BRAND NOT CONTRABAND

Would Nicotine Addiction Matter If Smoking Didn't Cause Disease?

IF YOU began the year with a resolution to give up smoking, you don't
need to be told that it will take all the luck and determination you
can muster. If you are still persevering, take heart: you are already
ahead of the game. According to the statistics, two out of three
people who tried to give up will have relapsed by now. By the end of
the year 90 per cent will be smoking again.

So, despite various curbs on cigarette advertising and smoking in
public places, the public health battle is far from won. Many health
officials feel the time is ripe for the next phase, and for
governments to wrest control of the content of cigarettes from the
manufacturers.

Moves in this direction are already afoot. In a couple of months'
time, health officials in Brussels will circulate drafts for rules
that will govern how much tar and nicotine Europe's cigarettes may
contain, and what information about their chemical make-up should be
printed on the packets. And in the US, the Food and Drug
Administration has for years made no secret of its desire to regulate
cigarettes in the same way as pharmaceuticals.

However, acquiring the political and legal power to redesign
cigarettes is one thing. Deciding how to redesign them to make them
safer is quite another. This is where things get a bit trickier---and
where it could all go horribly wrong.

Some of the many improvements that are on the cards are
uncontroversial. The idea that manufacturers should reveal the
identity and quantity of the ingredients of their cigarettes---and the
smoke that they produce---is a good way of giving them an incentive to
clean up their products. Cigarette smoke contains specific
cancer-causing chemicals. Consumers surely have a right to know which
brands contain the highest or lowest levels of these chemicals. And
who could argue against rules forbidding the use of sugary additives
designed to appeal to youngsters? Or additives that open up the
airways to allow more smoke in?

But officials must resist the urge to enforce the gradual removal of
nicotine from cigarettes to create the tobacco equivalent of
decaffeinated coffee. The American Medical Association is a big fan of
this approach and it is certainly technically feasible. Some
denicotinised cigarettes are already on sale. The problem, as study
after study shows, is that when smokers are given cigarettes low in
nicotine, they compensate by smoking more cigarettes or inhaling smoke
more deeply. Ultimately, smokers want a chemical fix and they are
unlikely to stop until they get it.

Advocates of the nicotine-free approach say the problem of
compensation would vanish if the nicotine levels were so low that no
amount of puffing could create the buzz smokers crave. But would
anyone buy such cigarettes? More likely they would turn to the black
market for an illicit supply.

Fortunately, there is an alternative route to a safer cigarette: keep
the nicotine but cut down the cancer-causing chemicals in the smoke.
Better still remove the smoke or as much of it as possible.
Manufacturers have already developed experimental "non-burning"
cigarettes in which nicotine is released as a vapour by the action of
heat on the tobacco. Governments should make sure such developments
reach the marketplace.

Of course, this approach requires us to accept that in one shape or
form nicotine is always likely to be with us. People with moral
objections to the recreational use of drugs will find that hard to
swallow. But if we are serious about curbing the harm smoking does,
pragmatism is the path to follow.

Prohibition was a dismal failure with alcohol. There is no reason why
it should work any better with nicotine.