Light and low-tar cigarettes

In this Background Brief ‘light' cigarettes refers to any brand with packaging using terms, numbers or colours that imply it is a ‘low tar' cigarette, for example ‘extra light', ‘ultra light', ‘super light', ‘super mild', ‘ultra mild', ‘smooth flavour', ‘fine flavour', ‘4', ‘2', ‘1', ‘white 1', and so on.

Around 65% of Australian smokers report smoking ‘light' or ‘mild' cigarettes.¹ The majority of these smokers believe that ‘light' cigarettes are better for their health than regular cigarettes.¹ They aren't; they carry the same health risks as regular cigarettes. Because of their mistaken belief, many people may put off stopping smoking, which would greatly reduce their risk of illness, disability and death from tobacco-related disease.^2,3

Less harsh smoke does not mean it is less dangerous.

The majority of people who smoke ‘light' cigarettes say they find the smoke ‘smoother' or less harsh on the throat and chest.¹ It might seem like common sense to believe that milder smoke will do less damage to your body, but scientific evidence shows that this is not true.^1,2

Here are two main ways that tobacco companies reduce the harshness, but not the deadliness, of cigarette smoke:

Additives are used to lessen the irritating effects of the smoke.⁴

These include sweeteners such as sugar, honey and cocoa.⁴ Other additives reduce or alter feeling in the throat.⁴ For example, menthol added to cigarettes produces a ‘cooling sensation' and also numbs the throat.⁵ Menthol is also used in lower doses in some non-menthol brands.⁵ Additives such as liquorice or cocoa may be used to open up the airways making it easier for smokers to inhale nicotine and tar more deeply into their lungs.⁴

As a smoker draws on a cigarette, tiny holes in the filter let in air, diluting the smoke.²

The effect is much like diluting whiskey with water. Watered-down whiskey tastes smoother and is less fiery and irritating to the mouth and throat, but the drinker would still have the same blood alcohol level as if they drank the same amount of whiskey without water. So too with light cigarettes: the smoker is getting the usual amount of nicotine and smoke going into their lungs and body, but with more air. So the smoke is not as concentrated as regular cigarettes but still has the same damaging effects. This cigarette design is called filter ventilation.²

One ‘light' cigarette equals one regular cigarette.

Research shows that there is little difference in the levels of nicotine, carbon monoxide and other toxins inhaled by smokers of ‘light' and regular cigarettes.² Smokers who choose to switch to supposedly ‘lower tar' cigarettes inhale just as much disease causing chemicals from each cigarette as they did from their previous brand.²

In Australia, some cigarettes brands use numbers on the front of their packs as well as terms such as ‘light' and ‘mild' to give the impression that some cigarettes are lower in tar. There is a lot of confusion about what these numbers actually mean. These numbers don't tell you the maximum amount of tar in a cigarette nor even the maximum amount of tar you can inhale from that cigarette. So what do they mean?

The numbers are the tar levels measured by a machine that extracts only a fraction of the total smoke that a cigarette can produce.² Cigarettes with low numbers have more air vents in their filter, so the machine takes in more air and less smoke.² Tests show that smokers of ‘light' cigarettes typically inhale two to three times more smoke than the machine, because they smoke the cigarette differently to get the amount of nicotine they need.^2,6

Addiction to nicotine is the major reason for continuing to smoke.² Smokers' bodies become used to a certain amount of nicotine: they tend to keep up the same level of nicotine in their blood from day to day.² This amount varies from person to person and depends upon how much nicotine they need to ‘feel normal', to satisfy cravings or control their mood.²

Modern ‘low tar' cigarettes have been deliberately designed to over-deliver, to make it easier for smokers to get the amount of nicotine they need. But when smokers inhale higher amounts of nicotine, they also inhale higher amounts of noxious gases and tar. As far as a human smoker is concerned, the tar level numbers on cigarette packs are meaningless. A lower number does not make the cigarettes safer or healthier than cigarettes with a higher number.² The type of cigarette they smoke has little effect on the levels of nicotine and other chemicals from smoke that end up in their blood stream.²

‘Light' cigarettes are as harmful as regular cigarettes.

