Subject: Re: clove cigarettes
From: [email-masked] (Ronald T Coslick Jr)
Date: 8 Apr 93 22:01:00 GMT
Newsgroups: alt.drugs

Regarding clove cigarettes, [email-masked] (Scott Grigsby)
writes:

>	If anyone could provide more information on this, I'd be 
>very appreciative!  I, too, have been told that cloves were much
>more damaging than cigarettes (someone even told me once that
>one clove was as damaging as a whole pack of say...Camel Lights!)
>I've also been told that they make you cough blood.  (Not that
>inhaling any smoke won't, eventually....).  Indeed, they certainly
>seem to char my lungs to hell much better than a regular cig! :-)
>But does anyone know for sure?  Thanks!
> 
>	Scott ([email-masked])

Hope this helps.

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                        Los Angeles Times
                         March 21, 1986
      SMOKE THICKENS OVER CLOVE CIGARETTE INHALATION STUDY 

By: DENNIS McLELLAN

  The results of an industry-sponsored study, released this week,
on the possible toxic effects of smoking clove cigarettes show that
clove cigarette smoke is no more harmful to laboratory rats than
smoke from conventional cigarettes.

  Scientists not connected with the study, however, caution that a
single study on rats does not provide conclusive evidence that the
pungent-smelling imported cigarettes from Indonesia do not cause
lung damage in humans.

  The independent study, which was conducted by the Department of
Inhalation Toxicology at the Huntingdon Research Centre in
Huntingdon, England, is the first inhalation study made available
to the public on clove cigarettes (or kreteks), which have come
under attack in the past year for causing serious health problems
and allegedly leading to the death of one Orange County teen-ager.

  The British inhalation study was funded by P. T. Djarum and House
of Sampoerna, both of Indonesia, although an industry spokesman
said the laboratory wasn't told who was backing the study.  The two
firms are the largest manufacturers of clove cigarettes -- which
contain 60% tobacco and 40% ground cloves.

  Cigarettes 'Vindicated'

  "I think the study shows that clove cigarettes have been
vindicated as far as being guilty of what the critics have said
they are guilty of: that these things are much worse for you than
non-clove cigarettes," said G. A. Avram, executive director of the
Specialty Tobacco Council, an organization representing the major
manufacturers and importers of clove cigarettes in the United
States.

  Avram, who released the results of the 119-page study at a news
conference in Washington, said the study "clearly establishes that
clove cigarettes do not cause acute respiratory distress or
anesthetize the lungs on the test animals." (Eugenol -- the major
component of cloves-- is used as a mild dental anesthetic; critics
of clove cigarette say the eugenol in the cigarettes numbs smokers'
throats.)

  The results of the British inhalation study differ sharply from
those of an as-yet-unpublished study conducted last year by the
American Health Foundation, which shows that eugenol can cause
extensive lung damage and may be lethal to laboratory animals when
administered directly into the lung via the trachea (in contrast to
inhalation studies, in which laboratory animals breathe smoke).

  Another study by the American Health Foundation, however,
supports the findings of the British study: In that, an inhalation
study, there were no acute toxic effects among hamsters exposed to
clove cigarette smoke, according to Edmond LaVoie, associate
division chief of environmental carcinogens at the nonprofit,
independent research foundation in Valhalla, N.Y.

  LaVoie added, however, that "one cannot discount the data
obtained in the intratracheal experiments because there are
limitations in using small rodents in inhalation experiments." The
American Health Foundation studies on clove cigarettes will be
published soon in Archives of Toxicology, a scientific journal.

  In view of the findings in the British inhalation study, however,
Avram maintains that "the burden of proof has shifted and it's now
up to them (clove cigarette critics) to prove there is a problem
with clove cigarettes instead of clove cigarettes being put on the
defensive." 

  Robert Phalen, director of the air pollution health effects
laboratory at the College of Medicine at UC Irvine and author of
"Inhalation Studies," a professional reference book, observed that
the inhalation study "is important, but I'd say a single study is
not definitive for something that has widespread use."

  Phalen added that "there's a segment of the population --
somewhere around 5% -- that have very sensitive lungs.  These
people can over-respond to a variety of chemicals when inhaling. 
The rat is not a good model for those people."

  Moreover, Phalen said, "You can never, in a small single animal
study, say that something is safe.  Let's say clove cigarettes
hypothetically caused one smoker in a thousand to die.  You could
never detect that in a study of human beings unless you had tens of
thousands of people and you couldn't detect that level of risk in
a study using less than several thousand animals." 

  "The conduct of a single study is suggestive but in no case
convincing evidence one way or the other unless the study is so
designed as to be essentially foolproof and these studies are so
complicated that they rarely can be made foolproof," said Dr.  Tee
L.  Guidotti, professor of occupational medicine at the University
of Alberta Faculty of Medicine in Edmonton, Canada, who has done
research on clove cigarette toxicity.

