essay light cigarette tar content

The Curious Case of the Light Cigarette

What happens when consumers take things for granted?

Stine Grodal, assistant professor of strategy and innovation at BU’s Questrom School of Business, studied the evolution of light cigarettes. Photo by Michael D. Spencer

Barbara Moran

In the mid-1960s, a new type of cigarette appeared in America. Manufacturers called them “lights,” and advertised that more sophisticated filters, highly porous paper, and new tobacco blends reduced the tar and nicotine that smokers inhaled. The “lights” were the tobacco companies’ answer to public concern about the link between smoking and lung cancer. They pitched their new product to health-conscious smokers and printed test results—total milligrams of tar and nicotine—right on the pack. The light cigarettes were a hit, with sales surpassing regular cigarettes in the early 1980s.

But a funny thing happened over those decades. While smokers may have craved a healthier cigarette, they also craved full flavor and a strong nicotine “kick,” says Stine Grodal , an assistant professor of strategy and innovation at Boston University’s Questrom School of Business , who published an empirical study of light cigarettes in the journal American Sociological Review in February 2015. Over time, she says, many consumers stopped scrutinizing the tiny print on the packages, assuming that light cigarettes were healthier than “full” cigarettes and choosing the brand with the best flavor and kick. To compete for customers, manufacturers slowly pushed the amount of tar and nicotine in light cigarettes upward, with average tar increasing seven percent between 1964 and 1993, and nicotine increasing 74 percent. How did the tobacco industry get away with it? The answer, says Grodal, lies in a curious sociological phenomenon called “taken-for-grantedness.”

Taken-for-grantedness is just what it sounds like: the idea that, over time, many ideas go from outrageous to ordinary. When scientists first began to patent genetically modified organisms, for example, the public reacted with concern and dismay. “Then, over time, patenting just became a thing that you did if you were a scientist,” she says. “If you wanted to have a career in science, you would both publish and patent. It became a part of the way you showed your status, and it was not contested at all. It became taken for granted.”

While taken-for-grantedness is a common area of research in institutional theory—the study of how institutions, concepts, and meaning evolve over time—scientists haven’t used it much to examine business strategy. Grodal and her co-author, Greta Hsu of the University of California, Davis, decided to try that tactic after Grodal read Allan Brandt’s book The Cigarette Century and learned about the enormous data available on the cigarette industry. “It’s very difficult to know what goes on inside businesses because the documents are secret,” she says. “But here was a case in which a lot of the internal documents had been revealed through the lawsuits, so we could have insight on how businesses function that we normally don’t have.”

To make sense of the industry documents, Grodal and Hsu had to first understand when American consumers started assuming that light cigarettes were healthier than regular cigarettes and stopped squinting at the fine print on the packs. To do this, they looked for references to light cigarettes in four major media outlets: the New York Times , Los Angeles Times , the Washington Post , and the Wall Street Journal . Over time, as the public became more familiar with light cigarettes, journalists described the cigarettes’ features less often and less explicitly. Grodal says that this declining description serves as a good proxy for taken-for-grantedness, because it reflects the public’s growing understanding and acceptance of light cigarettes. She found that public attention to the light cigarettes’ nicotine content decreased quickly but people paid closer attention to “tar”—an imprecise mixture of particles and chemicals, some of which were carcinogenic.

“People’s attention was very much on tar,” she says. “Tar was the bad thing, they thought. However, the cigarette producers were more concerned about nicotine, because they knew people smoked because of nicotine.”

According to internal documents unearthed by Grodal and Hsu, the cigarette companies recognized these consumer trends and used them to their advantage, raising nicotine levels in their light cigarettes to give them more kick and, to a much lesser extent, raising levels of tar to give them more flavor. Because the “light” label wasn’t regulated, they got away with it.

