Chinese “Herbal” Cigarettes Are as Carcinogenic and Addictive as Regular Cigarettes

Abstract

Objective: To examine the Chinese tobacco industry's claim that herbal cigarettes are less harmful than regular cigarettes. Methods: The study design was a cross-sectional survey. One hundred thirty-five herbal cigarette smokers and 143 regular smokers from one city in China completed a questionnaire on smoking behavior and provided a urine sample. The main outcome measures were cotinine and trans-3′-hydroxycotinine in all samples, and polycyclic aromatic hydrocarbon metabolites (PAH; 1-hydroxypyrene, naphthols, hydroxyfluorenes, and hydroxyphnanthrenes) and the tobacco specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-butanol (NNAL) and NNAL-glucuronide in randomly selected 98 samples (47 from the herbal smokers' group and 51 from the regular smokers' group). Values were normalized by creatinine to correct for possible variability introduced by dilution or concentration of the urine.Results: Health concern was among the main reasons that smokers switched to herbal cigarettes from regular cigarettes. Smokers reported increased consumption after switching to herbal cigarettes from regular cigarettes. For all the four markers analyzed (cotinine, trans-3′-hydroxycotinine, total NNAL, and total PAHs), we observed no significant difference in the levels (P = 0.169, P = 0.146, P = 0.171, and P = 0.554, respectively) between smokers of herbal cigarettes and smokers of regular cigarettes. Both total NNAL and total PAHs were significantly correlated with cotinine and trans-3′-hydroxycotinine (P < 0.001 for all four correlations). Conclusions: Our findings showed that herbal cigarettes did not deliver less carcinogens than regular cigarettes. The public needs to be aware of this fact, and the Chinese tobacco industry should avoid misleading the public when promoting herbal cigarettes as safer products.

An Early-Stage Epidemic: A Systematic Review of Correlates of Smoking Among Chinese Women

“…The tobacco industry also promotes products with fruity flavor, such as the “DJ Mix Light” with strawberry flavor. Some products feature “herbs” and “ginseng” as ingredients and are mislabeled as health promoting [46]. In summary, cigarette companies are trying to support a “new normal” for smoking among women—not only acceptable but also desirable, liberating, fashionable, and “glorious”.…”

Relationship between the Chinese tobacco industry and academic institutions in China

“…The tobacco industry also used prominent academic figures as spokespersons for the industry and to justify the ‘less harmful, low-tar’ strategy 47. In contrast, independent research showed that low-tar and herbal cigarettes in China do not deliver lower doses of nicotine or carcinogens 48 49…”

“…Existing evidence, while limited, suggests that the Chinese tobacco industry behaviour in some areas is similar to what the transnational tobacco companies have been doing in the west, from the promotion of cigarettes using popular athletes53 to unjustified claims that low-tar and herbal cigarettes were less harmful products 48 49. In September 2009, a Chinese tobacco industry official openly questioned the science behind passive smoking during a public hearing on smoke-free legislation in Shanghai 54…”

Lung Deposition Analyses of Inhaled Toxic Aerosols in Conventional and Less Harmful Cigarette Smoke: A Review

“…Gan et al . [63] claimed that Chinese “Herbal” Cigarettes are as carcinogenic and addictive as regular cigarettes. Concerning e-cigarettes, McCauley et al .…”