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Changes in Yield: 1998-2004

The Importance of Nicotine Nicotine Yield The average number of Disclosure milligrams of nicotine delivered Nicotine yield is a measure increased by 9.9% during this The Massachusetts of the amount of nicotine in period (from 1.72 milligrams in Control Program has analyzed the smoke which a smoker 1998 to 1.89 milligrams in 2004) data from 1998-2004 and has inhales. It does not measure (t115 = 12.03, p<.0001). found that the amount of nicotine the amount of nicotine in a inhaled by the average smoker . has increased 10% over the seven Average Nicotine Yield per Cigarette year period. 1998-2004

Summary 1.95 1.9 1.89 1.85 1.84 Although per capita consumption 1.85 1.83 The amount of nicotine the 1.81 of has declined, the smoker receives has increased 1.8 1.75 1.72 1.71

amount of nicotine consumed per Milligrams over time. Data reveal 1.7 cigarette has increased. 1.65 significant increases in nicotine 1.6 Concurrently, the amount of yield from 1998 to 2004 for all 1998 1999 2000 2001 2002 2003 2004 nicotine present in second-hand three tobacco companies smoke has also increased. (Lorillard, Philip Morris, and RJ

Reynolds) and for all types of Similar increases were found for Massachusetts is one of three cigarettes -- full flavor, light, states to receive information each type of cigarette tested (full mild/medium, ultra-light; and flavor, light, mild/medium, and about nicotine levels in tobacco menthol and non-menthol. products. Massachusetts General ultra-light), for both menthol and non-menthol cigarettes, for Law chapter 94 section 307B and Methods Department of Public Health filtered cigarettes and for all Data reported to the companies (PM, RJR, Lorillard). Regulations 105 CMR 660.000 mandate that cigarette companies Massachusetts Department of The total nicotine content of the report each year to the Public Health from 1998 through sub-brands tested increased Department the nicotine yield 2004 from the three major 16.6%, from 12.9 milligrams in ratings for all cigarette brands tobacco companies was analyzed. 1998 to 14.3 milligrams in 2004 In total there were 116 cigarette with a U.S. market share of (t72 = 12.79, p<.0001). Similarly, greater than 1.5%. sub-brands for which data was the milligrams of nicotine per available for both 1998 and 2004. gram of tobacco increased 11.3% Since the signing of the Master Averages for these 116 brands from 17.4 in 1998 to 19.4 in were computed for all Settlement Agreement in 1998, 2004 (t114 = 9.75, p<.0001). there has been no public intervening years as well. disclosure of nicotine yield Greater Than Ten Percent Results: Increasing Nicotine ratings. The Massachusetts 2004 (10%) Increase in Nicotine Yield report is the first to examine Yield Fifty-two (52) of the 116 sub- changes in nicotine delivery Results indicate a very strong brands had increases in nicotine since 1998. positive correlation between the yield above 10% for the seven average nicotine yield and the (7) year period. Analysis The 10% increase in nicotine year in which the testing was revealed that RJR’s brand delivered noted in the report is a conducted (r2 = .805; p<.01). had the largest percent increase significant finding because nicotine is highly addictive drug (36%) in nicotine yield from that affects nearly every organ in When compared to 1998 data, 92 of 1998-2004. the body. the 116 sub-brands had increased nicotine yields by 2004. Twelve

(12) sub-brands decreased and

twelve (12) remained unchanged.

Next was RJR’s King Size Lights with an increase in nicotine yield of 30%. Lowest Nicotine Yield Average Nicotine Delivery for 13 Sub-Brands 1998-2004

