2. Regulation of amounts of various constituents in cigarette smoke

3. To be meaningful from health point of view, regulation of smoke constituents should relate, not to machine yield, but to smokers intake, taking into account the interaction between the smoker and the product.

4. Jarvis MJ, Boreham R, Primatesta P, Feyerabend C, Bryant A. Nicotine yield from machine-smoked cigarettes and nicotine intakes in smokers: evidence from a representative population survey. J Natl Cancer Inst. 2001 Jan 17;93(2):134-8.

8. InI2001, the U.S. National Cancer Institute (NCI) published Monograph 13

9. Monograph 13 concluded: Measurements of tar and nicotine yields using the FTC method do not offer smokers meaningful information on the amount of tar and nicotine they will receive from a cigarette. and therefore asked for: Measurement of constituent yields in a manner that more closely resembles the way smokers actually consume cigarettes.

10. But, there is no such thing as the (one and only) way smokers actually consume cigarettes because: Different smokers use different ways to smoke the same cigarette Each individual smoker uses different ways to smoke different cigarettes

11. What is it that determines an individual smokers intake ? Nicotine: His personal need for nicotine (that governs the way he smokes in order to get the amount he needs). This intake is NOT essentially brand-related. Any other substance, for example Tar: The amount of Tar that in the smoke of the brand accompanies the smokers personal intake of nicotine. This intake IS brand-related, since it is influenced by the smoke composition (expressed by the proportion between the amount of Tar and the amount of Nicotine, the Tar/Nicotine (T/N) ratio, for the brand).

12. Is the T/N ratio (or an other such ratio) a fixed brand characteristic? The smoke composition does vary to some extent depending on the way the cigarette is smoked. However, the variation among all smokers except some very few, is small enough to be unimportant for brand comparison purposes. Consequently, an acceptable T/N ratio could be derived from the machine yield measures.

13. EXAMPLE A smokers intake of tar = machine yield of tar = his nicotine intake × machine yield of nicotine Amount of nicotine Tar/Nicotine ratio determined by determined by the smoker brand properties

14. Example of brand comparison

15. Example of rule in an intake-related regulation of cigarette smoke constituents. T/N ratio <10 (and, optionally, Machine yield of tar <12 mg Machine yield of nicotine <1.4 mg)

16. Example of brand comparison

17. Summary Regulation of amounts of smoke constituents A smokers intake of nicotine is about the same from all cigarettes and can therefore not be effectively influenced by limits for machine yield of nicotine. A smokers intake of other smoke constituents can be reduced by setting limits for the ratio between yield of certain substances and the yield of nicotine.

18. Regulation of information on packages regarding smoke constituents

19. Health-related purpose of consumer info on cigarette packages: To help the smoker minimize his intake of harmful smoke constituents. Therefore, info should be related to potential INTAKE. Consequently, machine yield figures are meaningless.

20. Machine yield figures on packages are even MISLEADING, since their appearence gives the FALSE impression that: - nicotine intake were determined by cigarette properties and differing widely between different brands but independent of how you smoke. - low figures for a substance, e.g. tar, would indicate low intake of that substance i.e. This is a mild cigarette.

21. Instead, smokers should be aware... - that they are themselves influencing their intake by the way they smoke - that the self-determined intake of nicotine is about the same from all cigarettes - that the intake of other substances is influenced also by cigarette properties (yield ratio to nicotine)

22. Possible model for a meaningful and truthful info box on packages: Nicotine delivery from one of these cigarettes - to a smoking machine (ISO standard): 0.6 mg - to a smoker: 0.1 – 2.0 mg depending on how it is smoked Every milligram of nicotine is accompanied by: Tar: 8 mg Carbon monoxide: 9 mg

23. Summary Regulation of information on packages Machine yield figures as displayed by current EU (and other) regulations are not only meaningless but misleading. Smokers should be informed that their intake of… - nicotine can be varied in a wide range by themselves depending on the way they smoke, but not very much by the choice of cigarette brand. - other substances is influenced by cigarette properties (brand-specific amount of various substances per unit of nicotine) so that choice of brand may help reduce intake of other substances.

24. Regulation of smokefree tobacco products

25. Mean nitrosamine content of moist snuff products from various sources based on dry weight

30. Summary Regulation of smokefree products Regulations must recognize the very large differences in toxicity between different smokefree products and aim at eliminating from the market those who carry serious health risks rahter than those who do not. There are examples of standards that can serve as models for designing meaningful regulations.