FTC Advised to List Tar and Nicotine Levels Directly on Cigarette Packages

BETHESDA, Md--An expert advisory committee to the President'sCancer Panel believes that the method of testing levels of tar,nicotine, and carbon monoxide in cigarettes is inadequate, asis the system used by the Federal Trade Commission (FTC) to informconsumers about these levels and what they mean to the smoker'shealth.

The panel's recommendations to the FTC included listing a rangeof levels of these substances directly on cigarette packages,rather than the current method of listing a single value thatgenerally appears in advertising only; educating consumers asto what the numbers mean; and regulating the use of such termsas "light" and "ultralight."

The National Cancer Institute called the meeting in response toa request by Rep. Henry Waxman (D-Calif), then-chairman of theHouse Subcommittee on Health and the Environment.

Harold P. Freeman, MD, chairman of the President's Cancer Paneland director of surgery at Harlem Hospital Center, chaired themeeting, and panel members included experts on environmental carcinogenesis,human behaviorists, pharmacologists, and epidemiologists, as wellas representatives from the tobacco industry.

The FTC began testing the amount of tar and nicotine in cigarettesin 1967, and, in 1980, carbon monoxide levels were added to thestandardized machine-based protocol. But problems with the testmethod (including the reliance on machine testing and changesin cigarette design, composition, and engineering) led publichealth officials and consumers to question its accuracy.

As a result, in 1983, the FTC announced that it had understatedthe amounts of these substances in certain cigarettes, and itdeleted some brands from its official ranking of brands accordingto tar, nicotine, and carbon monoxide levels.

Eventually, the FTC closed its cigarette testing laboratory becauseof these accuracy problems and because the testing had becomeincreasingly costly and complex. Since 1987, such testing hasbeen done by the industry-sponsored Tobacco Institute, with FTCoversight.

The panel advised that such testing should continue to be performedby the tobacco industry at industry expense, with federal oversight;that the FTC testing protocol should be re-examined at 5-yearintervals; and that cigarette manufacturers should be requiredto notify the appropriate federal agency whenever they make significantchanges in cigarette design that affect substance levels.

Smokers Are Not Machines

Panel members agreed that machine testing bears little resemblanceto actual human smoking, but human testing is, of course, impractical.The panel also indicated that smokers may not understand the meaningof the FTC "numbers" (the amount of tar, nicotine, andcarbon monoxide listed for each brand and type of cigarette tested).Smokers probably do not realize that individual smoking behaviorcan significantly affect the amount of such substances inhaled.

Moreover, the FTC's ranking of cigarette brands by machine-measuredyields of tar, nicotine, and carbon monoxide is misleading, sincethe human yield of these substances depends heavily on the waya person smokes. For example, if smokers block the ventilationholes found in many brands, the amount of tar, nicotine, and carbonmonoxide they inhale increases.

Thus, smoking a brand listed as containing 10 mg of tar does notconstitute half the risk of smoking a brand that contains 20 mgof tar. But it is unlikely that consumers realize this--even ifthey read the label and know what a milligram of tar is.

A more realistic approach to giving consumers information aboutbrands, said the panel members, would be to provide a range oflevels that varies depending on the way the cigarette is smoked,known as "puffing parameters."

The parameters include variables such as number of puffs per cigarette,length of each puff, and depth to which the smoke is inhaled.For example, smokers tend to take bigger puffs of "ultralight"cigarettes than regular ones. And someone who lets much of a cigaretteburn down in an ashtray will obviously be exposed to lower yieldsof tar, nicotine, and carbon monoxide than a person who activelypuffs on an entire cigarette.

"How you smoke may be more important than what you smoke,"Dr. Freeman said.

The committee urged the FTC to provide "a simple graphicrepresentation" of the information on tar, nicotine, andcarbon monoxide levels with each pack of cigarettes sold and inall advertising; the information should not imply a one-to-onerelationship between these levels and disease risk.

Currently, except for "ultralights," the FTC does notrequire manufacturers to print tar, nicotine, and carbon monoxideyields on cigarette packs. The commission does require that theyields appear in advertising, but only about 40% of the 900 brandsof cigarettes available in this country are advertised. The committeerecommended that this information also be made available to smokerswho use the unadvertised generic brands.

Regulating Advertising

Descriptors such as "light," "ultralight,"and "low-tar" are used inconsistently in advertisingand, according to panel consensus, should be standardized andregulated, as they are in food advertising and labeling.

The FTC currently requires that advertising claims be substantiatedbut not that a manufacturer include health information in itsadvertising. Thus, if a company includes the word "lite"in a brand name, consumers probably believe that such a brandis better for them than a brand with no such claim.

Or if a brand of cigarettes is advertised as "low-tar,"people may believe there is a health benefit in switching to sucha brand. There is, however, no evidence to substantiate thesebeliefs, the panel said.

A final issue debated at the meeting was whether to inform smokersthat cigarettes contain substances other than tobacco, such ascyanide and arsenic. Because of the potential for confusion, itwas generally agreed that these ingredients should be listed oncigarette packs and in advertising, but not quantified with aspecific level.