I am submitting the following evidence to the Health Select Committee as Director General of The Cancer Research Campaign, a medical oncologist and member of numerous expert panels and review groups.

  Our primary concern is to prevent a second epidemic of lung cancer, among women in particular. In the UK, incidence rates for the disease are currently five times higher in females than in many other European countries, reflecting the increased uptake in smoking by British women in the 1940s and 1950s (TCRC, 1999). We are now seeing a rise in smoking prevalence among teenage girls and young women and, while government initiatives to ban advertising and improve education and cessation services are important, there are further measures which we believe are also needed if we are to reverse this alarming trend.

  The evidence is now overwhelming that the tobacco industry knew for decades of the addictive and disease-causing effects of its products (eg ASH, 1998). Others will no doubt present this in detail to the Committee. That the industry also recognised the need to target women with a modified product, one which appeared to address their concerns about health, can also be traced through the industry's own documents (eg ASH/TCRC, 1998). The promotion of the "light" cigarette (low in tar and nicotine) is, with hindsight, one of the more pernicious developments in the sad history of tobacco promotion. Women are the greatest consumers of "light" cigarettes and believe them to be less harmful than those with a higher tar and nicotine content (Bates et al, 1999). Yet the industry's own documents reveal its early awareness that this was not the case (ibid).

  As an oncologist, I am deeply concerned by the evidence of an increase in a previously rare form of lung cancer, adenocarcinoma, which occurs deep in the lungs and has been linked to the altered smoking patterns observed with "light" cigarettes (Thun et al, 1997). These include deeper or longer inhalation or blocking the ventilation holes in the filter, behaviour which is believed to increase nicotine delivery and therefore compensate for the lower nicotine yield of the cigarettes while delivering comparable levels of tar to the lungs as would non-light brands.

  In view of the above, I believe the government has a duty to act urgently to prohibit the promotion of cigarette brands as "light" or "mild" and the use of colour and design to imply that such products are less harmful than other cigarettes. Government should also introduce credible testing methods which reliably mimic actual smoking patterns and provide consumer information on the levels of carcinogens and toxins actually delivered to the lungs.

  We further strongly urge the government to support expert recommendations on tobacco product regulation and labelling in Europe, as set out in Bates et al, 1999, including: full disclosure of, and justification for, the hundreds of additives in cigarettes; a common framework for regulating all nicotine delivery products; and regulation and full disclosure of individual levels of carcinogens and toxins in cigarette smoke, based on sound testing procedures. Providing such information on cigarette packs, together with comprehensive health warnings and cessation advice, will further help to reduce the attraction of the packaging (an important promotional device for the industry which is not covered by the imminent legislation on tobacco advertising).

September 1999

REFERENCES

  ASH. Tobacco Explained, 1998, London, Action on Smoking and Health.

  ASH/TCRC. Big Tobacco and Women, 1998, London, Action on Smoking and Health/The Cancer Research Campaign.

  Bates C, McNeill A, Jarvis M and Gray N. The future of tobacco product regulation and labelling in Europe: implications for the forthcoming European Union directive. Tobacco Control 1999;8:225-235.

  TCRC UK's women smokers top European league of death. The Cancer Research Campaign press release 11.9.99.

  Thun M, Lally C et al. Cigarette smoking and changes in histopathology of lung cancer. J Natl Cancer Inst 1997;89:1580-6.