Nicotine content in smoke from US cigarettes has increased

The amount of nicotine inhaled by cigarette smokers and by bystanders in secondhand smoke has risen by 10% over the past seven years, says a report from the Massachusetts Department of Public Health.

"Although per capita consumption of cigarettes has declined, the amount of nicotine consumed per cigarette has increased. Concurrently, the amount of nicotine present in second-hand smoke has also increased," the report says.

Massachusetts is one of only three US states that require tobacco companies to submit information every year on the nicotine content of cigarettes sold in the state. The state began requiring the information in 1998. This is the first report of changes in nicotine content from 1998 to 2004.

The information the state received showed major increases in nicotine yield for 92 of the 116 brands of cigarettes manufactured by all three major tobacco companies, Lorillard, Philip Morris, and RJ Reynolds. Yield is the amount of nicotine in the smoke a smoker inhales, not the amount in the cigarette.

"We want healthcare providers to know that smokers are getting more nicotine than in the past and may need additional help in trying to quit," said the Massachusetts health commissioner Paul Cote, Jr.

The department tests for nicotine yields using a method that it considers more accurate than the previous "smoking machine" tests. The department's method "better simulates the smoking behavior of the typical smoker under typical smoking conditions."

"Similar increases were found for each type of cigarette tested (full flavor, light, light/medium, and ultra-light), for both menthol and non-menthol cigarettes, for filtered cigarettes, and for all companies," the report says. Fifty two of the 116 brands had increases of more than 10%, with the greatest (36%) in RJ Reynold's Doral brand.

In 2004 93% of all cigarette brands tested were high in nicotine.

The health department says that the three most popular brands chosen by young smokers all delivered significantly more nicotine. A popular menthol brand (Kool) used by many black Americans increased its nicotine yield by 20%.

Nicotine "is a highly addictive drug that affects nearly every organ in the body," the department says. High levels of nicotine may make it more difficult for the average smoker to quit. High levels of nicotine intake by pregnant women can lead to low birth weight and developmental delays among infants.

Nicotine increases concentrations of blood sugar, placing smokers at higher risk of developing diabetes and making it harder for diabetic people who smoke to control their blood sugar. Drugs for asthma, high blood pressure, and depression can lose their effectiveness in combination with nicotine, the department says.