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frequently
asked questions
Frequently Asked Questions
What
is a PREP or potential reduction exposure product?
A PREP is a product used instead of typical cigarettes
or smokeless tobacco to try to reduce exposure to
tobacco toxins. Much about PREPS and their ability or
inability to reduce exposure is unknown. But if a PREP
actually results in reducing exposure to tobacco
toxins, then it also may be a product that would offer
less risk for tobacco-related disease. There is not
necessarily a link between reduced exposure and reduced
risk. Determining if there is one must be
scientifically tested.
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Are
PREPs safe?
No PREP is known to be safe. Inhaling or using any
tobacco product is not healthy. The only known way to
reduce the risk of smoking is to quit. For more
information, see the American Lung Association Quit
Smoking page at
.
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Are
PREPs safer than traditional tobacco products?
No PREP has been tested thoroughly enough to make the
claim that using it is safer than smoking or using
traditional smokeless tobacco products. Most PREP
testing has been done by tobacco companies which have a
financial interest in the success of their products.
That's why the National Cancer Institute (
)
has awarded a research and development grant to
TobPRAC (Tobacco
Product Assessment Consortium). TobPRAC scientists
will perform unbiased tests and clinical trials to
determine if PREPs are actually less harmful than
traditional tobacco products.
TobPRAC and many scientists worldwide believe that if a
PREP is found to meaningfully reduce exposure to
tobacco toxins, it may play a part in a wide-ranging
tobacco control plan. The plan would focus on
encouraging people to quit smoking and never to start
using tobacco products.
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Are
there any known benefits to PREPs?
Right now, the answer is no. However, the Institute of
Medicine has determined that reducing harm from tobacco
products is possible (
).
If PREPs can meaningfully reduce exposure to toxins, a
benefit could be the potential for less disease in
smokers. However, more independent evidence is required
before lower exposure can be linked to a lower risk of
disease.
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What
are some concerns about using PREPs to reduce harm?
Scientists must first understand what a
"meaningful" reduction in exposure means, and
who might benefit from this type of reduction.
Scientists must know:
-
If an individual has a history of smoking
-
How long the smoking lasted
-
What medical problems the individual has
-
The individual's gender and racial or ethnic
differences, which might result in different uses and
effects of PREPs.
One of scientist's main concerns is that because of the
many differences among individuals and how they might
use PREPs, a claim about PREPs will not be relevant for
everyone.
Another major concern is that claims by tobacco
companies that their products result in less exposure
may confuse or mislead consumers. For instance, if a
smoker believes that less exposure means fewer chances
for disease, they might decide to continue smoking
rather than quit. Or, former smokers may resume
smoking. This might result in increased tobacco-related
disease.
Another concern is that while a PREP may reduce one
toxin or class of toxins, other kinds of toxins might
not be decreased - or might even increase. This means
that all PREPs products must be thoroughly tested, and
not just those that claim to have fewer toxins.
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Does
reducing exposure mean the same thing as reducing
risk?
Cigarette smoke contains numerous carcinogens, mutagens
and other toxins that are inhaled into the lungs.
Smokeless tobacco products deliver carcinogens,
mutagens and other toxins into the mouth and throat. A
PREP may reduce exposure to these toxins. However, the
amount of reduction in exposure needs to be tested in
people with biomarkers (a biochemical feature that can
be used to measure the progress of disease or
treatment) to determine if the reduced exposure is
meaningful. Reduction in exposure may be small and so
the risk of tobacco-related disease might not change.
PREPs that change delivery of one or a few of their
many toxins might not lower risk. This means that
reducing exposure does not mean the same thing as
reducing risk.
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I
have read advertisements or newspaper articles that
PREPs are less risky than regular tobacco products.
According to some advertisements from tobacco and other
companies that manufacture PREPs, allegedly lower level
yields of tobacco toxins may reduce the incidence of
disease in smokers. Some companies make claims through
press releases that look and read as truth. To date, no
cigarette-like PREP has been sufficiently tested and
proven to possibly reduce disease risk.
Some scientists believe that if smokers switch to
smokeless tobacco products, they would be better off.
However, this has not been directly tested.
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What
are examples of PREPs?
Some PREPs look similar to traditional tobacco
products. Others look or behave differently. PREPs are
generally classified as combustible (smoked) and
smokeless.
Smokeless tobacco products include those that are cured
so that they have lower contents of one type of
carcinogen called tobacco-specific nitrosamines. In
Sweden, these snuff products are called
"snus". Snus is packaged in miniature pouches
like a tiny tea bag, and placed between the lip and
gum. Snus products are now being test marketed in the
U.S. (e.g., Camel Snus, Taboka and Marlboro Snus).
Another type of smokeless PREP is a nicotine mint that
also contains tobacco, called a cigalett or Ariva.
Combustible or cigarette-like PREPs use different types
of filters that reduce some types of tobacco toxins.
Some of these, such as Omni, are no longer on the
market. Marlboro UltraSmooth is currently being test
marketed.
Another type of cigarette-like PREP is advertised to
"heat" rather than "burn" the
tobacco. This claim may or may not be accurate.
Examples are Accord, which is no longer marketed in the
U.S. Another type is Eclipse.
Quest is a reduced nicotine cigarette. Some smokers may
falsely believe that Quest is a PREP. They mistakenly
believe that smoking a lower nicotine cigarette will be
less addictive, or that nicotine is the carcinogen in
tobacco smoke. Nicotine is not a known human
carcinogen, but a highly addictive agent that causes
chemical dependency on cigarettes. Smoking lower
nicotine cigarettes, however, is not known to reduce
addiction.
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How
will TobPRAC test the PREPs?
TobPRAC is funded by the National Cancer Institute to
conduct both laboratory and human studies with
volunteer smokers (clinical trials) to determine if one
tobacco product is less risky than another. ( See
mission statement for
more information.)
Over the five-year study, TobPRAC also will be
investigating such important issues as:
-
The ingredients and emissions of new and conventional
tobacco products, and their toxic effects
-
Chemical and physical characteristics of PREPs
-
Behavioral and physiological changes that result after
switching to PREPs
-
Exposure changes and toxic effects in people who use
PREPs
-
Characteristics of individuals who switch to PREPs in
comparison to those who quit smoking
-
Addictive potential of PREPs
-
How the availability of PREPS might discourage smokers
from quitting, or encourage former smokers and those
who have never smoked, to smoke.
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When
will I know whether or not PREPs are less harmful to
use than traditional tobacco products?
TobPRAC is committed to releasing results of its
studies quickly. But first the public health community
must agree on how to scientifically evaluate PREPs,
which are new types of tobacco products. A testing
framework will then be put in place in a regulatory
agency before product labeling begins. Results of a
variety of studies will be made public on this website
and others continually.
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Are
tobacco products regulated by a government agency such
as the Food and Drug Administration?
Although the Federal Trade Commission is in charge of
some aspects of tobacco products, no federal agency has
regulatory authority over tobacco products. So tobacco
companies are free to manufacture any type of product
they choose, as long as it contains tobacco.
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Are
advertisements and health claims by tobacco companies
approved by a government agency such as the Food and
Drug Administration?
No, tobacco companies can make unproven claims about
the benefits of their products. However, if a company
makes a claim that is false, the Federal Trade
Commission may stop the advertising, and state
attorneys general and others may have the right to sue
the companies.
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