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SAFETY INDEX FOR CIGARETTES To get a feel for the assumptions necessary I was asked to attempt to write a 'valid' safety index. Without going into all the thinking the following is the sort of thimg a serious attempt would come up with: There would be two indices, one for men and one for women but the differences would be merely in figures for mortality, loss of expectation of life etc. Here I will indicate the index for men. The index would relate to one cigarette and would be used by consumers~ possibly to compare two types of cigarettes of which they smoke quite different numbers. The Index: Where~is weight yield per cigarette. is average loss of life expectancy due to diseases ~ lung cancer -~cardiovascular ~ - ~_bronchitis " /,j..others is a relevant test result indicating relative biological activity of component from one cigarette compared with the same component in anQther arbitrarily choss~ as standard. is proportion of deaths caused by smoking. 0 Cg~td. ~ BAT Industries document for Province of British Columbia 13 November 2000 BAT INDUSTRIES 00290411

- 2 - ~ is the total number of deaths in a given population over a period - say one year. ~ is some measure of toxicity per unit weight of component relative to toxicity of nicotine. The following figures for U.K. could be used: Deaths from lung cancer Cardiovascular ( CHD. ) Bronchitis Men (% total) Womer, (% total) 30,000 (9.4) 7,500 (2.4) 94,000(29.5) 69,000 (21.6) 21,000 (6.5) 6,500 (2.0) The following a~sumptions are made or implied in the Index whether justifiable or not: I) Cardiovascular disease is caused to the extent of 15% of all such deaths by cigarette smoking and by components in smoke directly proportional to nicotine and also by carbon monoxide and further there are linear dose resporlse relations in all cases and no thresholds. 2) 95% of all lung cancer deaths are caused by smoking cigarettes and the risk for an individual is directly proportional to the DPM delivery measured by machine smoking. 3) Bronchitis deaths ace caused in 20% of the cases by smoking cigarettes and are directly propbrtional to the yield of nitrogen ox.ides in the smoke. 4) Average loss of expectation of life due to smoking related diseases are as follows: Lung Cancer 2 years Cardiovascular diseases 5 years Bronchitis I year Simplifying assumptions are necessary whether justifiable or not as follows: The only important smoking behavioural assumption is that nearly all smokers smoke for nicotine and adjust the way they smoke to compensate for changes in nicotine delivery. No other differences are important. No other diseases or components of smoke are important in this context. There is no interaction between diseases or between causes. BAT Industries document for Province of British Columbia 13 November 2000 BAT INDUSTRIES 00290412

G) All components are weight and not concentration related to disease. 7) All dose relationships are linear without thresholds. It should be noted that ~.could be benzpyrene content. Furthe~ promotion and initiation are not considered but these could be taken into account in the calculation of E~ as a rough approximation. -. The writer does not consider it reasonable to make all these assumptions and would argue some are not even plausible. But if they were acceptable within some limits a few examples will show that with any reasonably wide limits the order of cigarette indices can be changed at will. Consider three cigarettes: A: Tar 10 mgs. Nic. ~ mg. B: Tar 20 mgs. Nic. 3 mgs. C: Tar S mgs. CO 2 mgs. NOx 0.1 rag. CO 4 mgs. NO 0.% mg. X Nic. 0.8 mg. CO ~.2 mgs. NOx 0.1 mg. and Case I Assumptions as above: Case II Assume smoking causes 25% of heart disease. Index: Case I Case II Cigarette A 496~910 590,910 B 496,653 700~73 C 345,525 453~625 It can readily be seen that equally plausible assumptions could be made to change the ranking of cigarettes almost at will. It may be concluded that there is insufficient knowledge at present to enable any useful combination of smoke constituents to be made into a single index. BAT Industries document for Province of British Columbia 13 November 2000 BAT INDUSTRIES 00290413