Even as measures to discourage smoking grew more stringent in recent years, a new report indicates that the nicotine content of cigarettes rose, making it tougher for smokers to quit.
From 1998 to 2004, the amount of nicotine that could be inhaled from cigarettes increased an average of 10 percent, the study by the state Department of Public Health found. Nicotine is the chemical that causes cigarettes to be addictive, and the study, released yesterday, found higher levels in all classes of cigarettes, including those branded ``light."
During the past decade, aggressive campaigns across the nation have aimed to curb smoking, the leading cause of preventable deaths. Cities and states, including Massachusetts, have banned smoking in public places, and the price of cigarettes has soared. Still, smoking rates among US adults stubbornly persist above 20 percent.
``We in public health have tried to spend a lot of time figuring out why people don't stop smoking," said Lois Keithly , director of the Massachusetts Tobacco Control Program . ``It is more difficult to quit when there is a higher amount of nicotine in the cigarette."
Representatives of the three major tobacco makers in the United States -- Lorillard Tobacco Co. ,
Tobacco control specialists not involved with the Massachusetts report described it as the first major study tracking nicotine in cigarettes in seven years. And those specialists said they believe that the findings reflect trends nationwide.
Industry documents turned over during landmark litigation in the 1990s that led tobacco companies to settle with state governments for billions of dollars showed that the companies routinely spiked the nicotine content of their products so that cigarettes would be more pleasurable and addictive. The state study, tobacco control specialists said, suggests that practice has persisted.
``Their efforts are focused on getting people addicted quickly and keeping them addicted," said Diane Pickles , executive director of Tobacco Free Massachusetts , an advocacy organization.
A 1996 state law required cigarette makers to test the nicotine content of their products using a method specified by the Department of Public Health and report the results annually. Most of the tests are conducted at an independent laboratory in Canada that uses a machine to simulate a typical smoker's puffing.
Though the data in the report came from the tobacco industry, Sally Fogerty , an associate commissioner of public health, said her agency was confident the nicotine readings are reliable because it would not be in the companies' interest to report an increase.
Veterans of the decades-long fight against the tobacco industry said the rising nicotine levels show that companies will adopt strategies to get smokers addicted -- and to keep them hooked. ``I'm always shocked at the new things the industry does," said Richard Daynard , chairman of the Tobacco Products Liability Project at Northeastern University . ``This is sort of sleazy in a new and different way."
The industry is still absorbing the latest blow against it, a ruling this month by a federal judge in Washington, D.C., that the companies had conspired to deceive the public about the perils of smoking. The judge ordered cigarette makers to stop using monikers such as ``ultra-light" and ``low tar."
The Federal Trade Commission for three decades regularly released reports on the nicotine and tar content of cigarettes -- reports that frequently came under criticism for failing to adequately reflect the amount of nicotine smokers inhale in actual use.
The reports showed that nicotine levels on average had remained stable since 1980, after falling in the preceding decade. The last of those studies was released in September 1999, commission spokeswoman Claudia B. Farrell said yesterday.
The Federal Trade Commission has continued collecting data on nicotine, but she did not know why they have not published reports on the findings.
The Massachusetts approach to measuring nicotine tries to address shortcomings of the Federal Trade Commission's methodology so that it more realistically reflects how people actually smoke, state specialists said.
The state test assumes that half of the tiny holes that filter smoke will be blocked by a user's lips or hands, increasing the amount of smoke inhaled, while the federal reports assumed that all of the holes would be open.
The Massachusetts study analyzed nicotine in 116 cigarette brands, finding that the amount of nicotine that can be inhaled by a typical smoker increased in 92 brands from 1998 to 2004. Only a dozen brands registered a decrease in nicotine. Twelve others remained constant.
In 2004, Newport filtered cigarettes eclipsed Camel and had the highest level of inhalable nicotine, nearly 70 percent above the average. The brands with the lowest content were Doral Ultra-Light King soft pack and Winston Ultra-Light King soft pack.
After being inhaled, nicotine races to the brain in seconds, releasing a flood of chemicals associated with pleasure and motivation. Increasing the amount of nicotine, doctors said, presents a very real danger to smokers.
``If people are getting accustomed to higher levels of nicotine when they smoke, when they stop smoking , I would expect they would have more withdrawal symptoms," said Dr. Nancy Rigotti , director of tobacco research and treatment at Massachusetts General Hospital . ``And it would make it harder for them to quit smoking."
It could make it harder, too, to treat smokers who want to quit, Rigotti and the state's Keithly said. Current formulations of nicotine patches and gums might be too weak to counteract the craving created by high-powered cigarettes.
Massachusetts once was a national leader in spending on tobacco control, but a statewide budget crisis caused funding to plummet to just $5 million a year, from a high of $48 million a few years ago. In July, the state expanded smoking cessation services for the poor and uninsured; about 40 percent of Massachusetts adults covered by government health plans smoke.
Stephen Smith can be reached at firstname.lastname@example.org.