Maintaining Nicotine Dependence Nicotine and Dependence
3.3.4 Marketing of Cigarettes with a “Reduced” Health Risk
Byevendiscussingtechnicalaspectsofcigaretteproduction,thetobaccoindustryused everyendeavourtomakethepurchaserbelievethatthemoderncigaretterepresentedless ofahealthriskthancigarettesinthepast.Thus,itpointedtotheinstallationofthecigarette ilter [53] andhasrepeatedlycitedtheminimalhealthriskassociatedwiththisproduct.For theconsumer,however,thetobaccoindustryhasnevercommunicatedclearlywherethe healthriskactuallylies.Atmostitisstatedthatthenewer“low-nicotineandlow-tar”ciga- retteslightandultralightcigarettesare“healthier”thanregularcigarettese.g.Viceroy, Marlboro,Winston [54] Tables 3.4 – 3.6 .Withthecigaretteindustrymakingsuchclaims, lightandultralightcigarettesaresmokedmorefrequentlythan“orthodox”brands [41] . TheactualconcentrationsoftoxicsubstancesCO,benzo[a]pyrenehavesincebeenpub- lishedTables 3.5 and 3.6 .3.3.5 Compensatory Behaviour by Smokers
Thetobaccoindustryrealisedrelativelysoonthatlightcigarettesaresmokeddifferently fromregularcigarettes,afactthatwasalsoevidentfromacomparisonofhumansmoking behaviourpatternswiththoseofasmokingmachine [55] .Thedependentsmokerimmedi- atelydetectsthemodiiedreleasepatternofnicotinefromthenewcigarettes.Cigarettes withareducednicotineyieldareinhaledmoredeeplytoobtainthesamenicotinedose.In manycases,especiallyinsituationsofstressoralteredpsychologicalmood,eitherstronger Table 3.6 Acomparisonofsmokedatafortwolow-yieldUSiltercigarettessmokedaccordingto theFTCmethodandbysmokers [109] Parameters FTCmachine smoking Cigarettesmokers FTC0.6–0.8nicotine FTC0.9–1.2nicotine Puff Volumeml 35.0 48.645.2–52.3 a 44.140.8–46.8 b Intervals 58.0 21.319.0–23.8 a 18.516.5–20.6 b Durations 2.0 1.51.4–1.7 a 1.51.4–1.6 b Nicotine mgcigarette 0.70.6–0.8 1.741.54–1.98 c 2.392.20–2.60 d 0.11.09–1.13 Tarmgcigarette 8.57.7–9.5 22.318.8–26.5 e 29.025.8–32.5 f 15.414.2–14.9 COmgcigarette 9.79.0–10.4 17.315.0–20.1 g 22.520.3–25.0 h 14.614.2–14.9 BaPngcigarette 108.2–12.3 17.915.3–20.9 i 21.419.2–23.7 j 1410.1–19.4 NNKngcigarette 112.996.6–113.0 186.5158.3–219.7 i 250.9222.7–282.7 j 146.2132.5–165.5 Testgroups: a 56, b 71, c 30, d 42, e 18, f 19, g 15, h 16, i 6and j 3smokers cigarettes are used or two or more cigarettes are smoked in rapid succession [56] . ObservationsofthiskindweremadewiththeMarlboroLightbrand [57] .Infact,observa- tionsandindingsobtainedwithlightcigaretteshaveoftenbeenthesubjectofpublications [25,54,58,59] .Thehealth-relatedconsequencesoflong-termuseofthesecigarettescan- not yet be foreseen, especially because they are smoked with greater intensity, deeper inhalationandlargerinhaledandexhaledvolumes [60] .Manysmokerswerepreviously unawarethatlightcigaretteshaveorhadventsintheiltertoimproveventilatione.g.the Winston“Reds”brand [61–64] .Thetobaccoindustryarguedunoficiallythatastheciga- retteincreasinglyburnsdown,theholesbecomeblockedandhence,thereleaseofnicotine isincreased [65] . Cigaretteswithselectivereductionsinnicotinedeliveryhavebeenconsideredaspoten- tialtoolstopreventortreatnicotinedependenceorreduceharmbyvirtueofreducednico- tineandnitrosaminedelivery.Animportantquestioniswhetherindividualssmokethese productsmoreintensively,ashasbeenshowntooccurwithventilated-iltercigarettes.To investigatethisissue,wecomparedconventionalhighlyventilatediltercigarettes,having verylowtarandnicotineyieldswhensmokedbyFederalTradeCommissionmethod1mg tar,2mgcarbonmonoxide[CO],2mgnicotine,withlownicotinecontentcigarettes, manufacturedfromageneticallymodiiedstrainoftobacco,whichhadhighertarbutlower nicotineyield14mgtar,13mgCO,02mgnicotine.Atotalof16cigarettesmokerspar- ticipatedintwo8-hsessionsordercounterbalancedduringwhichtheysmokedeachtype ofcigaretteadlibitum.Expired-airCO,plasmanicotineandsmokingtopographymeasures werecollected.Subjectsshowedsigniicantincreasesinsmokingwhenusingthehighly ventilatediltercigarettesandpuffvolumewassigniicantlygreaterthanwiththelownico- tinecontentcigarettes.Subjectsachievedanexpired-airCOlevelofashighas74with thelownicotinecontentcigarettes;thelatterproducedCOlevelssimilartothosemeasured atbaselinewhensubjectssmokedtheirhabitualbrandsofcigarettes.Plasmanicotinelevels obtained when subjects smoked the highly ventilated ilter cigarettes also were signii- cantlyhigherthanwhentheysmokedthelownicotinecontentcigarettes.Theseresults indicatethatthedeliveryofsubstantialamountofsmoke,withselectivereductionsinnico- tineyield,appearstopreventcompensatorysmokingbehaviour.Furtherstudiesshould determinewhethersimilarresultsareobtainedinnaturalisticenvironments [66] .3.3.6 Optimising Nicotine Release
