Harm Reduction, Removing the Least Harmful Component

You’ll remember Shirley Cramer talking about “nicotine free” cigarettes at the E-Cigarette Summit and how, by some margin many of the general population (87% to be precise) think that nicotine is the harmful component of cigarettes. Well it turns out that there is a company out there trying to become the “world’s first manufacturer of cigarettes with the distinction ‘very low nicotine’“.

So, forget everything you’ve ever learned about the 4000+ other ingredients and chemicals contained within cigarettes it’s all about reducing exposure to nicotine. As thoroughly covered at the E-Cigarette Summit, and on many occasions before and after, the stigma surrounding nicotine needs to be addressed. In fact, as Joe Gitchell points out frequently (yes I have been listening Joe!), many in tobacco control and public health need to re-think nicotine. I would definitely agree with that. Wholeheartedly in fact.

The trouble with researching nicotine, along with its potential “addictive” or “lethal” properties in humans means there is a very big ethical dilemma. You see, it’s generally not widely accepted to test something on humans that may possibly kill or addict them to the substance. It’s just not cricket. So instead science relies on rats, mice and cell studies to evaluate possibilities, while that doesn’t specifically tell us what the effect will be in a human, it will give the researchers some very good indicators as to what might happen. The rest, as they say, is biology.

“Nicotine is a powerful, a very powerful, addicting agent,” said Andrew Hyland, chairman of the department of health behavior at Roswell Park Cancer Institute

See, a lot of the research I have read comes to similar conclusions but the trouble is, the majority of the research into nicotine is as a by-product of research into tobacco and there is (sadly) plenty of that kind of research.

Newhouse_Nicotine

So these brainiacs over at The 22nd Century Group are planning on becoming the “world’s first” manufacturer of cigarettes with “very low nicotine”. Nicotine, which by itself doesn’t necessarily have reinforcing properties and is rather unpleasant to ingest. Wibble.

“Unlike conventional cigarettes, which are very high in nicotine, ours are a reduced tobacco-based product,”

To be fair, most US tobacco cigarettes do contain much higher amounts of nicotine than the EU counterparts, mostly because the EU likes to be a nannying superstate trying to control everyone’s lives, while the US simply doesn’t give a fuck. But now, 22nd Century Group have filed a Modified Risk Tobacco Product Application with the FDA similar to the one submitted by Swedish Match, which hasn’t gone particularly well, but the experts at 22nd Century have been working hard on this with researchers concluding:

22nd Century’s proprietary Very Low Nicotine cigarettes were “associated with reductions in smoking, nicotine exposure, and nicotine dependence, with minimal evidence of nicotine withdrawal, compensatory smoking, or serious adverse events.”

The thing is, “Brand A” (listed as being “in development“) still contains quantities of tar, albeit at lower amounts than traditional smokes. Similar in nature is “Brand B“, where there is more nicotine, but apparently less tar, which according to 22nd Century:

We believe results from this and other exposure studies will warrant a modified risk claim for BRAND B. There is, however, no guarantee that  BRAND B  will be classified as a Modified Risk Cigarette by the FDA

So, more nicotine (or equal) than “Brand A” and still has tar (albeit in substantially less quantities) but is unlikely to receive a “Modified Risk”. Doesn’t that just take the “harm reduction” booklet and throw it out the window?

“The paradigm shift is to commercialize and develop less or reduced tobacco-based products,” Gellman said. “In short, every other option that’s been implemented, has failed. Absent of introducing anything that is more harmful than what you as the smoker are currently engaged in, it is the paradigm shift that we see.”

A changing to regular patterns would suggest a tobacco free product, or one that doesn’t generate the multitudes of chemicals through combustion would be a much better way to go wouldn’t it? Yet apparently, “every other option” has failed; which would of course include the humble e-cigarette.

That means people who use their product will still be smoking, but they’ll be ingesting just a fraction of the nicotine as traditional cigarettes. That’s key, experts say.

People will still be smoking. Isn’t that a rather juicy telling line right there? You see, as these are clearly tobacco products (albeit supposedly ‘less harmful’), they will be subject to any and all existing regulations including taxation.

But, they insist that it’s the nicotine that makes it difficult to quit smoking.

“The primary thing that makes it so difficult to quit is dependence on nicotine,” Hyland said.

So, the dependence is absolutely nothing to do with all the other additives that are contained within processed tobacco readily available (and regulated by the FDA) in the likes of Marlboros or Camels. The trouble is, as Hyland wryly points out is that these low nicotine cigs will be sitting alongside said Marlboros and Camels:

“The big caveat is, when you go to the store and there’s the low nicotine cigarettes and the regular Marlboros, compliance with adhering to that treatment is pretty low,”

So if you decide to switch to “Brand A” or “Brand B”, there’s a risk that *gasp* they’ll become a gateway to smoking traditional cigarettes. Yet there doesn’t seem to be much in the way of outcry at this from the usual suspects. Maybe it has something to do with:

22nd Century licensed Hercules Pharmaceuticals LLC, its pharmaceutical subsidiary

But good ol’ Hyland contradicts himself a little:

“For someone who’s able to use a product, like a very low nicotine product, or any product for finite period of time and switch completely off the Marlboros and Camels, that’s a success story in my book.”

So, something like a vapour product then?

According to the study: “(R)educed-nicotine cigarettes versus standard-nicotine cigarettes reduced nicotine exposure and dependence and the number of cigarettes smoked.”

Maybe the “reduced nicotine” cigarettes don’t actually taste good so those involved in this trial decided it was better to go without ? Why do researchers always forget about the enjoyment factor?

Oh right. It’s #NotAboutHealth

  • Paul Enderson

    Wow. It’s not often that I’m lost for words…

    • Astonishing isn’t it?

      All this time and they still think nicotine is the culprit.