Addiction Manipulation

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Key Points

  • Despite decades of denial, the tobacco industry has long known about the addictiveness of cigarettes.
  • Tobacco companies manipulated the addictiveness of cigarettes via changes in content and design to attract and retain smokers. As a consequence, smokers today are at a greater risk of disease than smokers in the 1960’s, despite smoking fewer cigarettes.
  • Greater implementation of FCTC guidelines around product innovation is needed to protect smokers from changes to cigarettes that increase addiction and harm.

Industry knowledge

Cigarettes have been called “dangerous by design”1. Industry documents reveal that tobacco companies have known for decades about the addictiveness of compounds in cigarettes, including nicotine. They knew how to design cigarettes to affect smokers’ perceptions and behaviours2, and knowingly altered the content and design of cigarettes to maintain addiction in their customers3. Yet up until the 1990’s, they continued to claim publicly that cigarettes were not addictive4 (see Image 1), despite overwhelming evidence at the time showing the opposite to be true56. Tobacco companies’ own internal documents show that they even admitted that they knew all along how addictive their products were3.

Image 1. Tobacco company executives claimed that nicotine is not addictive in 1994 (Source: AP Photo/John Duricka). See this video (source: University of California San Francisco)

Public knowledge

In contrast to tobacco companies’ knowledge of the addictive compounds in cigarettes, the public is unaware of the majority of chemicals in cigarettes, with little awareness of the existence of additives in cigarettes. Yet, consumers do want more information about the ingredients in cigarettes7.

Cigarette additives

Tobacco companies increased the addictiveness of cigarettes by manipulating the effects of additives in cigarettes8. They increased the amount of nicotine delivered to smokers; and added other chemicals (eg: flavours, sugars, ammonia) to reduce the harshness and improve the taste of cigarette smoke, and to increase the absorption of nicotine:

Nicotine

Nicotine is the primary addictive component in cigarettes, reaching the brain seven seconds after being inhaled9. The amount of nicotine delivered to smokers via tobacco smoke has increased overtime 1011. Between 1999 and 2011, it increased by 14.5%; which was due to changes made by manufacturers, rather than natural variation10. This trend has been seen in all major market categories of cigarettes11 .

See the page on Next Generation Products for information about nicotine in various consumer tobacco and nicotine products, and the page on Harm Reduction for information on the debate about the role of these products in tobacco control.

Flavours

Flavourings (eg: cocoa, licorice, menthol) improve the taste and decrease the harshness of cigarette smoke1213. The ingredients in cocoa and licorice can ease inhalation of tobacco smoke and nicotine14.

Menthol cigarettes (see Image 2) became popular in the 1950s. Menthol masks the harshness of tobacco and alleviates irritation from nicotine, which makes cigarettes easier to smoke15, promotes smoking initiation, and facilitates inhalation of tobacco smoke16. The cool sensation of menthol causes smokers to hold their breath, enabling greater exposure to the harmful substances in tobacco smoke. This results in increased addiction and tobacco-related diseases17.

See the page on Menthol Cigarettes: Tobacco Industry Interests and Interference for information on how the industry circumvents menthol bans.

Image 2. Newport and Marlboro menthol cigarettes (source: DailyRecord.co.uk).

Other chemicals

Chemical(s) Effect
Sugars and humectants Adding sugars and humectants to cigarettes generates greater levels of harmful substances such as acetaldehyde and acids, which reduce the harshness of tobacco smoke181920. Acetaldehyde also enhances nicotine’s effects14.
Ammonia In the 1960’s, Philip Morris (PM) started using ammonia to increase the available nicotine in cigarette smoke and increase its absorption21.
Tobacco-specific nitrosamines (TSNAs) TSNA’s are carcinogenic2223. In the 1960’s and 1970’s, tobacco companies started directly heating tobacco (in flue-curing practices), rather than indirectly heating it, which led to an increase in the levels of TSNAs in tobacco24. In 1999, tobacco companies claimed to be transitioning to manufacturing tobacco low in TSNAs. However, in 2010, the levels of TSNAs were similar to levels of a filtered cigarette in the US in 197925.
Levulinic acid In the 1980’s, RJ Reynolds started adding levulinic acid to reduce harshness and increase the amount of nicotine delivered to smokers via tobacco smoke. It also produced toxic components26 and enabled tobacco smoke to be inhaled deeper into the lungs8.
Pyrazines In response to the US Surgeon General Report of 1964 which reported on the health harms of smoking, PM developed the first ‘light’ cigarette (“Merit”) by adding components including pyrazines, which eased inhalation and nicotine deposition by reducing the harsh and irritating effects of tobacco smoke. These components were later added to “Marlboro Lights” (now “Marlboro Gold”) in the 1970s27.

