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The Truth About Nicotine: Smoking Out Testing Deficiencies

October 13th, 2009

Originally published by The Triple Helix.

Jessica O’Hara, Sarah Bronko, Gengen He, Akilah Jefferson, Rebecca Greene, and Nina Zheng, Georgetown University

Opinions expressed in the Op-Ed articles are solely those of the author and do not represent those of the Triple Helix. However, submission of varying and divergent opinions on controversial and current issues is encouraged.

It is no secret that the tobacco industry has been a major target of criticism and controversy by both health and government organizations for decades. Highly publicized lawsuits and rebuttals have been commonplace on the national news. Most of us have seen the smoking “TRUTH” campaign ads on television, have repeatedly heard “smoking kills” and have come to assume that people are listening and taking this information seriously. Yet, tobacco continues to remain a pertinent issue in America.

Despite the reductions in smoking trends over the past 20 years, there is still a major age group that is experiencing high rates of smoking. According to the Center for Disease Control, between the years of 1983-2003, a consistent decline in smoking occurred in all age groups EXCEPT persons aged 18-24, the age range of your typical university student. Studies have also shown that almost 90% of college students who are daily smokers and 50% of college students who are occasional smokers will still be smoking four years later after graduation [1].

This is no surprise considering new information released in January 2007 by a study conducted by the Harvard University School of Public Health. Initiated by the Massachusetts Department of Public Health (MDPH), Harvard scientists’ research concluded that over the past 10 years, tobacco companies have been steadily increasing the amount of nicotine delivered per cigarette. The study confirmed “increased machine-measured levels of smoke nicotine, the addictive agent in cigarettes, as a result of increased nicotine in the tobacco rod and by other design modifications.” [2] This increase in nicotine level makes it more likely that occasional smokers, including 28.7% of the college-age population, will become everyday smokers. Because of outdated testing methods and inadequate reporting requirements, this information slipped below federal radar and the nicotine increase was not discovered until 2006.

In light of the recent Harvard study, it becomes obvious that the increase in cigarette nicotine yield corresponds to the increased rates of addiction among smokers. We, as college students who fall within the 18-24 year old age range – a primary target age group of the tobacco industry – should enter this tobacco debate and take direct action.

Congress has recently taken measures to strengthen governmental oversight over the tobacco industry by introducing the Family Smoking and Prevention Act into both the House of Representatives and the Senate. H.R.1108 and S.625, each with identical language, call for the Food and Drug Administration to be recognized as “the primary Federal regulatory authority with respect to the manufacture, marketing, and distribution of tobacco products.”[3] Senator Ted Kennedy (D-MA), sponsor of S.625, took particular notice of the Harvard study when introducing the bill, stating that “Congress has been an accomplice in the travesty because of the success of the tobacco lobby in blocking real reform. Hopefully, the study will be a wake-up call to persuade Republicans and Democrats alike to enact long overdue legislation.” [4] In reference to nicotine yield disclosure, however, this legislation makes no mention of modifying the existing cigarette testing methods and reporting requirements currently used by the Federal Trade Commission (FTC). This omission is cause for concern.

The FTC has been regulating the nicotine yield of cigarettes since 1965 and has required the same testing method and report parameters ever since. After a report published by the National Cancer Institute (NCI) in the mid-1990s strongly suggesting that changes be made to the FTC protocol, the FTC attempted to take matters into its own hands. In 1997, the FTC officially announced plans to devise a new testing method after admitting that “limitations present in the system since its initiation in 1967 have become of substantial concern due to changes in modern cigarette design and a better understanding of the effects of compensatory smoking behavior.”[5]

The FTC requested in 1998 that the Department of Health and Human Services compile a review of the testing methods, admitting that “due to their scientific nature, these issues fall more within the expertise of HHS.”[6] The HHS and NCI were to convene a working group to address the issue; however, a decade later a consensus on the matter has still not been met. The Chief of NCI’s Tobacco Research Branch, Dr. Scott Lieschow, accounts for this delay by admitting that “we don’t know what a real alternative to the FTC method would be.”[7] The health of American smokers cannot afford another decade of stagnation and uncertainty.