Accordingtothetobaccoindustry,oneofitscrucialresearchobjectiveswastoincreasethe availabilityofnicotinereleasedfromtobaccotosmokersasthefreebase:thepHoftobacco hasanimportantfunctioninthiscontext.DependingonpH,nicotineispresentintheform ofadiprotonatedormonoprotonatedsaltandasthefreebase [67] .Theformeristhebound formpK 1 =3.02andthelatteristhefreelyavailableformpK 1 =8.02.Thefreeform penetratesbiologicalmembranesveryrapidlyandextensively,whereasthepenetrationof the bound form is very much slower and less quantitative. Because the nicotine base reachesthebrainfarmorerapidly,thetobaccoindustrybecameawareofthispropertyof free nicotine at a very early stage [68] . The higher the pH, the greater the amount of extractablenicotine [69] .ThepHofcigarettesmokeisbetween6.5and7.0,arangeinParts
» Tobacco Plants and Their Origin Use of Tobacco for Religious Purposes
» The Appropriation of Tobacco by Europeans
» Development of the Cigarette
» Objections to Smoking on Health Grounds
» Women Won Over by the Cigarette
» The Medical Use of Tobacco in the Nineteenth Century
» Tobacco Research in the Twentieth Century
» Tobacco Consumption in the Twentieth Century
» Cigarette Smoking in the USA Since 1965
» Cigarette-Related Mortality in Different Countries
» Smokers and Other Risk Factors
» Smoking Behaviour and Educational Level in the EU
» Non-Disclosure of Findings by the Tobacco Industry
» The Cigarette as a Vehicle for Nicotine Release
» Modifications of Nicotine Release
» Maintaining Nicotine Dependence Nicotine and Dependence
» Marketing of Cigarettes with a “Reduced” Health Risk
» Compensatory Behaviour by Smokers
» Optimising Nicotine Release Nicotine and Dependence
» Importance of Absorption Rate
» Ammonium and pH Manipulation
» Cigarettes with Reduced Tar Yield
» Agonists and Antagonists of the nAChR and its Subtypes
» Effects of Nicotine on Receptors in Different Organs
» Metabolic and Hormonal Effects of Nicotine
» Central Nervous System Effects of Nicotine
» Types of Dependence Nicotine Dependence
» Molecular Biological Aspects of Dependence
» Genetic Aspects Nicotine Dependence
» Withdrawal Symptoms Nicotine Dependence
» Immunological Reactions Caused by Cigarette Smoking
» Association Between Smoking and Lung Cancer
» Tobacco-Specific Carcinogens Genetic Factors That Increase the Risk for Bronchial Carcinoma
» The Cytochrome P450 and GST System and Carcinogenesis
» Peptide Receptors, Genetic Factors That Increase the Risk for Bronchial Carcinoma
» Exogenous Factors and Lung Cancer
» Pathophysiology of COPD Cigarette Smoking and COPD
» Genetic Factors Important Risk Factors for COPD
» Occupational and Environmental Factors
» Caveats Concerning the Informative Value of Studies
» Cigarette Smoking and Bronchial Asthma in Adults
» Bronchial Asthma in Children
» Other Lung Diseases Influenced by Cigarette Smoking
» Coronary Artery Disease and Myocardial Infarction
» Changes in Endothelial Function and Microcirculation
» Microcirculation and O Systemic Vascular Changes
» Arteriosclerotic and Inflammatory Vascular Reactions
» Genetic Factors Blood Coagulation and Fibrinolysis
» Nicotine and Ischaemic Heart Disease
» Cognitive Impairment Central Nervous System
» Influence on Cognitive Performance
» Intellectual Impairment in Childhood
» Smoker Personality Profiles and Genetic Inheritance of Smoking
» Peculiarities of the Smoker’s Personality
» Reasons for Increased Cigarette Consumption
» Comorbidity Between Depression and Smoking
» Extent of Cigarette Consumption
» Effects of Smoking in Forms of Dementia
» Smoking and Parkinson’s Disease