Scientific evidence shows that smokers of ‘light' cigarettes do not have less risk of smoking related diseases such as lung cancer, heart disease and emphysema, than smokers of regular cigarettes.^2,3,7 Switching to so-called ‘lower tar' or ‘light' cigarettes is not likely to reduce the amount of chemicals in the smoke actually inhaled and the resulting risk of disease.²

In fact, it is very difficult to substantially reduce the risk of disease while continuing to smoke. Even smokers of less than five cigarettes per day have almost three times the risk of dying from heart disease, and a higher risk of death from tobacco-related diseases than non-smokers.⁸ People who smoke less than ten cigarettes per day have around four to five times the risk of lung cancer.^8,9 The risk of disease increases with the number of cigarettes per day and years of smoking.^3,9

‘Light' cigarettes are as addictive as regular cigarettes.

Studies show that smokers can and do inhale higher amounts of nicotine than what is implied by ‘light' cigarette packaging.² It follows that new smokers may become addicted to ‘light' cigarettes just as quickly and easily as regular cigarettes. There is no evidence that switching to a ‘lower tar' cigarette reduces addiction or helps smokers to quit.²

The government does not regulate the design or contents of cigarettes and does not approve messages of safety of one cigarette over another.

There are no laws or regulations restricting what tobacco companies can add to cigarettes or how they are designed. Legally they do not even have to tell the government or smokers what they do to their cigarettes. For example, the tobacco companies did not publicise the introduction of air vents in cigarette filters that allow the smoke to be diluted, giving lower levels of nicotine and tar to the measuring machine but not to smokers.^2,10

The illusion that some cigarettes are safer than others is entirely a marketing strategy by the tobacco industry, to quieten fears of health conscious smokers who would otherwise quit if they didn't think they were smoking a safer cigarette.^2,11

Tobacco companies are still using marketing tactics that give the impression that some cigarettes are safer than others.

After recent action by the Australian Competition and Consumer Commission (ACCC), the main tobacco companies have agreed to remove the misleading terms ‘light' and ‘mild' from their packaging. However they are still using other marketing tactics to keep up the illusion that some cigarettes deliver less tar than others. Probably of most importance is the research on what people associate with different coloured packs. For example, industry documents state "Red packs connote strong flavour, green packs connote coolness or menthol and white packs suggest that a cigaret[sic] is low-tar. White means sanitary and safe. And if you put a low-tar cigaret[sic] in a red package, people say it tastes stronger than the same cigaret[sic] packaged in white".¹¹

Even the cigarette itself can be altered to give the impression of a safer product by using white tipping paper on the filter instead of the cork-coloured paper used on most full-flavoured cigarettes.¹² New words describing the ‘flavour' of cigarettes have appeared on some packs, e.g. ‘full', ‘rich', ‘smooth', ‘fresh' and ‘fine'. Together with pack colours and imagery they continue to build on the deception that some cigarettes are safer than others.¹³

Stopping smoking is the only way to gain control over your health now and in the future.

People who quit have a lower risk of disease than continuing smokers regardless of the type of cigarette they smoked.^3,14 When you smoke, the chemicals you take into lungs and bloodstream are damaging almost every organ in your body.³ They are depressing your immune system, damaging your genes, causing fat to build up on your artery walls, and bit by bit destroying your lungs.³ When you quit, these disease processes stop or slow down.⁴ Your body can start to heal. You reduce your risk of lung cancer, heart disease, stroke, emphysema, mouth cancer, losing your limbs from artery disease and many other tobacco-related diseases, compared to the risk if you continued smoking.³ As some damage is permanent, the earlier you quit, the better.³

Getting advice and support when you are planning to quit will give you a much greater chance of success.¹⁵ Help is available from your doctor, your pharmacist, other health professionals and the Quitline (13 7848). Nicotine replacement products are safe and double your chance of quitting.¹⁶ Prescription medicine (e.g. Zyban), available from your doctor, also increases your chances of quitting.¹⁷ Other options are also available.