Filter design

Tobacco companies deceitfully added filters to cigarettes in the 1950’s in an attempt to imply reduced harm, and entice smokers with health concerns, including women and young smokers. However, this design feature reduces smokers perceptions about the harms of smoking, yet in reality may increase the risk of harm2829. The ventilation holes in filters increased the amount of nicotine delivered to smokers30. Smokers of filtered cigarettes (see Image 3) take puffs deeper and more frequently (this is known as compensatory smoking)31, whilst blocking ventilation holes with their fingers3233, which means that carcinogens that are inhaled more deeply into the lungs34.

See the page on Cigarette Filters for information on marketing and the health and environmental harms.

Image 3. Cigarette filters (source: TheNewYorkTimesMagazine.com).

The U.S. Surgeon General’s report of 2014 concluded that, despite a decline in smoking prevalence, the risk of tobacco-related mortality has increased over the last 50 years due to changes in product composition and design. Specifically, it concluded that adding filters to cigarettes has caused an increase in lung adenocarcinomas (cancers in peripheral areas of the lungs)35.

See the page on Product Innovation for information on concerns around changes to products.

Global regulation

The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) recognises that “cigarettes and some other products containing tobacco are highly engineered so as to create and maintain dependence”36. Articles 9 and 10 of the WHO FCTC require Parties to regulate the contents of tobacco products and disclose tobacco products 37. The FCTC recommends that attractiveness and its impact on dependence should be taken into consideration for regulation. It recommends that countries:

  • Ban misleading and deceptive tobacco advertising, eg: descriptors such as “light” (see Image 4);
  • Ban or restrict ingredients used to increase palatability of tobacco products, eg: sugars and sweeteners, and flavourings;
  • Ban ingredients associated with energy and vitality in tobacco products;
  • Require manufacturers to disclose information on the ingredients in tobacco products to governments, for each product type and each brand36.

See the page on Advertising Strategy for information on the industry’s use of advertising.

Image 4. Packets of Marlboro lights cigarettes (source: NewYorkTimes.com).

Up to date information on tobacco control legislation around the world can be found on the Tobacco Control Laws website (published by the Campaign for Tobacco Free Kids). You can search litigation by country, tobacco control measure, or type of legal action. The website also contains analysis and assessment of FCTC compliance, and policy factsheets. Parties to the WHO FCTC submit regular FCTC COP reports detailing their progress in implementing the treaty, which are presented in the FCTC Implementation database. Further information on countries’ progress in implementing the WHO recommended MPOWER measures can be found in the WHO reports on the global tobacco epidemic, a serious of biennial reports detailing status and compliance.

The tobacco industry has deliberately manipulated the content and design of cigarettes to maintain addiction in its customers. Given the greater harm experienced by smokers as a result35, greater implementation of FCTC guidelines around product innovation is required to protect smokers from changes to cigarettes that increase addiction and harm.

 

TobaccoTactics Resources

Product Innovation

Menthol Cigarettes: Tobacco Industry Interests and Interference

Cigarette Filters

TCRG Research

For a comprehensive list of all TCRG publications, including TCRG research that evaluates the impact of public health policy, go to the Bath TCRG’s list of publications.

R. Hiscock, K. Silver, M. Zatonski, A. Gilmore, Tobacco industry tactics to circumvent and undermine the menthol cigarette ban in the UKTobacco Control, 18 May 2020, doi:10.1136/tobaccocontrol-2020-055769

J. R. Branston, R. Hiscock, K. Silver, D. Arnott, A. Gilmore, Cigarette-like cigarillo introduced to bypass taxation, standardised packaging, minimum pack sizes, and menthol ban in the UKTobacco Control, Online First, 26 August 2020, doi: 10.1136/tobaccocontrol-2020-055700

K. Evans-Reeves, K. Lauber, R. Hiscock, The ‘filter fraud’ persists: the tobacco industry is still using filters to suggest lower health risks while destroying the environmentTobacco Control, 26 April 2021, doi:10.1136/tobaccocontrol-2020-056245

S. Dance, K. Evans-Reeves. Menthol: Tobacco Companies are exploiting loopholes in the UK’s characterising flavours ban. Tobacco Control.