» Diabetic Retinopathy Ocular Diseases
» Graves’ Ophthalmopathy Ocular Diseases
» Macular Degeneration Ocular Diseases
» Ocular Tumours Ocular Diseases
» Retinal Detachment Ocular Diseases
» Lipid and Cholesterol Metabolism
» Insulin Resistance Diabetic Nephropathy
» Oesophageal Cancer Gastrointestinal Tract
» Gastrointestinal Ulcers Gastrointestinal Tract
» Cancers of the Gastrointestinal Tract
» Pancreatic Cancer Gastrointestinal Tract
» Toxic Substances and Inducers
» Kidney Cancer Urinary Tract Diseases
» Bladder Cancer Urinary Tract Diseases
» Prostatic Hyperplasia and Prostatic Cancer
» Fertility Disorders Urinary Tract Diseases
» Vitamin D and Oestrogen Metabolism
» Osteoporosis Disorders of Mineral Metabolism and Bone
» Hip Fractures Disorders of Mineral Metabolism and Bone
» Skin Changes Skin and Mucosa
» Skin Tumours Skin and Mucosa
» Breast Cancer Skin and Mucosa
» Effects of Smoking on the Placenta
» Malformations Possibly Caused by Smoking
» Smoking and Sudden Infant Death Syndrome SIDS
» Effects of Nicotine on the Foetus
» Medical Care Costs Attributable to Smoking During Pregnancy
» ETS in the Workplace and at Home
» Fibrinogen Cholesterol Endothelium and Platelets
» Markers of Inflammation Changes at the Molecular and Cellular Level
» Passive Smoking During and After Pregnancy
» Coronary Heart Disease Cardiovascular Disease
» Stroke and Subarachnoid Haemorrhage
» Respiratory Tract in Children and Teenagers
» Bronchial Carcinoma Respiratory Tract
» Indications and Diagnostic Considerations
» Self-Help Interventions by the Smoker
» Physician Advice for Smoking Cessation
» Group Behaviour Therapy Programmes
» Mass Media Communication Strategies
» E-Learning, Email and Internet for Smoking Cessation
» Evaluation of Nicotine Products
» Nicotine Chewing Gum Nicotine
» Nicotine Sublingual Tablet Nicotine Nasal Spray
» Treatment and Dosage Nicotine
» Nicotine Chewing Gum Adverse Events Associated with NRT
» Nicotine Patch Adverse Events Associated with NRT
» Nicotine Nasal Spray Adverse Events Associated with NRT
» Nicotine Inhaler Adverse Events Associated with NRT
» Nicotine Sublingual Tablet Adverse Events Associated with NRT
» Nicotine Lozenge Adverse Events Associated with NRT
» Drug Interactions During Smoking Cessation
» Contraindications for the Use of Nicotine Products
» Nicotine Formulations as OTC Products
» Contraindications and Drug Interactions
» Tranquillisers and Buspirone Other Pharmacotherapies
» Various Antidepressants Other Pharmacotherapies
» Opioid Antagonists Other Pharmacotherapies
» Silver Acetate Other Pharmacotherapies
» Therapeutic Monitoring in Smoking Cessation
» Ischaemic Heart Disease Special Therapeutic Situations
» Pregnancy Special Therapeutic Situations
» Weight Gain Special Therapeutic Situations
» Alcohol Consumption Special Therapeutic Situations
» Organic Depression Organic Depression and Schizophrenia
» Schizophrenic Patients Organic Depression and Schizophrenia
» Interactions Between Cigarette Smoking and Administration of Psychopharmaceuticals
» Pre-operative Smoking Cessation Special Therapeutic Situations
» Social Influence Inoculation Strategy
» Life Skills Strategy Prevention Programmes for Schools
» Class 2000 Health Promotion Programme
» Trier University Health Programme Long-Term Studies
» Role of Teachers in Primary Prevention
» Prevention by Restricting Sales of Tobacco Products to Minors
» Role of the Mass Media in Sales of Tobacco Products to Adolescents
» Role of Government and Community in Primary Prevention
» Effect of Tobacco Industry Advertising Messages
» Tobacco Advertising and Adolescent Smoking Initiation
» Advertising with “Light” Cigarettes
» Smoking Bans in Public Buildings and Public Spaces
» Tobacco Industry, Governmental and Non-governmental Organisations
» Politicians and Their Attitude to Smoking
» Scientists and the Tobacco Industry
» Governmental Control of Toxic Tobacco Constituents
» Bans on Advertising in Various Countries
» Tobacco Industry: Playing Down the Risks of Smoking and Passive Smoking
» Smoking and Non-smoking: Weighing the Benefits
Show more