“They could create whatever and call it ‘light,’” says Grodal. “It was all based on ‘Does the consumer accept this as ‘light?’ There was a blurring of that boundary. Some ‘full’ cigarettes had lower tar and nicotine than some that were labeled ‘light.’” This is no longer the case: in 2010, a law went into effect banning tobacco manufacturers from labeling cigarettes as “light,” “low,” or “mild.”

What does taken-for-grantedness mean for consumers today? While some product labels, like “very low sodium” or “cholesterol-free” are tightly regulated by the FDA , other terms and labels like “healthy” or “natural” are more vague. The take-home message, says Grodal, is to “put on your skeptical hat sometimes, not just with the shopping cart but also in other decisions.”

“We make a lot of choices based on people’s claims, whether it’s a service or a product,” she says. “Sometimes it just pays to be a little more aware, to stop and think, ‘what do they mean when they say that?’”

Explore Related Topics:

• Business & Social Sciences
• Share this story
• 1 Comments Add

Barbara Moran is a science writer in Brookline, Mass. Profile

Comments & Discussion

Boston University moderates comments to facilitate an informed, substantive, civil conversation. Abusive, profane, self-promotional, misleading, incoherent or off-topic comments will be rejected. Moderators are staffed during regular business hours (EST) and can only accept comments written in English. Statistics or facts must include a citation or a link to the citation.

There is 1 comment on The Curious Case of the Light Cigarette

In my country, electric hookah has become fashionable!

Post a comment. Cancel reply

Your email address will not be published. Required fields are marked *

Latest from The Brink

Boston’s rain-free month may mean fall foliage will come early this year, just how safe are soft robots, e-cigarette brands are skirting the rules about health warning labels on instagram, study finds, a new type of rna could revolutionize vaccines and cancer treatments, what a southern plantation’s paper trail can reveal about the lasting legacies of slavery, why are kids struggling with anxiety more than ever, getting their hands dirty in the lab—and in the charles river, 2024 ignition awards aim to bring bu science and tech to market, bu team wins major national science foundation grant to help phd students attack climate change, liberation through rhythm: bu ethnomusicologist studies history and present of african beats, oxygen produced in the deep sea raises questions about extraterrestrial life, the histories of enslaved people were written by slavers. a bu researcher is working to change that, making mri more globally accessible: how metamaterials offer affordable, high-impact solutions, “i love this work, but it’s killing me”: the unique toll of being a spiritual leader today, feeling the heat researchers say heat waves will put more older adults in danger, what the history of boston’s harbor can teach us about its uncertain future, eng’s mark grinstaff one of six researchers to receive nsf trailblazer engineering impact awards, how do we solve america’s affordable housing crisis bu research helps inspire a federal bill that suggests answers, missile defense won’t save us from growing nuclear arsenals, this ai software can make diagnosing dementia easier and faster for doctors.

• - Google Chrome

Intended for healthcare professionals

• My email alerts
• BMA member login
• Username * Password * Forgot your log in details? Need to activate BMA Member Log In Log in via OpenAthens Log in via your institution

Search form

• Advanced search
• Search responses
• Search blogs
• The fallacy of “light”...

The fallacy of “light” cigarettes

• Related content
• Peer review
• Nancy A Rigotti , associate professor of medicine, director ,
• Hilary A Tindle , research fellow
• Harvard Medical School Boston, MA, Tobacco Research and Treatment Massachussetts General Hospital Boston, MA
• Division of General Internal Medicine Beth Israel Deaconess Medical Center Harvard Medical School Boston, MA

Low tar is not low risk

Just 40 years ago, the 1964 Surgeon General's Report on Smoking and Health alerted the American public to the health risks of cigarette smoking. It launched a remarkably successful public health campaign that dramatically cut adult smoking prevalence, from 42.4% in 1965 to 22.8% in 2001, and recast the cultural acceptability of tobacco use. 1 Less well known is the fact that the cigarette itself has undergone major change in the past 40 years. Today's 46.2 million American smokers buy a product very different from the cigarette sold in 1964.