Doral Ultra-Light King soft pack 2.4 Percent Increase in Nicotine Yield 2.4 with a nicotine yield of 0.9 mg in 2.35 (1998-2004) 2.3 2.25 Brand/Sub-Brand % 1998 (the lowest nicotine 2.2 2.2 2.15 2.2

increase milligrams delivery in 1998) increased 22% 2.1 2.1 2.1 2.1 2.1 Doral 85 Filter Light 36% 2.05 resulting in a nicotine yield of 2 Hard Pack 1.95 1.1 mg in 2004. It remains with 1998 1999 2000 2001 2002 2003 2004 Doral 85 Filter Light 33% Ultra- Light King Soft Pack Doral 85 Filter Full 33% soft pack as having the lowest Flavor Soft Pack nicotine yield in 2004. Implications of Increased Kool 85 Filter Light 30% Nicotine Levels Menthol Soft Pack Target audiences of the cigarette • Increased levels of nicotine may brands with the highest nicotine yield (Newport, , and make it difficult for the Doral) and the greatest percent average smoker to quit. Highest Nicotine Yield • Similarly, physicians may not be increase (Doral and Kool) are In 1998, Newport 100s (full some of the most vulnerable able to determine the proper dosage for Nicotine Replacement Therapy flavor, menthol, soft pack of 25 populations (minorities and youth). as nicotine levels increase. cigarettes) and Camel Regulars • Increased levels of nicotine non-filter (full flavor, non- consumed by pregnant women can menthol, soft pack) tied for lead to developmental delays in highest nicotine delivery (2.9 Nicotine Yield in Brands childhood as well as low birth weight infants2. mg). All brands that year were Smoked by Youths • Insulin absorption may be slowed less than 3.0 mg. In 2004, by nicotine leading to increased Newport filtered cigarettes had “ is the choice of risk for Type 2 diabetes and the highest nicotine yield at 3.2 nearly two-thirds of youth increased hospitalizations3,4. mg. Five (5) cigarettes were 3.0 smokers by the time they reach • Medications designed to treat mg or above in 2004. the end of high school. The asthma, high blood pressure, and second most widely used brand depression can lose their Three (3) filtered sub-brands of effectiveness in combination with Newport have surpassed Camel by teens is Newport, and the nicotine5,6. non-filter and Doral non-filter in third is Camel. • Exposure to nicotine from second highest nicotine yield in 2004. None of the other brands hand smoke has profound effects Some filtered cigarettes are accounts for even 2 percent of on children, including cognitive 1 deficits7. delivering more nicotine to the the market among teens.” smoker than non-filtered cigarettes. The charts below reveal the This report was produced by the increases in nicotine delivery for the two most popular brands Massachusetts Sub-Brands with Highest Nicotine Program, Massachusetts among youth. Department of Public Health. Yield - 2004 Manufacturer/Brand/ Nicotine Sub-Brand Yield Average Nicotine Delivery Lois Keithly, Ph.D., Director (mg) for 21 Marlboro Sub-Brands 1998-2004 Doris Cullen, M.A., Research 1.9 Analyst Lorillard: Newport 100 Filter 3.2 1.9 1.9 1.9 Full Flavor Hard Pack/Soft 1.85 Thomas Land, Ph.D., Research 1.8 Pack Menthol 1.8 1.8 1.8 Analyst Lorillard: Newport 100 Filter 3.1 1.75 milligrams 1.7 Full Flavor Soft Pack 25 1.7 Menthol 1.65 1.6 RJ Reynolds: Camel 70 Non 3.0 1998 1999 2000 2001 2002 2003 2004 2 Nora Volkow, M.D., presentation at the 13th Annual World Conference on Tobacco, July 2006; Castles, et. al., Effects of Filter Full Flavor Soft Pack during pregnancy. Five meta-analyses. American Journal RJ Reynolds: Doral 85 Non 3.0 of Preventive Medicine, Volume 16, Number 3, 1999. 3 Eliasson, B., Progress in Cardiovascular Diseases, Volume 45, Filter Full Flavor Soft Pack Number 5, March – April 2003. 4 Zevin, S., Clinical Pharmakinetics, Volume 36, Number, 6, June 1 1999. Johnston, L. D., O'Malley, P. M., Bachman, J. G., & 5 http://www.mayoclinic.com/health/drug-information/DR202407 Schulenberg, J. E. (1999). Cigarette brand preferences among 6 Volkow, N.D., et. al., Proceedings of the National Academy of adolescents. (Monitoring the Future Occasional Paper No. 45.) Sciences, U S A, Volume 94, 1997. Ann Arbor, MI: Institute for Social Research. 7 Yolton, K., et. al., Environmental Health Perspectives, Jan 2005.