References

  1. R.N. Proctor, The cigarette catastrophe continues, The Lancet, 2015;385(9972):938-939, doi:10.1016/S0140-6736(15)60519-0
  2. G.F. Wayne, G.N. Connolly, J.E. Henningfield, Assessing internal tobacco industry knowledge of the neurobiology of tobacco dependence, Nicotine & Tobacco Research, 2004;6(6):927-940, doi:10.1080/14622200412331324839
  3. abR.D. Hurt, C.R. Robertson, Prying open the door to the tobacco industry’s secrets about nicotine. The Minnesota tobacco trial, Health Law and Ethics, 1998;280(13):1173-1181, doi:10.1001/jama.280.13.1173
  4. P.J. Hilts, Tobacco chiefs say cigarettes aren’t addictive, The New York Times, 1994
  5. M.A.H. Russell, The nicotine addiction trap: A 40-year sentence for four cigarettes, British Journal of Addiction, 1990;85(2):293-300, doi: 10.1111/j.1360-0443.1990.tb03085.x
  6. National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health, The health consequences of smoking – 50 years of progress: A report of the Surgeon General, 2014
  7. J.C. Morgan, M.J. Byron, S.A. Baig, I. Stepanov, N.T. Brewer, How people think about the chemicals in cigarette smoke: A systematic review, Journal of Behavioral Medicine, 2017;40:553-564, doi:10.1007/s10865-017-9823-5
  8. abM. Rabinoff, N. Caskey, A. Rissling, C. Park, Pharmacological and chemical effects of cigarette additives, American Journal of Public Health, 2007;97(11),1981-1991, doi:10.2105/AJPH.2005.078014
  9. The World Health Organization, Gender, women, and the tobacco epidemic. Chapter 7. Addiction to Nicotine, 2010
  10. abT. Land, L. Keithly, K. Kane, L. Chen, M. Paskowsky, D. Cullen, R.B. Hayes, W. Li, Recent increases in efficiency in cigarette nicotine delivery: Implications for tobacco control, Tobacco Control, 2014;16(6):753-758, doi:10.1093/ntr/ntt219
  11. abG.N. Connolly, H. R. Alpert, G. F. Wayne, H. Koh, Trends in nicotine yield in smoke and its relationship with design characteristics among popular US cigarette brands, 1997-2005, Tobacco Control, 2007;16:e5
  12. N.A. Sokol, R.D. Kennedy, G.N. Connolly, The role of cocoa as a cigarette additive: Opportunities for product regulation, Nicotine & Tobacco Research, 2014;16(7):984-991, doi:10.1093/ntr/ntu017
  13. F.J.R. Paumgartten, M. R. Gomes-Carneiro, A. C. A. X. de Oliveira, The impact of tobacco additives on cigarette smoke toxicity: A critical appraisal of tobacco industry studies, Cadernos de Saude Publica, 2017;33(3):e00132415, doi:10.1590/0102-311X00132415
  14. abAction on Smoking and Health, Tobacco additives. Cigarette engineering and nicotine addiction. A survey of the additive technology used by cigarette manufacturers to enhance the appeal and addictive nature of their product, 1999
  15. V. B. Yerger, Menthol’s potential effects on nicotine dependence: A tobacco industry perspective, Tobacco Control, 2011;ii29-ii36
  16. J.M. Kreslake, G.F. Wayne, H.R. Alpert, H.K. Koh, G.N. Connolly, Tobacco industry control of menthol in cigarettes and targeting of adolescents and young adults, American Journal of Public Health, 2008;98(9):1685-1692, doi:10.2105/AJPH.2007.125542
  17. S. Garten, R.V. Falkner, Role of mentholated cigarettes in increased nicotine dependence and greater risk of tobacco-attributable disease, Preventive Medicine, 2004;38(6):793-798, doi:10.1016/j.ypmed.2004.01.019
  18. R. Talhout, A. Opperhuizen, J. G. C. van Amsterdam, Sugars as tobacco ingredient: Effects on mainstream smoke composition, Food and Chemical Toxicology, 2006;44(11):1789-1798, doi:10.1016/j.fct.2006.06.016