In the late 1960s, tobacco manufacturers introduced “light” or “low tar” brands that yielded 7-14 mg tar per cigarette, compared to the 22 mg tar of the average cigarette sold at that time. 2 Later, “ultralight” brands appeared, with tar yields below 7 mg per cigarette. Today, almost 90% of cigarettes sold in the United States are in these categories. 3 Better taste is not the reason why smokers buy light cigarettes. They buy them because they have the misconception that smoking lower tar products reduces their risk of lung cancer and other tobacco-related diseases. 4 Advertisements for these …

Log in using your username and password

BMA Member Log In

If you have a subscription to The BMJ, log in:

• Need to activate
• Log in via institution
• Log in via OpenAthens

Log in through your institution

Subscribe from £184 *.

Subscribe and get access to all BMJ articles, and much more.

* For online subscription

Access this article for 1 day for: £50 / $60/ €56 ( excludes VAT )

You can download a PDF version for your personal record.

Buy this article

• Article Information

See More About

Select your interests.

Customize your JAMA Network experience by selecting one or more topics from the list below.

• Academic Medicine
• Acid Base, Electrolytes, Fluids
• Allergy and Clinical Immunology
• American Indian or Alaska Natives
• Anesthesiology
• Anticoagulation
• Art and Images in Psychiatry
• Artificial Intelligence
• Assisted Reproduction
• Bleeding and Transfusion
• Caring for the Critically Ill Patient
• Challenges in Clinical Electrocardiography
• Climate and Health
• Climate Change
• Clinical Challenge
• Clinical Decision Support
• Clinical Implications of Basic Neuroscience
• Clinical Pharmacy and Pharmacology
• Complementary and Alternative Medicine
• Consensus Statements
• Coronavirus (COVID-19)
• Critical Care Medicine
• Cultural Competency
• Dental Medicine
• Dermatology
• Diabetes and Endocrinology
• Diagnostic Test Interpretation
• Drug Development
• Electronic Health Records
• Emergency Medicine
• End of Life, Hospice, Palliative Care
• Environmental Health
• Equity, Diversity, and Inclusion
• Facial Plastic Surgery
• Gastroenterology and Hepatology
• Genetics and Genomics
• Genomics and Precision Health
• Global Health
• Guide to Statistics and Methods
• Hair Disorders
• Health Care Delivery Models
• Health Care Economics, Insurance, Payment
• Health Care Quality
• Health Care Reform
• Health Care Safety
• Health Care Workforce
• Health Disparities
• Health Inequities
• Health Policy
• Health Systems Science
• History of Medicine
• Hypertension
• Images in Neurology
• Implementation Science
• Infectious Diseases
• Innovations in Health Care Delivery
• JAMA Infographic
• Law and Medicine
• Leading Change
• Less is More
• LGBTQIA Medicine
• Lifestyle Behaviors
• Medical Coding
• Medical Devices and Equipment
• Medical Education
• Medical Education and Training
• Medical Journals and Publishing
• Mobile Health and Telemedicine
• Narrative Medicine
• Neuroscience and Psychiatry
• Notable Notes
• Nutrition, Obesity, Exercise
• Obstetrics and Gynecology
• Occupational Health
• Ophthalmology
• Orthopedics
• Otolaryngology
• Pain Medicine
• Palliative Care
• Pathology and Laboratory Medicine
• Patient Care
• Patient Information
• Performance Improvement
• Performance Measures
• Perioperative Care and Consultation
• Pharmacoeconomics
• Pharmacoepidemiology
• Pharmacogenetics
• Pharmacy and Clinical Pharmacology
• Physical Medicine and Rehabilitation
• Physical Therapy
• Physician Leadership
• Population Health
• Primary Care
• Professional Well-being
• Professionalism
• Psychiatry and Behavioral Health
• Public Health
• Pulmonary Medicine
• Regulatory Agencies
• Reproductive Health
• Research, Methods, Statistics
• Resuscitation
• Rheumatology
• Risk Management
• Scientific Discovery and the Future of Medicine
• Shared Decision Making and Communication
• Sleep Medicine
• Sports Medicine
• Stem Cell Transplantation
• Substance Use and Addiction Medicine
• Surgical Innovation
• Surgical Pearls
• Teachable Moment
• Technology and Finance
• The Art of JAMA
• The Arts and Medicine
• The Rational Clinical Examination
• Tobacco and e-Cigarettes
• Translational Medicine
• Trauma and Injury
• Treatment Adherence
• Ultrasonography
• Users' Guide to the Medical Literature
• Vaccination
• Venous Thromboembolism
• Veterans Health
• Women's Health
• Workflow and Process
• Wound Care, Infection, Healing