Quit Victoria offers a range of information and resources:

Quitline 13 QUIT (13 7848)

• the Quitline is a confidential telephone information and advice service. For the cost of a local call, professional telephone advisors provide encouragement and support to help smokers quit.

Quit Victoria's website

• Our website has a range of information that can be accessed, including:
• Quit coach http://www.thequitcoach.org.au/ - an internet based resource to help smokers quit by generating free personal advice tailored to their needs.

References

1. Borland R, Yong HH, King B, Cummings KM, Fong GT, Elton-Marshall T, et al. Use of and beliefs about light cigarettes in four countries: findings from the International Tobacco Control Policy Evaluation Survey. Nicotine Tob Res 2004;6 Suppl 3:S311-21.
2. U.S. Department of Health and Human Services. Risks associated with smoking cigarettes with low machine-measured yields of tar and nicotine. (Smoking and Tobacco Control Monograph 13) Bethesda, MA: U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, 2001. NIH Publication No. 02-5074. http://cancercontrol.cancer.gov/tcrb/monographs/13/, accessed 22 May, 2003.
3. United States. Department of Health and Human Services. The Health consequences of smoking: a report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2004.
4. Bates C, Jarvis M, Connolly G. Tobacco Additives: cigarette engineering and nicotine addiction. London: Action on Smoking and Health, 1999. http://www.ash.org.uk/html/regulation/html/additives.html, accessed 27 May, 2003.
5. Ferris Wayne G, Connolly GN. Application, function, and effects of menthol in cigarettes: a survey of tobacco industry documents. Nicotine Tob Res 2004;6 Suppl 1:S43-54.
6. Djordjevic MV, Stellman SD, Zang E. Doses of nicotine and lung carcinogens delivered to cigarette smokers. J Natl Cancer Inst. 2000 Jan 19;92(2):106-11.
7. Harris JE, Thun MJ, Mondul AM, Calle EE. Cigarette tar yields in relation to mortality from lung cancer in the cancer prevention study II prospective cohort, 1982-8. BMJ. 2004 Jan 10;328(7431):72.
8. Bjartveit K, Tverdal A. Health consequences of smoking 1-4 cigarettes per day. Tobacco Control 2005;14(5):315-20.
9. United States. Department of Health and Human Services. Reducing the health consequences of smoking : 25 years of progress : a report of the Surgeon General : 1989 executive summary. Rockville, Md.: U.S. Dept. of Health and Human Services Public Health Service Centers for Disease Control Center for Chronic Disease Prevention and Health Promotion Office of Smoking and Health; 1989.
10. King B, Borland R. The "low-tar" strategy and the changing construction of Australian cigarettes. Nicotine Tob Res 2004;6(1):85-94.
11. Pollay RW, Dewhirst T. The dark side of marketing seemingly "Light" cigarettes: successful images and failed fact. Tob Control 2002;11 Suppl 1:I18-31.
12. Cummings KM. Tobacco risk perceptions and behavior: implications for tobacco control. Nicotine Tob Res 2004;6 Suppl 3:S285-8.
13. King B, Borland R. What was "light" and "mild" is now "smooth" and "fine": new labelling of Australian cigarettes. Tob Control 2005;14(3):214-5.
14. Rigotti NA, Tindle HA. The fallacy of "light" cigarettes. BMJ 2004;328(7440):E278-9.
15. Lancaster T, Stead L, Silagy C, Sowden A. Effectiveness of interventions to help people stop smoking: findings from the Cochrane Library. BMJ. 2000 Aug 5;321(7257):355-8. Review.
16. Silagy C, Lancaster T, Stead LF, Mant D, Fowler G. Nicotine replacement therapy for smoking cessation (Cochrane Review). In: The Cochrane Library, Issue 4, 2001. Oxford: Update Software.
17. Hughs JR, Stead LF, Lancaster T. Antidepressants for smoking cessation (Cochrane Review). In: The Cochrane Library, Issue 2, 2003. Oxford: Update Software.