Monday, October 27, 2003
Less Hazardous Cigarettes and Harm Reduction
A class-action lawsuit in Illinois against R.J. Reynolds has been postponed for almost three
months, according to this story from the Seattle Post-Intelligencer. The delay means
that it is possible the Reynolds case will not resume until after the Illinois Supreme
Court comes to a decision on a similar case against Philip Morris. The cases allege that
the cigarette makers failed to inform consumers that light cigarettes were not less harmful
than full-tar cigarettes. Morris lost its case last March in Madison County, and was ordered
by the judge to pay $10.1 billion in compensatory and punitive damages (exclusive of
lawyers' fees). In September, the Illinois Supreme Court reduced to $6.8 billion the bond
required of Philip Morris USA to appeal the lower court judgment; simultaneously, the
state Supreme Court also agreed to hear the appeal of the Morris case directly, without
an intermediate stop at the state appeals court level.
But are light cigarettes safer? Whoa, even asking that question might expose me to
legal risk! Philip Morris International is no longer taking any chances; here's an excerpt
from their FAQ:
Are 'light' cigarettes safer?
There's no such thing as a safe cigarette. Smokers shouldn't assume that "light" or "ultra light" cigarettes are safe, safer or less harmful than others. Cigarette smoking causes lung cancer, heart disease, emphysema and other serious diseases in smokers, and it is addictive. This is true for all cigarettes. The only way to reduce the serious risk of smoking-related diseases is to give up smoking. For detailed information about the health effects of smoking and our use of terms such as "light", please see the Smoking and health section of our site.
Back to Vice Squad (i.e., not Philip Morris International). This report issued by the Institute of
Medicine of the National Academies of the Sciences in 2001 talked of the "conflicting" data
on whether low-yield cigarettes have any health benefit relative to regular cigarettes. The
main issue, it seems, is that smokers increase the intensity of inhaling when they use
light cigarettes, offsetting some (or perhaps all) of the lower concentration of toxicants.
"Moreover, widespread use of these products [low-yield cigarettes] might have increased
harm to the population in the aggregate if tobacco users who might otherwise have quit
did not, if former tobacco users resumed use, or if some people who would otherwise not
have used tobacco did so because of perceptions that the risk with low-yield products
was minimal [p. 2]."
So, we get the old harm reduction trade-off. Introducing a safer cigarette might lead to
smaller harm per use (or might not, if changes in smoking intensity
are completely offsetting) but more harm in total if prevalence increases enough. In many
areas of human endeavor, that would be good enough to endorse harm reduction
approaches. Improved football helmets reduce harms per football player, but maybe more kids
then play football, with total harms increasing. Nonetheless, almost no one argues against
safer football helmets. But if it is a drug we are talking about, harm reduction tends to
be more controversial. Incidentally, the Institute of Medicine offered a tempered
endorsement of the pursuit of harm reduction in tobacco use; for a stronger endorsement
(though relying heavily on the Institute of Medicine report), see this article by Gio