Short Term Effects of Switching to Cigarettes with Reduced Ignition Propensity

1
Short Term Effects of Switching to Cigarettes
with Reduced Ignition Propensity

• Vaughan Rees, PhD
• Richard OConnor, PhD
• Kaila Norton, BA
• Jami Rothman, MPH
• Andrew Seidenberg, MPH
• Gregory Connolly, DMD, MPH

• Harvard School of Public Health, Boston, MA
• Roswell Park Cancer Institute, Buffalo, NY

Third International Conference on "Fire Safer"
Cigarettes NFPA Meeting, May 2008
2
Reduced Ignition Propensity Cigarettes

• Have potential public health advantages for those
  who are at risk of fire injury
• Introduce product design regulatory strategies
  based on consumer protection law
• May galvanize public opinion about alternative
  tobacco control strategies

3
RIP CigarettesWhat About the Smoker?

• Questions have been raised about the potential
  for increased exposure to tobacco toxins among
  smokers
• Connolly et al (2005) demonstrated that fire safe
  cigarettes produce smoke toxin yields that are
  similar to conventional cigarettes, with the
  exception of slightly increased CO

4
First do no Harm!

• As momentum toward adoption of state and national
  RIP laws increases, we need to be confident that
  there is no increased risk to the smoker
• Consider large-scale switching to lights
  cigarettes in 70s 80s
• No health benefit from switching to low yield
  products, despite public perception

5
Objective

• Using a short term switching design, aim to
  establish whether LIP cigarettes are prone to
  increase exposure to toxins among smokers

6
Switching Studies

• Effective research strategy for evaluating
  subjective, physiological and behavioral
  responses to new tobacco product
• Can assess exposure to biomarkers for disease
  relative to control product
• Have been used in evaluation of low yield
  products, and potential reduced exposure products
  (PREPs)

7
Methods

• Switching Design

8
Major Outcome Measures

• Smoking Topography
• Puff number
• Puff volume
• Puff duration
• Puff interval
• Exposure
• CO Boost
• Salivary Cotinine
• Urinary NNAL, 1-HOP

9
Smoking Topography

• Measured using a hand held monitor
• Measures puffing style or intensity
• Allows estimate of total smoke consumed per
  cigarette
• Lights tend to be smoked more intensively

10
ResultsSubject Characteristics
11
ResultsSmoker characteristics
12
Smoking topographyExperimental Group
N 66, ps 0.10
13
48 hr Field TopographyExperimental (Boston)
group
N 66, ps 0.10
14
Outcome dataCO Boost
15
Cotinine exposure
16
Conclusions

• After switching to a lowered ignition propensity
  cigarette of the same brand
• Negligible changes in smoking topography (puffing
  style)
• No increase in CO
• No increase in cotinine
• No evidence of increased exposure or smoke
  consumption in the short term

17
Limitations and Next Steps

• Design not counterbalanced
• CON cigarette always first
• Awaiting further analysis
• Cigarettes smoked per day
• Urinary biomarkers (NNAL, 1-HOP)
• Limited measures of subjective responses
• Sensory perceptions
• Future smoking intentions
• (satisfaction and taste were measured)
• Examine data for relationships between cigarette
  design, smoking behavior and exposure

18
Acknowledgment

• National Cancer Institute Grant 1 R01 CA 117108
  
• THANK YOU!