Others Also Liked

• Download PDF
• X Facebook More LinkedIn

Tanner NT , Thomas NA , Ward R, et al. Association of Cigarette Type With Lung Cancer Incidence and Mortality : Secondary Analysis of the National Lung Screening Trial . JAMA Intern Med. 2019;179(12):1710–1712. doi:10.1001/jamainternmed.2019.3487

Manage citations:

© 2024

• Permissions

Association of Cigarette Type With Lung Cancer Incidence and Mortality : Secondary Analysis of the National Lung Screening Trial

• 1 Health Equity and Rural Outreach Innovation Center (HEROIC), Ralph H. Johnson Veterans Affairs Hospital, Charleston, South Carolina
• 2 Thoracic Oncology Research Group, Medical University of South Carolina, Charleston
• 3 Hollings Cancer Center, Medical University of South Carolina, Charleston
• 4 Department of Public Health Sciences, Medical University of South Carolina, Charleston

In response to increasing evidence implicating cigarette smoking as a cause of lung cancer in the 1950s, tobacco manufacturers introduced filtered and “lower-tar” cigarettes to allay consumer concerns, knowing they did not actually reduce health risks. Puncturing ventilation holes of varying sizes and numbers into the filter to dilute inhaled smoke became the optimum way to reduce tar yield. 1

Despite these changes, smoking remains responsible for 80% to 90% of lung cancer diagnoses and 5-year survival is 18%, highlighting the importance of prevention. 2 Lung cancer screening with low-dose computed tomography has been shown to improve mortality, and tobacco treatment is a required component of effective screening. We investigated the association of filter status, tar level, and menthol flavor with lung cancer outcomes in the National Lung Screening Trial.

This is a secondary data analysis of 14 123 National Lung Screening Trial participants who completed detailed smoking questionnaires. 3 We examined baseline cigarette tar level (regular, light, or ultralight), flavor (unflavored or menthol), and filter status (filtered or unfiltered) and their association with lung cancer diagnosis, mortality, and all-cause mortality. Cox regression models were used to study the influence of cigarette tar level, flavor, and filter on clinical outcomes, controlling for sex, age, race, pack years, nicotine dependence (as measured by the Fagerström Test for Nicotine Dependence), and treatment arm. This study was approved by the Medical University of South Carolina institutional review board. Patient consent was waived because deidentified data were used. Two-sided t testing was conducted as indicated with a P value less than .05 being considered significant.

Of 14 123 participants, 7056 (50%) were current smokers, 13 038 (92%) were white, and had a history of smoking an average of 60 pack of cigarettes per year ( Table 1 ). Most individuals (12 488 [88%]) smoked filtered cigarettes, and nearly half smoked light (4660 [33.0%]) or ultralight (1562 [11.1%]) cigarettes. After adjustment, unfiltered cigarette smokers were nearly 40% (hazard ratio, 1.37; 95% CI, 1.10-1.17) more likely to develop lung cancer and nearly twice (hazard ratio, 1.96; 95% CI, 1.46-2.64) as likely to die of lung cancer compared with those who smoked filtered cigarettes. Additionally, all-cause mortality was nearly 30% (hazard ratio, 1.28; 95% CI, 1.09-1.50) higher ( Table 2 ). There was no difference in mortality outcomes between light/ultralight or flavored vs regular cigarette smokers.

