Next steps for the regulation of cigarettes Bill King and Ron Borland

Introduction As we know, there are known knowns There are things we know we know We also know there are known unknowns That is to say, we know there are some things We do not know But there are also unknown unknowns The ones we don’t know we don’t know -Donald Rumsfeld 2002.

Possibilities for regulating cigarettes 1.Regulate to attempt to reduce toxicity –Emission limits. 2.Regulate to attempt to reduce addictiveness –Nicotine limits. 3.Regulate to attempt to reduce attractiveness, especially illusions of reduced harmfulness. –Restrict engineering and additives that help mask inherent signs of toxicity, and/or make the cigarettes taste better than they otherwise would

Toxin reduction Responsibility of companies and regulators Combustion sets limits to possible amount Requires selective filtration If there were any easy solutions, the industry would have adopted them

Reduction in addictiveness Phase out the nicotine –Prohibition by stealth, unless viable alternative source –NRT and/or smokeless tobacco An agenda worth considering –But lots of research needed on viability

Reinventing the “gasper” Cigarettes used to be little more than tobacco rolled in paper Large numbers of additives to enhance flavour, facilitate inhalation of smoke etc Filter ventilation key engineering feature that dilutes smoke, making it seem “lighter” All plausibly add to consumer appeal, and are unnecessary

Low tar Australia Australia took the ‘low tar’ harm reduction strategy further than any other country The system of ‘tar bands’, with six prescribed categories, enabled the industry to produce a huge variety of ‘mild’ brands Six varieties for major brand families Most countries have only regular/ light/ ultra light for major brand families

The Winfield brand family 2005 Nominal tar: 1mg 2mg 4mg 6mg 8mg 12mg 16mg % ventilation:

How do you get so much variety in tar yields and taste? Simple: filter ventilation Without filter ventilation you couldn’t produce more than 2 or 3 distinguishable varieties.

Post ‘Lights’ Australia As of March 2006 Australian cigarette brands no longer have: –tar, nicotine and carbon monoxide figures on-pack (replaced by qualitative warnings) –Mild or Light descriptors in brand names Labelling/ descriptions have changed –replaced by Smooth and Fine descriptors and colour schemes –But, we assume, actual cigarettes remain the same

Mild becomes rich and fine

Old T/N/CO figures and new qualitative warning

Nominal tar: 1mg 2mg 4mg 8mg 12mg 16mg % ventilation: The PJ brand family in transition

The Marlboro brand family gets a new addition

Mean level of endorsement of Light Benefit Scale UK banAUS ban

The other member of the Marlboro family Menthol flavouring also creates illusions of reduced harmfulness Menthol vapour blocks irritation receptors and stimulates cold receptors Why allow that?

Banning flavour additives There is no public health reason to allow flavour additives However, apart from menthol and ‘candy’ cigarettes, we don’t really understand the role of most additives We shouldn’t allow the industry to trade-off ceasing using flavour additives while being able to use engineering to manipulate flavour and harshness We do know that filter ventilation is being used to manipulate flavour and harshness

The mechanism of the “Lights” fraud Filter ventilation not only fools smokers –It also fools the ISO testing regime Heavily vented cigarettes test as very low tar Yet, within limits, deliver equivalent tar to smokers –Smokers compensate by puffing more and harder –The dilution effect is reduced at higher puff intensities

Conclusions While steps that have been taken to deal with the ‘low tar’ deception that may have reduced the problem, they have not ended it The deception is an ongoing cause of harm Banning filter ventilation is the most direct way to deal with the problem –This would effectively result in banning “lights” –Those that are genuinely low delivery would remain But few smoke them There is no reason to allow the current fraud to continue

International Tobacco Control Policy Evaluation Project Major Research Support