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Asian herbal-tobacco cigarettes: "not medicine but less harmful"?

¹ Centre for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, California, USA
² Division of General Internal Medicine, University of California, Davis, Sacramento, California, USA

Correspondence to:
Elisa Tong
4150 V Street, PSSB #2400, Division of General Internal Medicine, University of California, Davis, Sacramento, California 95817, USA; ektong{at}ucdavis.edu

Objective: To describe the development and health claims of Asian herbal-tobacco cigarettes.

Methods: Analysis of international news sources, company websites, and the transnational tobacco companies’ (TTC) documents. PubMed searches of herbs and brands.

Results: Twenty-three brands were identified, mainly from China. Many products claimed to relieve respiratory symptoms and reduce toxins, with four herb-only products advertised for smoking cessation. No literature was found to verify the health claims, except one Korean trial of an herb-only product. Asian herbal-tobacco cigarettes were initially produced by China by the 1970s and introduced to Japan in the 1980s. Despite initial news about research demonstrating a safer cigarette, the TTC analyses of these cigarettes suggest that these early products were not palatable and had potentially toxic cardiovascular effects. By the late 1990s, China began producing more herbal-tobacco cigarettes in a renewed effort to reduce harmful constituents in cigarettes. After 2000, tobacco companies from Korea, Taiwan, and Thailand began producing similar products. Tobacco control groups in Japan, Taiwan, and Thailand voiced concern over the health claims of herbal-tobacco products. In 2005, China designated two herbal-tobacco brands as key for development.

Conclusion: Asian herbal-tobacco cigarettes claim to reduce harm, but no published literature is available to verify these claims or investigate unidentified toxicities. The increase in Asian herbal-tobacco cigarette production by 2000 coincides with the Asian tobacco companies’ regular scientific meetings with TTCs and their interest in harm reduction. Asia faces additional challenges in tobacco control with these culturally concordant products that may discourage smokers from quitting.

Abbreviations: ARTIST, Asian Regional Tobacco Industry Scientists Team; JTS, Japan Tobacco & Salt Public Corporation; KFDA, Korean Food and Drug Administration; PREP, potentially reduced exposure product; TTC, transnational tobacco company; TTWMB, Taiwan Tobacco and Wine Monopoly Bureau

Keywords: Asia; Chinese; herb; tobacco; harm reduction