723 



- fyi^tsir ^1 



SMOKERS OF LOW- YIELD CIGARETTES DO NOT CONSUME LESS NICOTINE 



, L Benowttz, M D , Sharon M. Hall, Ph.D., Ronald I. HuunNO, Ph.D., Peyton Jaco» II J, Ph.D., 

 R£CSE T. Jones, M.D., and Abdel-Latbf Osman, M.D. 



^Ibaet AOwtsemenis suggest thai smokers of c^- 

 fOa bw n nicotine are exposed lo less nicotine and tax. 

 Isoint yields are measured with smolung machines. tuA 

 do not smoke ctgarattes as people do. We 

 measured the actual nicotine content of conv 

 cjgaretles with different nicotine and tar yields as 

 with smoKirtg machines, and also measured 

 nwjiine ntaka as indicated by b<ood conceotratwns 

 metaboAe, cotinine, in 272 subfects srrKfking various 

 of cigareRes. 

 found that low-yield cigarette tobacco M not con- 



)BACCO advcrtisemenu claim that low-yield 

 . dfarettes "have" and deliver leu tar and nicodite 

 I kigher-yield brands. Many physicians advise pa- 

 I who cannot stop smoking to switch to low-tar, 

 *ine agarettes, believing that they are safer. 

 the figures for nicotine and tar determined 

 <&e i m ofcing machines used by U.S. Federal 

 t Conimissioa (FTC) arxl dted by cigarette ma»- 

 I in advertisements are misleading. The FTC 

 • do oot reflect what b actually taken into the 

 [^ of the cigarette smoker. 



meajuremeiits of cigarette nicotine and tar 



■ are determined by a smoking machine, a syringe 



S5-ml pufls each minute until a set length of 



: it burned.' Cigarettes can have low yields in 



•machir>e assays for several reasons. The to- 



> may be lower in nicotine and may generate less 



'The use of ventilated filters or porous cigarette 



may result in dilution of the tobacco smoke. 



I that bum Taster may reduce the time in which 



^afarette bums; faster burning means that fewer 



> are taken by the machine to bum a given amount 



Kozlowski et al. have pointed out that the 



• Omal I>miiaix*>f3 Dnil oT «ic Mnftcal Scmci. Sa I 



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 I «t MeAoK. Uv>aU7 o^ Cllifcnu. Sa Fmcnoi Adikoi 

 > Ck Beaoov ■ Saa Fiucaoo CcBcrtl Ho^«^ aid Ma&cal 

 • ■"« *■ S«FVxw. 1001 room A«e . Sm Fnacuai. CA XllO 

 I ■ (Wl br (nsa (DA 01696. DA «£rn. DA023M. DAODM. 

 9>l Iram ikc Saocoal losooac aa O^ Atmt 



lain less nicotirw. in fact the nicoCine concentration in to- 

 bacco invo.sefy correlated (r - -0.53, P<O.Cte) wtlh Qtt 

 corceotration measured by smoldng machines. Blood co- 

 tinine concsntratioos correlated with lt>e nun^er of aga- 

 rettes smoked per day but not with the nicotine yieW nvsas- 

 ured by smokjng n'^achines Onty 3.8 to 5 per cent of total 

 variarKX in blood cotirune was contributed by nicotirw 

 yield. 



We conclude that smokers of bw-nicobne cigarettes do 

 not consume less nicotine. (N Engl J Med 1983: 309:13»- 

 42.) 



use of ventilated filters artd more rapid burning dmes 

 can explain much of the reduced yield of currently 

 manufactured cigarettes.'-* The ventilation character- 

 istics of the filter as well as the number of puSi taken 

 before a dgarelte is discarded can be controlled to a 

 substantial degree by the way in which the cigarette is 

 held aiuj smoked. Many smokers will alter their smok- 

 ing behavior, changing the number of dgarettes 

 smoked, the method of puffing, and the depth of inhal- 

 ing the smoke, to maintain a desired level of nicodne 

 intake.*^ For adl these reasons, we questioned whether 

 or oM smokers of low-yield cigarettes truly consume 

 less nicodne. 



We.. addressed two questioas: What is in the ciga- 

 rette tobacco — that is, does the tobacco of low-yield 

 cigarettes contain less nicodne.' And do the FTC fig- 

 ures predict the actual nicotirK intake of smokers.' We 

 measured blood ooncentratioiu of cotinine as an index 

 of nicodne consumption. Cotinine is the major meub- 

 olite of nicotine and persists in the body for a much 

 longer period than nicotine,' with a hajf-life averaging 

 20 hours (unpublished dau). Because of the long half- 

 life, cotinine blood conccntfations vary relauvdy little 

 throughout a day of smoking and thus are a reason- 

 ably consistent measure of nicodne exposure. 



Methods 



TV njoodnc con tent </ tobacco frooi ib popuUr bnnds of cif»- 

 mtcs wu mtajurcd Elsumatca o( iucDUn« delivered by ouchjnc 

 ringed from 05 to 1 .5 mg Cigajtnes were cu( lo the bvii lengths 



