issues involved in regulating nicotine.

Thanks largely to the propaganda being spewed forth by the Campaign for Tobacco-Free Kids, the public is not receiving a fair and accurate portrayal of the concepts that are necessary to understand in order to rationally formulate policy regarding the regulation of nicotine in cigarettes.

Take this editorial appearing in today's Huntington Herald-Dispatch.

According to the editorial, a new study [the MDPH report] "shows it's harder to quit smoking now than in the past." The editorial concludes that "Increasing the nicotine content of cigarettes to keep people hooked has to stop -- now."

The Rest of the Story

Let's not be hasty.

First of all, the report does not conclude that, or provide any evidence that quitting smoking is more difficult now than in the past because companies have increased the nicotine yields of their cigarettes by about 10%.

I didn't hear anti-smoking groups applauding the cigarette companies for decreasing the addictiveness of their products and making it easier for smokers to quit when the companies substantially reduced the nicotine yields of their products over past decades.

But now all of the sudden increasing the nicotine yields is proof that cigarette smoking is more addictive?

Rest assured, one of the foremost experts on nicotine addiction in the world - Dr. Neal Benowitz at UCSF - is not convinced that we know the impact on addiction of the MDPH report findings on increased nicotine yields:

"I don't think we know what the consequences are for the population in terms of addictive behavior and how hard it is for people to quit."

Well if we don't know what the consequences are, it's tough to sell me on the idea that we need to stop this from happening, as this editorial, and more importantly, the campaign of deception by the Campaign for Tobacco-Free Kids demands.

If you want to sell me on regulation of nicotine, then try selling the idea that we need to simply get rid of it. After all, if we can't tolerate the cigarette companies manipulating (i.e., controlling) nicotine levels, then the solution is to get rid of the nicotine. Outside of that, the cigarette companies are, by definition, going to be controlling (i.e., manipulating) the nicotine levels of their products. They have to. They have no choice (unless they want to put out a product that is so random in its nicotine delivery that they lose most of their customers).

So clearly, it's not the manipulation (e.g., increase) in nicotine levels that is the problem here that is unacceptable and that needs to be addressed. If any problem needs to addressed through regulation, it's the addictive nature of cigarettes (i.e., the presence of nicotine) itself.

As I've pointed out, increasing nicotine levels could actually limit cigarette consumption and smoking intensity, reducing tar intake and having some marginal health benefits. So prohibiting the companies from doing this makes little public health sense.

In fact, the prestigious Institute of Medicine, in a 2001 report on harm reduction, recommended the use of nicotine-enriched cigarettes in clinical trials because of their potential to reduce smoking-induced harm:

“Potential advantages of this trial are that the low-tar/moderate-nicotine product, if it reduces harm, could be used as a reference product for future regulation of marketed products.”

The type of rhetoric being presented in this editorial and in the Tobacco-Free Kids' public statements reveals a very shallow understanding of the health and policy issues related to regulation of nicotine content in cigarettes.

I do not blame the editorial board of this paper at all. They are getting their information from the tobacco control community, and it is our fault that we are not communicating these policy issues appropriately. Unfortunately, it appears that our obsession with getting FDA legislation enacted and our eagerness to blast the tobacco companies for everything is getting in the way of our ability to communicate tobacco science and health issues accurately and with the proper perspective.

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