Less tobacco may not mean less risk

WASHINGTON (CNN) -- A new report says more research is needed to determine if using modified tobacco products like nicotine patches truly reduces the risks of disease associated with smoking.

A committee from the Institute of Medicine looked at products approved by the Food and Drug Administration for short-term use to help smokers quit: nicotine patches, gum, inhalers and nasal sprays.

Such "potential reduced-exposure products," or PREPs, contain small amounts of toxic substances such as nicotine.

The committee found that while PREPs can reduce exposure to toxic substances, people who use them may not have less risk of tobacco-related diseases -- heart attack, lung disease, stroke and many types of cancers -- than smokers do. Too little research has been done to make that determination, the report said.

"We believe that it may be possible to reduce harm from tobacco use with new products, but we frankly do not know the health effects of the various products on the market today that claim to do this," said Stuart Bondurant, professor of medicine at the University of North Carolina and chair of the committee that wrote the report, titled "Clearing the Smoke."

"Many still incorporate tobacco, and because no tobacco product is safe, the effects of these new products must be studied carefully to make a reliable judgment as to whether they actually reduce risk and harm," he said.

The committee found there has been no comprehensive evaluation of PREPs that provides a scientific basis for concluding a reduced risk of disease. The impact of PREPs on tobacco-related disease may not be known for many years, it said.

There is no clear consensus on whether cutting back on cigarettes provides similar benefits to quitting altogether.

A recent Mayo Clinic study suggested the level of toxins in the body does not go down when heavy smokers cut their smoking in half. Other studies found that when smokers switched to lower-yield or filter cigarettes, they inhaled more deeply to get the same amount of nicotine as before.

The report calls for regulation not only of all tobacco products, but also of all PREPs in an effort to assure that adequate research is conducted and that the public has reliable information on risks and benefits.

Committee members also want regulation of claims manufacturers make, to reduce misperception and misuse of their products. Companies that market PREPs must have scientifically sound evidence and epidemiological data to back up claims that their product can reduce the risk of a specific disease, for instance.

Committee members suggest a number of steps, including:

--Developing a surveillance system to assess the impact of promotion and use of PREPs;

--Giving manufacturers adequate incentives to develop and market products that reduce exposure to tobacco toxicants and have a reasonable prospect of reducing the risk of disease;

--Making sure consumers are accurately informed of all the known and potential consequences of using the products;

--Regulating promotion, advertising and labeling of the products to prevent false or misleading claims; and

--Monitoring the health and behavioral effects of using PREPs.

According to the Institute of Medicine, an estimated 47 million Americans smoke cigarettes. Seventy percent of them want to quit, but each year less than 3 percent succeed.

The Institute of Medicine is an arm of the National Academy of Sciences, a private institution chartered by Congress to provide scientific and medical advice to the government.

The Associated Press contributed to this report.

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