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Editorial Reviews. About the Author. Fred C. Pampel is a professor of sociology and a research associate of the Institute of Behavior Science at the University of.
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The handheld, battery-operated, microchip-controlled product heats a cigarette-like tobacco roll when it is puffed Slade and Henningfield The health consequences of new cigarette products have not been demonstrated in scientific studies. The challenges include a need for development and validation of testing methods for new products WHO b. Extended nonlaboratory studies under natural conditions with a broader range of biomarkers of toxicants are required to determine whether novel products result in overall reduction of exposure to toxicants, and still longer and more extensive studies would be required to determine whether or not the disease risk of the individual or population harm are decreased WHO a , ; Hatsukami et al.

For example, products delivering lower levels of nitrosamines might theoretically reduce cancer risks, but because many of these products still deliver nicotine and CO , cardiovascular risks may remain unchanged or may even increase. In addition, if TSNAs are removed, other potent carcinogens may sustain overall high levels of exposure to carcinogens Fowles and Dybing There are substantial risks that the marketing of novel cigarettes could lead to increased tobacco use in current smokers, relapse in former smokers, and initiation in those who never smoked, particularly youth Henningfield et al.

For example, in a survey of 1, current cigarette smokers and former smokers older than 18 years of age, 91 percent thought Eclipse was safer than regular cigarettes, 24 percent believed Eclipse was completely safe, and Those interested in using Eclipse included 6. Further extending these findings, Hamilton and colleagues found that advertisements for light cigarettes were perceived to imply that their use is healthier than use of regular cigarettes, partly because consumers wrongly believed that the advertisements must be approved and endorsed by a government agency. In addition, products designed or marketed to be used in places where smoking is not allowed may defeat public health efforts to reduce smoking rates.

For example, studies have found that having a percent smoke-free workplace reduced smoking prevalence by 6 to 22 percent and average daily consumption by up to 14 percent among smokers compared with workers subject to minimal or no restrictions Farrelly et al. Products that enable nicotine consumption in the workplace and other places could reverse these potential reductions in smoking prevalence through use of one product in the workplace and continued smoking outside, that is, dual product use Henningfield et al. Moreover, the dual use of tobacco products is likely to result in greater exposure to toxicants than does use of either product type alone Henningfield et al.

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Balancing the risks and benefits of new cigarette products is challenging because of the diversity of products, their associated potential risks and benefits on the multitude of tobacco-related diseases, and the dearth of empirical data on their effects. WHO developed similar scientific questions, as well as recommendations for research and product testing WHO d , a , , Although all the questions raised by these organizations merit consideration, the following questions are a critical starting point for evaluating new cigarette or cigarette-like products:. The Tobacco Control Act grants the U.

Although some provisions of the act went into effect shortly after the statute was enacted, such as the ban on flavored cigarettes, others will be implemented over time. Sections and of the Tobacco Control Act provide that premarket review of certain tobacco products by FDA is required before the products may be marketed. After reviewing the application, the agency will issue an order either permitting the product to be marketed or denying its marketing according to specified bases for its action.

New tobacco products determined by FDA to be substantially equivalent to products already on the market as of February 15, , are not required to undergo premarket review. Section recognizes so-called special rule products, which also require pre-market approval. Such products may be marketed for up to five years subject to renewal if the agency determines that the applicant has met specified criteria, the applicant agrees to conduct certain postmarket surveillance and studies, and other specified findings regarding the relative harm of the product are made.

Under this section, FDA must issue guidance or regulations on the scientific evidence required for the assessment and ongoing review of modified-risk tobacco products in consultation with IOM.

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At the time the adverse effects of smoking were being recognized, the tobacco industry developed cigarettes with low machine-measured yields of tar and nicotine, and public health authorities encouraged consumers to select them Peeler ; Shopland Unfortunately, it took public health researchers and federal authorities many years to discover what the tobacco industry knew much earlier: the health benefits of reductions of tar and nicotine intakes were negligible at best for persons using these products Federal Register , ; NCI ; WHO ; U.

Philip Morris No. Thus, by the twenty-first century, it was apparent that five decades of evolving cigarette design had not reduced overall disease risk among smokers, and new designs were used by the tobacco industry as a tool to undermine prevention and cessation efforts NCI ; Stratton et al. Similarly, informative and comprehensive scientific evaluations do not exist for any of the other new products developed ostensibly to reduce toxicants in cigarette smoke. This lack of data limits any conclusions that can be drawn about potential health risks or benefits.

The well-documented risks of cigarette design changes must be weighed against any potential benefits Stratton et al. As this chapter makes clear, substantial risks may be associated with new tobacco products: 1 smokers who might have otherwise stopped smoking may continue to smoke because of perceived reduction in risk with use of new products; 2 former smokers may resume smoking because of perceived reduction in risk with use of new products; and 3 nonsmokers, particularly youth, may start to use new products because of their perceived safety.

The theoretical benefit of cigarette design changes is to reduce exposure to toxicants sufficiently to reduce the risk of disease and death. However, if these products are used by persons otherwise unlikely to use a tobacco product, which would undermine efforts to prevent tobacco use, or if the products delay cessation among persons who would otherwise stop using tobacco, the overall health of the population would be harmed.

