Tobacco and Public Health - TCSC Indonesia

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NICOTINE DOSING CHARACTERISTICS ACROSS TOBACCO PRODUCTS
Canadian and Japanese brands contained the lowest amounts of preformed NNN in
tobacco (from 259 to 1110 ppb), while the US brands contained the highest (from 1750
to 3050 ppb). Cigarettes made with dark tobaccos contain the highest amounts of
NNN (up to 5534 ppb). NNK content was of the same order of magnitude in both
Canadian and US brands (up to 920 ppb), whereas Japanese cigarettes contained the
lowest concentrations of preformed NNK in tobacco (up to 330 ppb).
The significance of nicotine content in tobacco: An international comparison of
cigarettes with a wide range of the FTC nicotine and tar MS yields (0.1–1.3 mg nicotine
and 1–17 mg tar per cigarette) showed very similar levels of nicotine in tobacco
(Kozlowski et al. 1998). One gram of tobacco from American-blended cigarettes
(n = 32) contained on average 10.2 mg nicotine (7.2–13.4 mg range); the tobacco from
Canadian Virginia blend cigarettes (n = 23) contained on average 13.5 mg nicotine
(8.0–18.3 mg range); tobacco from British Virginia blend cigarettes (n = 37),
12.5 mg nicotine (9.0–17.5 mg range). The similar potential of cigarettes, regardless of
their labeling and marketing claims (filtered vs non-filtered; low- vs high-yield), to
deliver any amount of nicotine and carcinogens in the MS can partially explain an
ever-increasing trend in lung cancer incidence and mortality rates, especially among
women (Jemal et al. 2002), despite the fact that a significant reduction of smoke yields
has occurred during the past five decades (Hoffmann and Hoffmann 1997). Smokers
responded to changing cigarettes by changing their behavior to obtain a desired
amount of nicotine (Burns and Benowitz 2001). They switched to lower-yield products,
smoked greater number of cigarettes per day, and increased the intensity of smoking (e.g.
drawing larger puffs more frequently and blocking the ventilation holes on filter tips)
to obtain the desired dose of nicotine. As a consequence, more intense smoking not
only increased the dose of nicotine in smoke, but also the dose of carcinogens. The
most recent evaluation of risks associated with smoking cigarettes with low machinemeasured
yields of tar and nicotine revealed that switching to low-yield cigarettes had
no, or very little, effect on reducing cancer risk (Burns et al. 2001). In summary, the
presence of a large pool of nicotine in tobacco enables the smoker, driven by a physiological
need, to titrate his or her own dose by engaging in compensatory (more intense)
smoking behaviors (Henningfield et al. 1994; Kozlowski et al. 1998; Djordjevic et al.
2000a). Hence, both the qualitative and quantitative composition of tobacco blend need
to be taken into consideration when evaluating the addicting and carcinogenic potential
of cigarettes.
Mainstream smoke
Mainstream smoke yields as measured with standard
machine-smoking methods
The MS yields of cigarettes are influenced primarily by filtration, ventilation, and the
choice of tobacco processing and blending. As with any agricultural product, there is a
natural variation of tobacco composition from year to year. In the interest of manufac-