A new cigarette testing
methodology is needed for the FDA.

Courtesy of www.ntis.gov
The debate over the most accurate cigarette testing method continues: Has enough information been synthesized for the Government to garner support for one cigarette testing methodology over another? Will a smoking machine ever be designed that will be able to adequately reflect the habits of a human smoker? Will the FDA be capable of regulating and applying the standards of a new method?

Issues concerning the tobacco industry are often pegged as partisan and controversial. In order to attain broad-spectrum support, the Family Smoking Prevention and Tobacco Control Act has been meticulously crafted as a bipartisan bill to appeal to all political and interested parties. Philip Morris USA, for example, has even endorsed the FDA legislation in its entirety. [8] For this reason, an amendment to the bill which suggests parameters for a new testing method based on that used by Harvard and the MDPH, is not enthusiastically welcomed as we learned from conversations with the congressional staffer who drafted the bill. Any change to the bill as it stands would put FDA legislation in serious jeopardy of not being passed.

There is an alternative to legislative action. For example, the FDA could be instructed to adopt a new testing methodology. A recent report released on May 24th by an NIH panel urged the FDA to mandate a reduction of nicotine levels in cigarettes. The report, entitled Ending the Tobacco Problem: A Blueprint for the Nation, notes the inaccuracy of current testing methods and their inability to gauge the full toxicity of tobacco products. It expresses the need for “a regulatory body that can systematically assess toxic exposures, make judgments about potential risks from tobacco products, regulate industry claims about the products to ensure that they are accurate and not misleading… and provide relevant surveillance to determine actual human exposures and risks. [9]

Congress should disregard partisan differences and vote to pass S. 625 and H.R. 1108. Without change, we again risk the unmonitored manipulation of cigarette nicotine content for another ten years at the expense of the health of present and future Americans.

References:

[1] “Study: Majority of College Smokers Don’t Quit,” Center for Tobacco Research and Intervention, 14 April 2004 (28 January 2007).

[2] Connolly, G.; Alpert, H.; Wayne, G. & Koh, H. (2007). Trends in Smoke Nicotine Yield and Relationship to Design Characteristics Among Popular U.S. Cigarette Brands, 1997 – 2005. Harvard School of Public Health, Online: http://www.hsph. harvard.edu/nicotine/trends.pdf.

[3] H.R.1108 and S.625. The Family Smoking Prevention and Tobacco Control Act. Introduced: February 15, 2007.

[4] “ Statement by Senator Edward M. Kennedy on Harvard Study Revealing Big Tobacco Efforts to Keep Smokers Hooked,” Senator Edward M. Kennedy Press Releases, 17 January 2007, http://kennedy.senate.gov/newsroom/ pressrelease.cfm?id=0d0ec94c-312c-40d3-9761-0822f6864ef2 (1 February 2007).

[5] FTC Cigarette Report. (1997). Online: http://www.ftc.gov/os/1999/07/ seciiiof1997cigarettereport.pdf.

[6] Letter from Donald S. Clark, Secretary of the FTC, to Donna E. Shalala, Secretary of the Department of Health and Human Services (Letter dated: November 19, 1998): Online: http://www.philipmorris.cn/global/downloads/SH/1998_FTC_ test_letter.pdf.

[7] Zielinski, J. (2005). Smoking machine tests inadequate and confusing, but no replacement a decade later. Journal of the National Cancer Institute, 97(1):10-11. Online: http://jnci.oxfordjournals.org/cgi/content/full/97/1/10.

[8] Michael E. Szymanczyk’s (Philip Morris USA Chairman & CEO) letter to the sponsors of FDA legislation. (Letter dated: February 15, 2007). Online: http://www.philipmorrisusa.com/en/our_initiatives/downloads/pdf/Michael_E_Szymanczyk_Letter_FDA.pdf.

[9] Bonnie, Richard J.; Stratton, Kathleen and Robert B. Wallace. “Ending the Tobacco Problem: A Blueprint for the Nation.” Institute of Medicine of the National Academies. 24 May 2007: 236.

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