New Study Indicates Changes in Cigarette Design Have Increased Lung Cancer Risk And Tobacco Regulation Can Greatly Reduce Lung Cancer

Statement of Matthew L. Myers, President, Campaign for Tobacco-Free Kids

May. 1 2009

Washington, D.C. — An important study presented Thursday at a scientific conference in Dublin, Ireland, provides powerful new evidence that U.S. smokers' risk of developing lung cancer has dramatically and progressively increased over the past four decades. In fact, cigarettes smoked today in the United States may double the risk of lung cancer compared to cigarettes smoked 40 years ago. The study also concludes that changes in cigarette design are the likely cause of this increased lung cancer risk and that regulation of tobacco products could significantly reduce lung cancer rates. The study concludes: "These data suggest that up to one half of current lung cancer occurrence may be attributable to changes in cigarette design and correspondingly that current lung cancer rates might be reduced by up to 50% through regulatory control of cigarette design and composition."

The study findings were presented at the 2009 Joint Conference of the Society for Research on Nicotine and Tobacco (SRNT) and SRNT-Europe in Dublin. The study was conducted by researchers David Burns and Christy Anderson of the University of California-San Diego School of Medicine. Dr. Burns is a well-known tobacco control scientist who has served as author, editor or senior reviewer of each of the U.S. Surgeon General reports on tobacco since 1975. He has also edited a series of tobacco control monographs for the National Cancer Institute and is a member of the World Health Organization Study Group on Tobacco Product Regulation.

This study provides some of the strongest evidence to date that how cigarettes are designed and manufactured has a large impact on the amount of death and disease that they cause, and conversely, that effective regulation of tobacco products can reduce disease and save many lives. Lung cancer caused by smoking kills more than 125,000 Americans each year. Preventing half these deaths would save 62,500 lives a year. Tobacco use also causes many other forms of cancer, cardiovascular disease, chronic obstructive pulmonary disease (COPD) and numerous other serious illnesses that harm virtually every organ in the human body. It is the overall leading cause of preventable death in the United States, killing more than 400,000 Americans and costing the nation $96 billion in health care bills each year.

This study demonstrates why it is critical that Congress quickly enact legislation granting the U.S. Food and Drug Administration (FDA) regulatory authority over tobacco products. Because no government agency has any authority to regulate tobacco products, tobacco companies currently have free reign over how they manufacture tobacco products and what they put in them. They can make changes that make their products more deadly or more addictive without the knowledge of the public or any government agency. Under the pending legislation, for the first time, a science-based regulatory agency, the FDA, would gain authority to regulate the manufacturing, marketing and sale of tobacco products.

Among other things, this legislation would grant the FDA authority to require changes in the design and contents of tobacco products to protect public health, such as the reduction or elimination of harmful chemicals. The bill would also require tobacco companies to disclose the contents of their products, research about their products and changes to their products. They could no longer secretly change their products. The bill would also crack down on tobacco marketing and sales to kids, require bigger and stronger health warnings, strictly regulate health claims about tobacco products and take other steps to protect public health. These regulations would be funded by a user fee paid by tobacco companies.

The House of Representatives approved this legislation on April 2 by a strong, bipartisan vote of 298 to 112. The new study makes it even more urgent that the Senate quickly take up and pass this long-overdue legislation and resist all efforts to weaken it. President Obama has expressed his strong support for the legislation.

For the study, researchers examined lung cancer rates as well as changes in the design and smoke composition of cigarettes in the United States over the past four decades and then compared U.S. and Australian lung cancer rates over time. From this analysis, the researchers reached four major conclusions:

• The study provides new evidence that among U.S. smokers the risk of developing lung cancer has progressively increased over the past four decades, controlling for amount and duration of smoking.
• This increase in the risk of lung cancer among smokers coincides with a change in cigarette design over the past five decades. The study suggests that up to one half of current lung cancer occurrence may be attributable to changes in cigarette design.
• This increase in risk of smoking over time is not evident for squamous cell carcinoma (one type of lung cancer) of the lung and is driven largely by changes in the risk of adenocarcinoma (another type of lung cancer). The increase in adenocarcinoma as a proportion of all lung cancers is much less evident in Australia. This suggests that the difference may be caused by a difference in the cigarettes used in the two countries. One major known difference in cigarettes between the two countries is the lower levels of tobacco specific nitrosamines (a lung specific carcinogen for adenocarcinoma) in Australian cigarettes. The increased risk of adenocarcinoma in the U.S. may be explained by the higher levels of tobacco specific nitrosamines in U.S. cigarettes.
• These observations strongly support the need for regulation of tobacco, since technology exists to lower nitrosamines in tobacco, and that current lung cancer rates might be reduced by up to 50% through regulatory control of cigarette design and composition.