This study evaluated mortality in the setting of lung cancer screening based on the type of cigarette smoked and found that smoking unfiltered cigarettes is associated with significantly higher lung cancer incidence and death. There was no difference in lung cancer outcomes when comparing light/ultralight or menthol smokers with regular cigarette smokers.

This study confirms that smoking filtered and unfiltered cigarettes is associated with increased risk of lung cancer incidence and mortality and is consistent with other studies in the literature. 4 Identifying individuals who smoke unfiltered cigarettes is important as they stand to benefit greatly from aggressive tobacco treatment. Although filtered cigarettes fared better than unfiltered cigarettes, this study demonstrated lung cancer mortality in filtered cigarette smokers to be 1600 per 100 000 persons compared with a never-smoking cohort with just 34 lung cancer deaths per 100 000 persons. 5 The difference in outcomes in those smoking filtered and unfiltered cigarettes observed in this study and others likely reflects filtered cigarette design features including the amount, density, and blends of tobacco in the column, additives, and filter paper porosity. 5 , 6 Further, evidence suggests that despite adoption of new cigarette designs, cigarette smoking continues to pose enormous health risk. 1 , 5

Light/ultralight cigarette smokers had similar mortality rates compared with those smoking regular cigarettes. This outcome may be explained by the concept of compensatory smoking in which smokers achieve higher nicotine levels by changing smoking behaviors. 6 Tobacco companies marketed low-tar cigarettes to consumers as an alternative to quitting, suggesting that this improved health risks. Unfortunately, most smokers believe light/ultralight cigarettes reduce risk, and this misconception may dissuade them from quitting. 7

This study confirms that smoking any type of cigarette conveys serious health risks. Within the context of this study, unfiltered cigarettes are the most dangerous, and individuals who smoke them should be targeted for aggressive tobacco treatment interventions. Some smokers may switch to light or ultralight cigarettes believing they are safer; however, this is not the case. Lung cancer screening is considered a teachable moment, and the findings here should lead to the design of personalized tobacco treatment interventions within this context. Importantly, this study adds to the overwhelming evidence showing the risk of developing and dying of lung cancer caused by smoking both filtered and unfiltered cigarettes.

Accepted for Publication: June 21, 2019.

Corresponding Author: Nichole T. Tanner, MD, MSCR, Health Equity and Rural Outreach Innovation Center (HEROIC), Ralph H. Johnson Veterans Affairs Hospital, 109 Bee St, Charleston, SC 29425 ( [email protected] ).

Published Online: October 21, 2019. doi:10.1001/jamainternmed.2019.3487

Author Contributions: Dr Tanner had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Tanner, Thomas, Rojewski, Toll, Silvestri.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Tanner, Thomas, Ward, Rojewski, Gebregziabher, Silvestri.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Ward, Gebregziabher, Silvestri.

Obtained funding : Toll.

Supervision: Toll, Silvestri.

Conflict of Interest Disclosures: Dr Tanner reports grants from the American Cancer Institute during the conduct of the study; grants from Cook Medical, Exact Sciences, Olympus America, and Veracyte outside the submitted work; and consulting from Cook Medical, Exact Sciences, Biodesix, and Olympus America outside the submitted work. Dr Rojewski reports grants from the National Cancer Institute during the conduct of the study. Dr Toll reported personal fees from Pfizer and has consulted on an advisory board regarding e-cigarettes and has offered testimony on behalf of plaintiffs who filed litigation against tobacco companies. No other disclosures were reported.

Funding/Support: This study was supported in part by research funding from the Hollings Cancer Center at the Medical University of South Carolina.

Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: We thank K. Michael Cummings, PhD, MPH (Medical University of South Carolina), for his thoughtful review and comments on this paper. He received no compensation for his assistance.

• Register for email alerts with links to free full-text articles
• Access PDFs of free articles
• Manage your interests
• Save searches and receive search alerts

• News and Features
• Conferences
• Clinical Tools
• Special Collections

“Light” Cigarettes and Cancer Risk (Fact Sheet)

FactSheet_LightCigarettes

What is a so-called light cigarette?

Tobacco manufacturers have been redesigning cigarettes since the 1950s. Certain redesigned cigarettes with the following features were marketed as “light” cigarettes:

• Cellulose acetate filters (to trap tar).
• Highly porous cigarette paper (to allow toxic chemicals to escape).
• Ventilation holes in the filter tip (to dilute smoke with air).
• Different blends of tobacco.

When analyzed by a smoking machine, the smoke from a so-called light cigarette has a lower yield of tar than the smoke from a regular cigarette. However, a machine cannot predict how much tar a smoker inhales. Also, studies have shown that changes in cigarette design have not lowered the risk of disease caused by cigarettes (1).

On June 22, 2009, President Barack Obama signed into law the Family Smoking Prevention and Tobacco Control Act, which granted the U.S. Food and Drug Administration the authority to regulate tobacco products. One provision of the new law bans tobacco manufacturers from using the terms “light,” “low,” and “mild” in product labeling and advertisements. This provision went into effect on June 22, 2010. However, some tobacco manufacturers are using color-coded packaging (such as gold or silver packaging) on previously marketed products and selling them to consumers who may continue to believe that these cigarettes are not as harmful as other cigarettes (2–4).

Are light cigarettes less hazardous than regular cigarettes?

No. Many smokers chose so-called low-tar, mild, light, or ultralight cigarettes because they thought these cigarettes would expose them to less tar and would be less harmful to their health than regular or full-flavor cigarettes. However, light cigarettes are no safer than regular cigarettes. Tar exposure from a light cigarette can be just as high as that from a regular cigarette if the smoker takes long, deep, or frequent puffs. The bottom line is that light cigarettes do not reduce the health risks of smoking.

Moreover, there is no such thing as a safe cigarette. The only guaranteed way to reduce the risk to your health, as well as the risk to others, is to stop smoking completely.

Because all tobacco products are harmful and cause cancer, the use of these products is strongly discouraged. There is no safe level of tobacco use. People who use any type of tobacco product should quit. For help with quitting, refer to the National Cancer Institute (NCI) fact sheet Where To Get Help When You Decide To Quit Smoking.

Do light cigarettes cause cancer?

Yes. People who smoke any kind of cigarette are at much greater risk of lung cancer than people who do not smoke (5). Smoking harms nearly every organ of the body and diminishes a person’s overall health.

People who switched to light cigarettes from regular cigarettes are likely to have inhaled the same amount of toxic chemicals, and they remain at high risk of developing smoking-related cancers and other disease (1). Smoking causes cancers of the lung, esophagus, larynx (voice box), mouth, throat, kidney, bladder , pancreas, stomach, and cervix, as well as acute myeloid leukemia (6).

Regardless of their age, smokers can substantially reduce their risk of disease, including cancer, by quitting.

What were the tar yield ratings used by the tobacco industry for light cigarettes?

Although no Federal agency formally defined the range of tar yield for light or ultralight cigarettes, the tobacco industry used the ranges shown in the table below (5, 7).

These ratings were not an accurate indicator of how much tar a smoker might have been exposed to, because people do not smoke cigarettes the same way the machines do and no two people smoke the same way.

Ultralight and light cigarettes are no safer than full-flavor cigarettes. There is no such thing as a safe cigarette (1). 

Picked For You

Latest News

Want to read more?

Please login or register first to view this content.

Login Register