When Phillip Morris International (PMI) decided to release its new “lower tar” cigarette, it was one of the biggest challenges in modern history. It took over 30 years for tobacco companies to lower their smoking rates from their peaks, a testament to the dangerous power of smoking.
And yet when the “low tar” Marlboro came out, sales surged. Even though there were some good arguments to be made that American consumers were ready for lower tar cigarettes, regulators and public health experts remained unconvinced that the new Marlboro was good enough for the planet to take. That has been true for decades.
These regulators and scientists rely on a correlation-based approach to evaluate public health risks and risks. Data, data, data — and the frequency with which data is generated.
This new study confirms our strong opinion that the use of correlation-based data can create confusion, if not increased health risk. We use a scientific approach that relies on multiple observations, rather than cherry picking data sets.
It turns out that when consumers are provided with data on smoking trends and all competing smoking policies, they vote with their wallets. With our recent results, we have determined that “low tar” Marlboro provides a much higher level of protection from the harmful effects of second-hand smoke than conventional cigarettes.
The FDA and the authors of this study have not attempted to evaluate “low tar” Marlboro’s health effects. That’s a completely different approach. The data gathered by PMI was not available for outside study. But we were able to evaluate the effects of Marlboro’s “low tar” classification in the light of any additional consumer data available, such as cigarette pack health warnings.
In other words, we can evaluate the data as it exists, so long as the data sources have been independently gathered and assessed. This study found that the “low tar” classification provided smokers with an abundance of information, and that this much information on a single product, in this case a packaged cigarette, is not trivial.
It is not possible to quantify the exact correlation between “low tar” Marlboro and cigarette warnings, other than to say that since the industry began marketing its low tar cigarettes in the early 1990s, “low tar” Marlboro’s highest-profile color and smoke designation has coincided with implementation of the country’s strongest quit smoking provisions and increased consumption of cigarettes that contain effective warning labels.
Therefore, the “low tar” classification is clearly linked to reduced overall cigarette use, while other types of cigarette packaging are not linked. It would be incorrect to conflate the “low tar” classification with “reduced consumption,” because other packaging strategies could also have contributed to reduced consumption. For example, “low tar” Marlboro now dominates the low tar-packaged cigarette segment in Europe, and it appears to be achieving similar results in Asia.
While there have been previous studies from other countries that measure the impact of “low tar” cigarette packages on the market, this study serves as the first comparative analysis on the efficacy of “low tar” cigarette packages on their own, and thus the efficacy of FDA regulation. And we think the study raises real questions about the ability of these sorts of “regulatory interventions” to reduce deaths and health-related problems. As a group, U.S. scientists have long promoted the idea that smoke-free policies that have increased cigarette bans will not necessarily reduce the harms of smoking. We share their view, and are clear about our disagreement with the current FDA approach to regulating cigarettes.
There is no new “smoking-cessation” medicine, no new approach to improving the health of smokers, no completely tamper-proof box or device and no new “no second-hand smoke” law. All of these things are necessary for reducing the number of smokers, but none are feasible in the current regulatory environment.
We think that one of the only things that is feasible at this point is true prevention, with continuing efforts to provide consumers with “low tar” cigarettes. This approach is already producing demonstrable health benefits. In addition, we believe that FDA regulation has historically been far too focused on restricting the promotion and sale of cigarettes. We look forward to FTC implementing new rules to enhance scientific review of cigarette science and follow-up recommendations to the FDA for effective scientific regulation of tobacco and other products.
Alan S. Hilfer, PhD is Chairman and CEO of Altria Group and Chair of Altria’s Health Policy Forum.
John Lothian is Senior Director of Science and Regulatory Affairs at Philip Morris International and part of PMI’s Health Policy Forum.
