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The science of tobacco control: Cancer researchers contribute to historic legislation

President Obama in June signed the Family Smoking Prevention and Tobacco Control Act, giving the U.S. Food and Drug Administration (FDA) the power to regulate tobacco products. The law now prevents cigarette manufacturers from using terms such as “light,” “mild,” and “low;” curbs tobacco marketing aimed at children; and opens the door for eventual limits on carcinogens and nicotine in tobacco products.

This historic legislation may not have existed without the complementary efforts of researchers Stephen Hecht, Ph.D., and Dorothy Hatsukami, Ph.D., at the Masonic Cancer Center, University of Minnesota.

Hecht has spent his career decoding the process by which cigarettes cause lung cancer, from identifying carcinogens to discovering their “biomarkers”—byproducts created when the body metabolizes cancer-causing substances in tobacco. His research helped to establish that light cigarettes are just as harmful as regular ones.

For her part, Hatsukami helped to establish that smokers develop a physical addiction to nicotine, tests newer “reduced toxic or nicotine exposure” products to determine their potential impact on health, and contributed to the Tobacco Control Act.

The two scientists began collaborating about 10 years ago, when Hatsukami invited Hecht to lunch to discuss how they could merge their complementary areas of expertise to challenge tobacco manufacturers’ misleading claims. Together, they’ve made the University of Minnesota the command center for tobacco product evaluation.

The duo answered a few questions in Hecht’s office in the Masonic Cancer Research Building.

What impact will this legislation have on tobacco products?

Hatsukami: In recent years, manufacturers have developed a number of new products that are touted as providing less health risk. This act says you have to have scientific evidence to back up those claims so consumers are not misled into thinking they are smoking safer cigarettes, as was the case with light cigarettes. In addition, tobacco companies have to disclose what toxicants are in the products. More importantly, there are provisions that allow the government to reduce the levels of carcinogens and nicotine in tobacco products.

Hecht: One of the big questions is, how much do you reduce the level of carcinogens and nicotine to have an effect? Let’s say you can reduce them by 50 percent. How many products will be knocked off the market?What will that do to tax revenue? Tobacco is not just a scientific issue; there are practical and economic aspects of it. Tobacco has been ignored for years because it’s a winner in terms of money.

How will the law change the landscape for tobacco use in the United States?

Hatsukami: First there’s the low-hanging fruit: light and ultralight labels will be off tobacco products. Graphic warning labels will be bigger. Companies will be required to identify the toxicants in tobacco. A lot more states will be smoke-free. You’ll also see changes in how products are advertised. You might see product innovations, such as pharmacological products or nicotine delivery products [that bypass some of the harmful effects of smoking]. Reducing the nicotine levels in tobacco products will take much longer because there are a lot of scientific questions to resolve first.

Hecht: Smoking prevalence will continue to decrease.

How do you respond to people who criticize smoking regulation as an infringement on individual freedom?

Hatsukami: Hiding information from the public is an infringement on freedom. I don’t view this as infringing on personal rights so much as providing accurate information and not misleading consumers so they can make an informed decision. It’s also about protecting our youth from using a highly addictive product.

Hecht: If food products had the level of toxicants in them that tobacco products have, the food manufacturers would be thrown in jail. There’s a double standard in how these products are regulated, and it’s all because of money.

Have you ever smoked?

Hatsukami: I used to, occasionally. I loved it.

Hecht:It was great. I was an undergrad at Duke University in North Carolina. You would wake up every morning and smell the tobacco.

What’s the next frontier in your tobacco research?

Hecht: We want to find the susceptible smoker—identify people who are vulnerable to the harmful effects of smoking and to nicotine addiction.

Hatsukami:We’re also developing ways to help people quit,minimize the toxicity of smoking, and change the tobacco product itself to reduce the potential for addiction. Our vision is to dramatically reduce tobacco addiction and tobacco-related death and disease. After all, reducing smoking is one of the most effective means of improving our public health.

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