Chinese 'low-tar' cigarettes do not deliver lower levels of nicotine and carcinogens

Tob Control. 2010 Oct;19(5):374-9. doi: 10.1136/tc.2009.033092. Epub 2010 May 27.


Background: Low-tar cigarette smoking is gaining popularity in China. The China National Tobacco Corporation (CNTC) promotes low-tar cigarettes as safer than regular cigarettes.

Methods: A total of 543 male smokers smoking cigarettes with different tar yields (15 mg, regular cigarettes, 10-13 mg low-tar cigarettes and < 10 mg low-tar cigarettes) were recruited in Shanghai, China, who then completed a questionnaire on smoking behaviour and provided a urine sample for analysis of the nicotine metabolites cotinine and trans-3'-hydroxycotinine. A total of 177 urine samples were selected at random for the analysis of the carcinogens polycyclic aromatic hydrocarbon metabolites (PAHs) (1-hydroxypyrene, naphthols, hydroxyfluorenes and hydroxyphenanthrenes) and the tobacco specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-butanone (NNK) metabolites, 4-(methylnitrosamino)-1-(3-pyridyl)-butanol (NNAL) and NNAL-glucuronide. Values were normalised by creatinine to correct for possible distortions introduced by dilution or concentration of the urine.

Results: Smokers of low-tar cigarettes smoked fewer cigarettes per day (p=0.001) compared to smokers of regular cigarettes. Despite this lower reported consumption, levels of cotinine, trans-3'-hydroxycotinine and PAHs in urine of people smoking low-tar cigarettes were not correlated with nominal tar delivery of the cigarettes they smoked. Urine concentrations of NNAL were higher in smokers of lower tar than higher tar cigarettes.

Conclusions: Chinese low-tar cigarettes do not deliver lower doses of nicotine and carcinogens than regular cigarettes, therefore it is unlikely that there would be any reduction in harm. CNTC's promotion of low-tar cigarettes as 'less harmful' is a violation of the World Health Organization Framework Convention on Tobacco Control, which China ratified in 2005.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Carcinogens / analysis*
  • China
  • Consumer Product Safety*
  • Cotinine / analogs & derivatives
  • Cotinine / urine
  • Humans
  • Male
  • Middle Aged
  • Nicotine / urine*
  • Nitrosamines / urine
  • Polycyclic Aromatic Hydrocarbons / urine
  • Smoking / adverse effects
  • Smoking / urine*
  • Surveys and Questionnaires
  • Tars* / analysis
  • Tobacco / chemistry*


  • Carcinogens
  • Nitrosamines
  • Polycyclic Aromatic Hydrocarbons
  • Tars
  • tobacco tar
  • hydroxycotinine
  • Nicotine
  • 4-(N-methyl-N-nitrosamino)-1-(3-pyridyl)-1-butanone
  • Cotinine