Soap, Sex, and Cigarettes: A Cultural History of American Advertising

A Harvard University study concluding that cigarette makers have for years deliberately increased nicotine levels in cigarettes to make them more addictive led to renewed calls Thursday for greater federal oversight of the industry.

"Given the harm that tobacco causes, it shouldn't be a game of cat-and-mouse to figure out what the industry is doing to cigarettes," said Dr. Josh Sharfstein, commissioner of health for the city of Baltimore.

Sen. Edward Kennedy, D-Mass., who is now chairman of the Senate Health, Education, Labor and Pensions Committee, promised to reintroduce within weeks a bill that would allow the Food and Drug Administration to regulate cigarettes.

Kennedy said the Harvard study, which was released this week, "is dramatic new proof that Big Tobacco is addicted to addicting millions of young smokers."

Kennedy's bill passed the Senate in 2004 but failed in the House. With Democrats now in control of both houses, public health advocates said they had new hope that the legislation -- debated for more than a decade -- could pass.

Philip Morris, the nation's largest cigarette maker, released a statement taking issue with the Harvard study but saying the company supported Kennedy's bill.

The company, which is owned by the Altria Group, said its own reports showed that nicotine yields for its top-selling Marlboro brand were the same in 2006 as they were in 1997. Changes between those years, it said, "reflect that there are random variations in cigarette nicotine yields."

The Harvard researchers analyzed data only from 1997 through 2005, although they promised to include 2006 figures in future analyses.

Dr. Gregory Connolly, a professor at the Harvard School of Public Health who was a leader of the study, said there was nothing random about the growth in nicotine yields, which occurred across all cigarette brands and makers.

"We know from our data that there are intentional design changes that result in more nicotine in smoke that increases the capacity for the cigarette to cause and maintain addiction," Connolly said.

Company representatives at Lorillard Tobacco, owned by Loews, and R.J. Reynolds Tobacco, owned by Reynolds American, did not respond to phone messages.

Cigarette makers have for decades denounced scientific efforts to measure the byproducts and effects of cigarette smoking. And for decades, experts have been arguing over the best ways to measure smoke from smoking.

One common way has been to use machines to mimic smoking. For years, these tests were done at the Federal Trade Commission.

In recent years, however, government regulators have asked cigarette makers to do these machine tests themselves. And beginning in 1997, Massachusetts regulations required cigarette makers to file an annual report with health regulators on the results of these tests.

In August, the Massachusetts Department of Public Health issued a study showing that according to the industry's own reports, the amount of nicotine that could be inhaled from cigarettes had increased an average of 10 percent from 1998 through 2004. The report was immediately criticized by cigarette makers.

So Connolly and colleagues decided to undertake a far more sophisticated analysis of the underlying data provided by cigarette makers. The Harvard group found that nicotine yields from smoking had increased an average of 1.6 percent each year from 1998 through 2005, or about 11 percent altogether.

A sophisticated mathematical analysis of the data demonstrated that the increase could not be due to random variations, Connolly said.

Soap, Sex, and Cigarettes: A Cultural History of American Advertising