• 10/5/2004
  • Atlanta, GA
  • David Wahlberg
  • Atlanta Jornal-Constitution

Makers of a new cigarette claim it curbs the risk of cancer. Another is sold with the slogan, “Great taste, less toxins.”

Snuff in new teabag-like pouches can be sucked and tossed instead of spit out. And anyone care for a tobacco lozenge?

Tobacco companies, reeling from lawsuit settlements, clean indoor air campaigns and growing public distrust are pitching a variety of “reduced-harm” products. The trend — to be discussed at a cancer conference in Atlanta this week — has ignited controversy over whether the potentially less risky offerings should be promoted as an alternative when smokers can’t or won’t quit.

Many public health researchers wonder: is there such thing as a “safer cigarette” — or any kind of “safer tobacco?”

The issue also has lit up the legal world. State attorneys general are questioning marketing claims. Bills in Congress calling for federal tobacco regulation and a buyout of tobacco quotas could restrict — or even expand — development of the “kinder, gentler” innovations. The ongoing federal trial seeking $280 billion from the tobacco industry for 50 years of alleged fraud could also have an impact.

While the “reduced-harm” products and the furor over them are new, the reason health officials are cautious dates to the 1970s. Tobacco companies touted “low-tar” and “light” cigarettes as less harmful, and health authorities initially agreed. Then studies found that smokers compensated by puffing harder and inhaling more deeply, causing a new kind of cancer further down in the lungs.

“We are very concerned about repeating the low-tar fiasco,” said Terry Pechacek, associate director for science at the Centers for Disease Control and Prevention’s Office on Smoking and Health in Atlanta.

“Complete cessation is the proven strategy for reducing risk,” Pechacek said. “Anything less than that has to be judged against that standard.”

One of the first new tobacco products was Eclipse, sold in a few test markets in the late 1990s and distributed nationally last year. Made by R.J. Reynolds, it looks like a conventional cigarette but uses a special process to heat tobacco, instead of burn it, which the company says reduces harmful chemicals in smoke. Ads say Eclipse “may present less risk of cancer, chronic bronchitis and possibly emphysema.”

Advance, also an R.J. Reynolds brand (after the company merged this summer with Brown & Williamson, which developed it), uses a carbon filter and a special tobacco curing process to lower toxin levels, said Mark Smith, an R.J. Reynolds spokesman. It was test-marketed in Phoenix this summer with the Miller Lite-esque slogan, “Great taste, less toxins.”

Boom in new products

The new smokeless tobacco products resemble gum and breath mints more than they do Copenhagen and Skoal. They aren’t billed as less harmful than regular smokeless tobacco, but presented as an alternative to cigarettes, thus possibly lowering risk.

Users of Revel, by U.S. Smokeless Tobacco, pop a pouch filled with tobacco in their mouths and discard it when done. “No spit, no mess, no problem,” proclaims Revel’s Web site. An Ariva lozenge, containing compressed tobacco, dissolves in about 20 minutes. “It permits long-term smokers to use it when they cannot or chose not to smoke,” said Sara Troy Machir, spokeswoman for Ariva’s maker, Star Scientific.

Philip Morris has issued Accord, a smoke-reducing cigarette heated in a device that looks like a pager, with minimal success. Spokeswoman Jennifer Golisch said the company soon will test-market a regular-looking cigarette without publicizing its claims of reduced risk, to gauge consumer interest in taste. Some observers anticipate it will be disguised as a Marlboro.

Though the industry has spent $3 billion developing new products over the past five years, they haven’t captured much market share. But the products are early entries in what could be a sophisticated, booming field, said Ken Warner, director of the University of Michigan Tobacco Research Network. He will speak on the topic in Atlanta on Tuesday at the annual meeting of the American Society for Therapeutic Radiology and Oncology.

“These things are coming out at the rate of one every three months, and they’re not going to go away,” Warner said. “They are exactly what the smoker wants — a way to feel better and not feel guilty about continuing to smoke.”

Whether the products actually reduce harm depends on if individual risk or society’s burden of disease is at stake, health officials say. It is difficult to measure because cancer, heart disease and other tobacco-related conditions take years to develop. The officials also say it is nearly impossible to verify industry claims of fewer toxins or less harm without Food and Drug Administration regulation.

Safer alternatives?

About 46 million American adults — 22.5 percent — smoke, causing more than 400,000 deaths each year, according to the CDC. More than two-thirds of smokers say they want to quit, and a third try to stop each year, but only 10 percent of those who try remain tobacco-free for a year, according to the Institute of Medicine. Roughly 10 million Americans use smokeless tobacco.

Health experts say it is possible for cigarettes to be engineered to produce lower levels of some carcinogens, but they doubt the reduction is significant enough to make any difference in disease — and they wonder if other alterations could increase risk.

Independent testing at Virginia Commonwealth University found Advance reduced one toxin by half, but also revealed that Eclipse’s special filter increased carbon monoxide output by a third, said Tom Eissenberg, who conducted the federally funded research. Carbon monoxide intake contributes to heart disease, which causes more tobacco-related deaths than lung cancer, authorities say.

Cigarette smoke contains more than 4,000 chemicals and more than 200 toxins, at least 40 of which can cause cancer, said Mitch Zeller, former director of tobacco programs at the FDA. Slight decreases in a few may be meaningless, he said.

“We’re talking about the difference between falling out of a 14th-story window and a 12th-story window,” he said. “Both are going to kill you.”

Smoking vs. smokeless

Some health experts believe smokeless tobacco is a healthier alternative to smoking, said Tom Glynn, director of cancer science and trends at the Atlanta-based American Cancer Society. Though the products can cause oral cancer, they eliminate toxin-filled smoke and second-hand smoke, thus reducing harm to others.

“Fewer people would die if all smokers switched to smokeless tobacco tomorrow,” Glynn said. But if many of those smokers would have quit otherwise, the overall damage would be worse, he said. The new pouches and lozenges could attract former smokers or children, leading to a greater overall use of tobacco.

The CDC’s Pechacek dismisses both “reduced-harm” cigarettes and smokeless tobacco as alternatives to giving up smoking, saying anti-smoking achievements have not been fully realized because cessation programs have not been fully funded.

“We believe the attainable goal in this country is less than 5 percent [of adults smoking],” he said.

Tobacco companies say they’re being responsible by offering safer products to people who continue to use tobacco. “We’re damned if we don’t and damned if we do,” said Smith of R.J. Reynolds. But anti-smoking groups say the concept of “reduced harm” is just smoke and mirrors.

“We’re going to see a repeat of what we saw with low-tar and light cigarettes,” said Matt Barry, senior policy analyst for the Campaign for Tobacco-Free Kids. “These companies don’t have a track record worthy of trust.”