Tobacco and Public Health - TCSC Indonesia

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REGULATION OF THE CIGARETTE: CONTROLLING CIGARETTE EMISSIONS
on this. This study reveals two important things. One that the average amount of salivary
cotinine (a satisfactory surrogate for nicotine) achieved is fairly similar regardless
of FTC yield. The second is that there is great diversity in the amount of nicotine taken,
many smokers actually ‘undersmoking’ as well as many ‘oversmoking’. Since a major
object of regulation is to reduce contaminant intake the starting range for nicotine
dose should be something that provides saliva levels of cotinine between the low and
the high levels currently seen, so that compensation is not increased. Clearly this
requires research on humans with various doses delivered by unventilated cigarettes.
Consideration would also need to be given to (possibly higher) doses that reduced
compensation under experimental conditions.
Other restrictions on cigarette chemistry would bear on the nicotine dose but might
arise from limitations that might be placed on additives for other reasons.
Communicating the dose
If regulation can reduce the range of the dose available by compensatory smoking
so that it varies much less, then a suitable measure would be the total amount in the
cigarette rod—which has an analogy to the current labelling of alcohol.
Additives
The modern cigarette may include up to about 600 additives, which are nominated to
certain health departments but for which safety testing is not yet required in burnt
form. The European Union has legislated for disclosure and the provision of toxicology
of additives in burnt and unburnt form and the effect of this legislation on the composition
of the cigarette has yet to be seen. However, the future of the cigarette must
certainly include a move towards simplicity as an orthodox approach to such a consumer
product would usually require detailed testing of each chemical added to the
basic raw material, in this case in burnt form. This approach could properly be taken to
all additives, which should be broadly defined so that all additives, starting with fertilizer
and ending with the paper, should meet the criterion that they do not add to the
harmfulness of the product.
Future nicotine policy
The question of reducing, over time, the amount of nicotine in the cigarette with the
intention of making it less addictive has been raised (Benowitz and Henningfield 1994)
and needs consideration. This is discussed under ‘Global Tobacco Policy’—Chapter 37.
Conclusions
It is past time for the cigarette to be regulated. The object should be to provide the
consumer with the minimum risk cigarette, one that is correctly labelled, provides
a dose of nicotine that is as consistent as possible and carries the lowest possible dose