ARE LOW-NICOTINE CIGARETTES THE ANSWER?

It's common knowledge that smoking cigarettes (and pipes, and chewing tobacco) cause billions of dollars of health care expenses a year.  And hundreds of thousands of deaths.  Meanwhile, Avandia, Redux and other effective drugs are removed from the market because of a few dozen deaths.  What's the deal here?
 
Well, first of all Big Tobacco is wealthy.  And in our current, nearly amoral situation in Washington, DC, both congress and the administration appear to be "for sale" in terms of legislation.  In several important states, it is a major industry and source of jobs.    In addition, the Big Tobacco is very clever.   Here are a few examples:
 
1.  In the early 1970s, President Nixon announced (via Surgeon General Jesse Steinfield) that the government was forcing the Cigarette Manufacturers to put labels on every pack of cigarettes, stating that smoking could be hazardous to your health.  Victory for public health?  NO NO NO.  Dr. Steinfield was my professor when I was on the Oncology (cancer) team at Mayo Clinic.  The truth is/was that the tobacco industry was suffering a major decline in sales and "new starts" (ie people starting to smoke) because of the effectiveness of anti-smoking ads on television.  (For example, Hamilton Burger, the District Attorney who constantly lost cases to Perry Mason on TV, was dying of lung cancer and made an emotional plea to people to stop or never start.).   So, along with some financial incentives, the tobacco industry proposed labelling packages in exchange for removing the ads.  And, oh, my the way, they had also done market research that showed that the labels would have little or no effect on smokers. 
 
2.  On several occasions, the tobacco industry has launched and lauded "low nicotine" cigarettes...appearing to create new products that were safer for people who enjoy smoking.  The truth of the situation was A) they charged more for the allegedly safer cigarette, and B) for those who are addicted, ingesting less nicotine per cigarette requires them to consume more cigarettes, to  achieve their daily dose of nicotine.
 
3.  The key to the success of the Marlboro brand, was the inclusion of ammonia in the cigarette.  Hence, lighting the cigarette created a Free Basing of Nicotine...more addictive than "plain" cigarettes.
 
Given the fact that people today can avoid carbon monoxide, tar and other impurities in cigarettes by using nicoderm patches, nicorette gum, or nicotrol vapors to get their nicotine "fix," my belief is that the tobacco industry is likely putting other addicting substances into cigarettes so that those who switch to the alternatives will go through withdrawal not treatable by increasing the amount of nicotine inhaled, chewed, or absorbed topically.

So what to do?

1.  Make it clear to your kids and grandkids when they are in ELEMENTARY SCHOOL that smoking is incredibly dangerous and harmful.  When a celebrity dies of lung cancer or drugs, tell them that these people got started with drugs via smoking cigarettes (then marijuana, then cocaine, then heroin, then meth).  And that those dying of cancer are dying a very difficult and painful death.

2.  Encourage legislators to increase taxes on cigarettes high enough to pay for the health costs of nicotine.  Studies have shown that the higher the price of a pack of cigarettes, the fewer new starts, the more quitters, and the lower the consumption of habitual smokers.  This is advocated by my former Mayo colleague Dr. Rich Hurt, chief of the Nicotine Dependency Center at Mayo Clinic.

 
3.  Encourage legislators to extend the No Smoking zones from restaurants to other public places and workplaces.  If people cannot smoke in those situations, it leaves a lot less time to be able to smoke.  In other words, smoking becomes less convenient.   Dr. Hurt also advocates this approach.

If you need help in stopping smoking, see one of our providers.