There is little doubt that new tobacco products will continue to be developed. Turn recording back on. National Center for Biotechnology Information , U. Search term. Cigarette Design Changes over the Years The history of tobacco product design and marketing has been discussed elsewhere and need not be repeated Reynolds and Shachtman ; Goodman , ; Hilts ; Kluger ; Tate ; Brandt New Cigarette Products Cigarette smoke contains more than 7, chemicals, including at least 69 known carcinogens and many other toxicants implicated in major diseases International Agency for Research on Cancer [IARC] ; Borgerding and Klus ; Rodgman and Perfetti , and because the potency of toxicants and mechanisms of action differ, reducing concentrations of individual toxicants might have only a negligible effect on disease risk from smoking Fowles and Dybing ; Pankow et al.

Cigarette-Like Products In , R. Evaluation of New Cigarette Products The health consequences of new cigarette products have not been demonstrated in scientific studies. Although all the questions raised by these organizations merit consideration, the following questions are a critical starting point for evaluating new cigarette or cigarette-like products: Does use of the product decrease individual and population exposure to the harmful substances in tobacco smoke?

Is this decreased exposure associated with a decrease in individual and population risk of disease? Are there surrogate indicators of disease risk that could be measured in a timeframe of sufficient duration for product evaluation? What are the public health implications of products that may reduce exposure to toxicants in tobacco smoke? Specifically, do these products increase initiation of tobacco use, decrease cessation, promote relapse among those who have quit, or lead to dual product use?

There is insufficient evidence to determine whether novel tobacco products reduce individual and population health risks. The overall health of the public could be harmed if the introduction of novel tobacco products encourages tobacco use among people who would otherwise be unlikely to use a tobacco product or delays cessation among persons who would otherwise quit using tobacco altogether. Nicotine and carcinogen exposure with smoking of progressively reduced nicotine content cigarette.

Establishing a nicotine threshold for addiction: the implications for tobacco regulation. New England Journal of Medicine. Washington: National Academies Press; Borgerding M, Klus H. Analysis of complex mixtures—cigarette smoke. Experimental and Toxicologic Pathology. Brandt AM. New York: Basic Books; Tobacco specific nitrosamines and potential reduced exposure products for smokers: a preliminary evaluation of Advance.

Tobacco Control. Evaluating acute effects of potential reduced-exposure products for smokers: clinical laboratory methodology. Clinical laboratory evaluation of potential reduced exposure products for smokers. Browne CL. The Design of Cigarettes. Withdrawal suppressing effects of a novel smoking system: comparison with own brand, not own brand, and de-nicotinized cigarettes. Mandated lowering of toxicants in cigarette smoke: a description of the World Health Organization TobReg proposal. Smoking without nicotine delivery decreases withdrawal in hour abstinent smokers. Pharmacology, Biochemistry, and Behavior.

Centers for Disease Control and Prevention. Ten great public health achievements—United States, — Morbidity and Mortality Weekly Report. Smoking attributable mortality, years of potential life lost, and productivity losses—United States, — Doses of nicotine and lung carcinogens delivered to cigarette smokers. Journal of the National Cancer Institute. European Commission. US Statutes at Large. The impact of work-place smoking bans: results from a national survey. Federal Register U. Fed Reg. Regulations restricting the sale and distribution of cigarettes and smokeless tobacco to protect children and adolescents; final rule 21 CFR Parts , , , , , and Federal Trade Commission.

FTC rescinds guidance from on statements concerning tar and nicotine yields [press release]. Fowles J, Dybing E. Application of toxicological risk assessment principles to the chemical constituents of cigarette smoke. Goodman B. Marlboro - Marlboro Lights study delivery data. Philip Morris Collection Bates No.

Goodman J. Tobacco in History: the Cultures of Dependence. New York: Routledge; Goodman J, editor. Tobacco in History and Culture: An Encyclopedia. Scribner Turning Points Library. Hatsukami D, Hecht S. Hope or Hazard? Methods to assess potential reduced exposure products. Harm reduction approaches to reducing tobacco-related mortality. Annual Review of Public Health. Developing the science base for reducing tobacco harm. Reducing the addictiveness of cigarettes. Regulatory strategies to reduce tobacco addiction in youth.

Brave new world of tobacco disease prevention: promoting dual product use? American Journal of Preventive Medicine. Hilts PJ. Smoking and Tobacco Control Monograph No 7. Bethesda MD : U. NIH Publication No. Hoffmann D, Hoffmann I.

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The changing cigarette, — Journal of Toxicology and Environmental Health. The less harmful cigarette: a controversial issue. A tribute to Ernst L. Chemical Research in Toxicology. Hughes JR.

Infobase Publishing - Tobacco Industry and Smoking, Revised Edition

Reduced smoking: an introduction and review of the evidence. Smoking behaviour and toxin exposure during six weeks use of a potential reduced exposure product: Omni. Psychology of Addictive Behaviors. International Agency for Research on Cancer. Kessler D. New York: Public Affairs; Kluger R. New York: Alfred A Knopf; American Journal of Public Health.

Cigarette filter ventilation is a defective design because of misleading taste, bigger puffs, and blocked vents. Maximum yields might improve public health—if filter vents were banned: a lesson from the history of vented filters. Labstat International. Test Report. Kitchener Canada : LabstatInternational; RJ Reynolds Collection.

Bates No. Quantitative comparisons between a nicotine delivery device Eclipse and conventional cigarette smoking. National Cancer Institute. NIH Publication No Percent free base nicotine in the tobacco smoke particulate matter of selected commercial and reference cigarettes. Cancer Epidemiology, Biomarkers and Prevention. Parascandola M. Glass fiber contamination of cigarette filters: an additional health risk to the smoker? Release of carbon granules from cigarettes with charcoal filters. Literature review and summary of perceptions, attitudes, beliefs, and marketing of potentially reduced exposure products: communication implications.

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