Scientific assessment of the use of sugars as cigarette tobacco ingredients: A review of published and other publicly available studies

Abstract

Sugars, such as sucrose or invert sugar, have been used as tobacco ingredients in American-blend cigarettes to replenish the sugars lost during curing of the Burley component of the blended tobacco in order to maintain a balanced flavor. Chemical-analytical studies of the mainstream smoke of research cigarettes with various sugar application levels revealed that most of the smoke constituents determined did not show any sugar-related changes in yields (per mg nicotine), while ten constituents were found to either increase (formaldehyde, acrolein, 2-butanone, isoprene, benzene, toluene, benzo[k]fluoranthene) or decrease (4-aminobiphenyl, N-nitrosodimethylamine, N-nitrosonornicotine) in a statistically significant manner with increasing sugar application levels. Such constituent yields were modeled into constituent uptake distributions using simulations of nicotine uptake distributions generated on the basis of published nicotine biomonitoring data, which were multiplied by the constituent/nicotine ratios determined in the current analysis. These simulations revealed extensive overlaps for the constituent uptake distributions with and without sugar application. Moreover, the differences in smoke composition did not lead to relevant changes in the activity in in vitro or in vivo assays. The potential impact of using sugars as tobacco ingredients was further assessed in an indirect manner by comparing published data from markets with predominantly American-blend or Virginia-type (no added sugars) cigarettes. No relevant difference was found between these markets for smoking prevalence, intensity, some markers of dependence, nicotine uptake, or mortality from smoking-related lung cancer and chronic obstructive pulmonary disease. In conclusion, thorough examination of the data available suggests that the use of sugars as ingredients in cigarette tobacco does not increase the inherent risk and harm of cigarette smoking.

Bimodal Concentration-Response of Nicotine Involves the Nicotinic Acetylcholine Receptor, Transient Receptor Potential Vanilloid Type 1, and Transient Receptor Potential Ankyrin 1 Channels in Mouse Trachea and Sensory Neurons

“…In addition, acrolein is a major constituent of smoke, in particular of the gas phase of cigarette smoke, and there it accompanies a variety of further volatile TRPA1 agonists, such as formaldehyde, acetaldehyde, and crotonaldehyde (Roemer et al, 2012).…”

Influence of Additives on Cigarette Related Health Risks

“…In no case was there a statistically significant dose relationship between inclusion level and increased severity score, even at high inclusion levels compared to the levels used in commercial cigarettes. Recently, ROEMER et al (448) published a review of scientific studies on the use of sugars as tobacco additives. The reasons for the addition of sugars in manufacturing, biological data related to sugars transferred unchanged from tobacco into mainstream smoke, and their fate during smoking and influence on smoke composition and toxicity were discussed.…”

O impacto dos aditivos do tabaco na toxicidade da fumaça do cigarro: uma avaliação crítica dos estudos patrocinados pela indústria do fumo

“…Moreover, the authors pointed out that the sweet taste and agreeable smell of caramelized sugars are appreciated in particular by starting adolescent smokers 8 . Nonetheless, Philip Morris International (PMI) researchers 14 who reviewed "publicly available studies" on the use of sugars as tobacco ingredients concluded that, although causing some differences in smoke composition (e.g. increase in formaldehyde), addition of sugars "did not lead to relevant changes in the activity in in vitro and in vivo assays" 14 (p. 244).…”

“…Nonetheless, Philip Morris International (PMI) researchers 14 who reviewed "publicly available studies" on the use of sugars as tobacco ingredients concluded that, although causing some differences in smoke composition (e.g. increase in formaldehyde), addition of sugars "did not lead to relevant changes in the activity in in vitro and in vivo assays" 14 (p. 244). The industry scientists reiterate tobacco companies' claims that sugars are added to American-blend cigarettes merely to replenish sugar lost during Burley tobacco curing, and that sugar addition by no means increases the inherent risk and harm of smoking 14 .…”

“…increase in formaldehyde), addition of sugars "did not lead to relevant changes in the activity in in vitro and in vivo assays" 14 (p. 244). The industry scientists reiterate tobacco companies' claims that sugars are added to American-blend cigarettes merely to replenish sugar lost during Burley tobacco curing, and that sugar addition by no means increases the inherent risk and harm of smoking 14 . To support the industry's allegations that the addition of sugars does not alter smoking prevalence, Roemer et al 14 cited a single study by Lee et al 15 (an ecological-designed cross-sectional study) comparing smoking prevalence between markets with predominantly American-blend (with sugars and tobacco additives) and Virginia-type tobacco (without addition of sugars and few tobacco additives) 15 .…”