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Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction
Knowledge Regarding Constituents, Additives, and Toxicity
Bolling and colleagues (2000) conducted a survey of 1,036 smokers in England in October 1998 to examine consumers’ reactions to cigarette yield and product information. They also conducted focus groups and in-depth interviews in February 2000. While most smokers knew that tar (92%) and nicotine (98%) were present in tobacco smoke, fewer (29%) knew that carbon monoxide was present and almost none (≤5% for all chemicals) knew about the presence of toxic chemicals such as arsenic, lead, and cyanide. Bolling and colleagues also reported that smokers were shocked to learn about the presence of dangerous chemicals in their cigarettes, in part because such information undermined their beliefs that cigarettes were “natural” products.
In 1997, R.J. Reynolds Tobacco Company re-positioned the Winston brand with an advertising campaign claiming its product was made with “100% tobacco,” containing “no additives” (see table 3–1, Arnett, 1999). In mall intercept interviews, 400 adolescents were surveyed about the Winston advertisements in Arizona and Washington, and 203 adults were surveyed in Washington. The two most common responses to the question, What do you think the Winston ads mean by saying that Winstons have “no additives”? were that Winston cigarettes contained only tobacco and that Winston cigarettes have no added chemicals. However, 36% of adolescents and 18% of adults also perceived them as meaning that Winston cigarettes were healthier than other cigarettes. Furthermore, 39% of adolescents and 20% of adults perceived the advertisements as claiming that Winstons were “less likely than other cigarettes to harm your health.” Additionally, 42% of adolescents and 14% of adults stated that the advertisements meant that Winstons are “less likely than other cigarettes to be addictive.” Overall, about two-thirds of adolescents and one-quarter of adults believed that the no additives claim meant at least one of the above implied health claims.
Evidence also suggests that consumers perceive menthol-containing cigarettes to be less harmful because they seem less harsh on the throat. Menthol cigarettes appear to be at least as dangerous as nonmenthol cigarettes (U.S. DHHS, 1998). About 26% of all cigarettes sold in the United States are mentholated (FTC, 2000). The vast majority of African-American smokers smoke menthol brands (U.S. DHHS, 1998). Epidemiological studies of mentholated cigarettes suggest that these products are at least as dangerous as nonmentholated cigarettes (Herbert and Kabat, 1989; Kabat and Herbert, 1991, 1994; Sidney et al., 1995). Additionally, the committee is aware of no evidence in support of the assertion that cigarettes without additives are less hazardous than those with additives.
Given the persistent health claims that were made about these products earlier in the century (Table 3–1), surprisingly little research has been