  19. J.L. A. Pennings, J.W.J.M. Cremers, M.J.A. Becker, W.N.M. Klerx, R. Talhout, Aldehyde and volatile organic compound yields in commercial cigarette mainstream smoke are mutually related and depend on the sugar and humectant content in tobacco, Nicotine & Tobacco Research, 2020;22(10):1748-1756, doi:10.1093/ntr/ntz203
  20. A.K. Gupta, R.Mehrotra, Presence of high level of sugars, humectants, and their toxic by-products in diverse tobacco products, Nicotine & Tobacco Research, 2021;23(7):1259-1260, doi:10.1093/ntr/ntab010
  21. T. Stevenson, R.N. Proctor, The secret and soul of Marlboro. Philip Morris and the origins, spread, and denial of nicotine freebasing, American Journal of Public Health, 2008;98(7):1184-1194, doi:10.2105/AJPH.2007.121657
  22. S.S. Hecht, D. Hoffman, Tobacco-specific nitrosamines, an important group of carcinogens in tobacco and tobacco smoke, Carcinogenesis, 1988;9(6):875-884, doi:10.1093/carcin/9.6.875
  23. E. Konstantinous, F. Fotopoulous, A. et al, Tobacco-specific nitrosamines: A literature review, Food and Chemical Toxicology, 2018;111:198-203, doi:10.1016/j.fct.2018.05.008
  24. N. Collishaw, Blowing smoke: The history of tobacco-specific nitrosamines in Canadian tobacco, Tobacco Control, 2017;26:365-370
  25. I. Stepanov, A. Knezevich, L. Zhang, C.H. Watson, D.K. Hatsukami, S.S. Hecht, Carcinogenic tobacco-specific N-nitrosamines in US cigarettes: Three decades of remarkable neglect by the tobacco industry, Tobacco Control, 2012;21:44-48
  26. L. Keithly, G.F. Wayne, D.M. Cullen, G.N. Connolly, Industry research on the use and effects of levulinic acid: A case study in cigarette additives, Nicotine & Tobacco Research, 2005;7(5):761-771, doi:10.1080/14622200500259820
  27. H.R.Alpert, I.T.Agaku, G.N. Connolly, A study of pyrazines in cigarettes and how additives might be used to enhance tobacco addiction, Tobacco Control, 2016;25:444-450
  28. Conference of the Parties to the WHO Framework Convention on Tobacco Control, Ninth Session, Report on the cigarette ventilation meeting, Report by the Convention Secretariat, 2021
  29. K. Evans-Reeves, K. Lauber, R. Hiscock, The ‘filter fraud’ persists: The tobacco industry is still using filters to suggest lower health risks while destroying the environment, Tobacco Control, 2021, doi:10.1136/tobaccocontrol-2020-056245
  30. Centres for Disease Control and Prevention (US), How tobacco smoke causes disease: The biology and behavioral basis for smoking-attributable disease: A report of the Surgeon General, 2010
  31. M.V. Djordjevic, S.D. Stellman, E. Zhang, Doses of nicotine and lung carcinogens delivered to cigarette smokers, Journal of the National Cancer Institute, 2000;92(2):106-111, doi:10.1093/jnci/92.2.106
  32. L.T. Kozlowski, E.L. White, C.T. Sweeney, B.A. Yost, F.M. Ahern, M.E. Goldberg, Few smokers know their cigarettes have filter vents, American Journal of Public Health, 1998;88(4):681-682
  33. G. Scherer, Smoking behaviour and compensation: A review of the literature, Psychopharmacology, 1999;145:1-20, doi:10.1007/s002130051027
  34. M. Song, N.L. Benowitz, M. Berman, et al, Cigarette filter ventilation and its relationship to increasing rates of lung adenocarcinoma, Journal of the National Cancer Institute, 2017;109(12):djx075, doi:10.1093/jnci/djx075
  35. abCenters for Disease Control and Prevention (US), The health consequences of smoking – 50 years of progress. A report of the Surgeon General, 2014
  36. abThe World Health Organization, WHO Framework Convention on Tobacco Control, 2003
  37. Conference of the Parties to the WHO Framework Convention on Tobacco Control, Ninth Session, Implementation of Articles 9 and 10 of the WHO FCTC (Regulation of contents and disclosure of tobacco products), Report by the Expert Group, 2021
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