  "We can't say anything about long-term health effects from a
single short-term study," Guidotti said.  "We do know that the
International Agency for Research on Cancer, which is the
international authority on such matters, has concluded that eugenol
is a possible human carcinogen.  The addition of a possibly harmful
substance (eugenol) to an already hazardous product (cigarettes)
can only increase the risk that much further."

  Lawsuits Filed

  In general, Guidotti added, clove cigarettes "have more tar,
nicotine and carbon monoxide than conventional cigarettes."

  "I think it (Avram's assertion that clove cigarettes are as safe
as regular cigarettes) is bunk," said Eric Lampell, attorney for
the two Orange County families that have each filed $25-million
lawsuits against the makers, importers and sellers of clove
cigarettes for supplying their children with what they charge were
"dangerous and defective" cigarettes.

  Anticipating possible criticism over having a vested interest in
a study examining his own product, Avram said the Huntingdon
Research Centre did not know until the study was completed that the
sponsor, Avram's North Carolina law firm, was representing two
clove cigarette manufacturers.

  Avram said two more inhalation studies will be forthcoming soon
from the independent British contract research organization. 
"And," he said, "the preliminary indications we're getting are that
they are even more encouraging from our point of view than this
original one." 

  Avram was scheduled to present the inhalation study Thursday to
a state Senate committee in Maryland where legislators are
considering a bill to ban clove cigarettes.  
  Missouri and Utah currently are considering similar bills. 
Nevada and New Mexico already have banned the imports, but a
Florida judge declared unconstitutional a 3-week-old law banning
clove cigarettes in that state.  

Reacted 'Hastily'

  The Speciality Tobacco Council maintains that legislators have
reacted "hastily" in banning clove cigarettes "without taking time
to obtain a balanced appraisal on the issue."

  The council was formed early last year in the wake of media
reports on the potential health hazards of smoking clove
cigarettes, which have been sold in the United States since 1970
but did not become popular until the early 1980s.  (Sales of the
imports, according to Avram, have dropped to about half of their
peak of 150-170 million in 1984 as a result of the controversy.)

  Last March, Ron and Carole Cislaw of Costa Mesa filed a
$25-million lawsuit, claiming that the sellers, makers, and
importers of clove cigarettes were, among other things, negligent
in supplying "dangerous and defective" cigarettes.  Their
17-year-old son Tim developed shortness of breath shortly after
smoking a clove cigarette and eventually died of respiratory
failure.  A second $25-million lawsuit was filed in July by a Buena
Park woman whose 17-year-old allegedly contracted a debilitating
lung ailment after smoking clove cigarettes.

  Last May, the U.S Centers for Disease Control reported 12 cases
of severe illness possibly associated with smoking clove
cigarettes.  Symptoms in the 11 patients who were hospitalized,
according to the CDC report, included pulmonary edema (blood- or
fluid-filled lungs), bronchospasm (a constriction of the air
passageway) and hemoptysis (coughing up blood).

  Minor symptoms reported to the CDC included nausea and vomiting,
increased incidence of respiratory tract infections, worsening of
chronic bronchitis and increased incidences and severity of asthma
attacks.  Mild coughing up of blood, the report said, has been
reported with particular frequency.   Preliminary Results

  The CDC report, however, stressed that a cause-and-effect
relationship between clove cigarette smoking and the patients'
illnesses has not been proved.

  When preliminary results of the the American Health Foundation
intratracheal study were obtained by The Times last June, the
Specialty Tobacco Council labeled the foundation's method of
administering eugenol via the trachea into the lungs of laboratory
animals as an "unsound scientific test."

  "You might regard the intratracheal instillation (method) as a
massive overkill and it does not reflect the smoking of a (clove)
cigarette," said Murray Senkus, a consultant for one of the major
manufacturers of clove cigarettes in Indonesia and a former
director of research and development for R.  J.  Reynolds Tobacco
Co.

  LaVoie responded by saying, "We gave them (the laboratory
animals) less than one-third the dose of eugenol which is delivered
to the lungs by one clove cigarette: less than one-third the amount
of eugenol in one clove cigarette kills 50% of the animals."

  UC Irvine's Phalen said "intratracheal studies can be useful and
important in looking at the toxicity of something the lung has been
exposed to.  However, it is not a definitive method of
administration for something that's inhaled.  One of the principles
of toxicology is to expose animal subjects by the same route that
one expects human populations to be exposed."

  In light of the results of the American Health Foundation's own
inhalation study on clove cigarettes, LaVoie said he is not
surprised by the results of the British inhalation study.

  He maintained, however, that "because the rats used in the
(inhalation) studies are obligatory nose breathers -- they by
nature breathe through their nose -- only a very small portion of
the smoke components ever reach or become deposited in the lung. 
This is an inherent deficiency of the animal model and I would say
both models (intratracheal instillation and inhalation) do not
mimic the way humans actively smoke."

  More Studies Recommended

  LaVoie said he could not say much about the British study because
he hasn't seen it.  "I can say that no two-month inhalation study
using small rodents would convince me that these cigarette products
are safe."

  LaVoie recommends conducting more inhalation studies that are
"longer term and possibly more sophisticated in order to bypass
some of the inherent differences in the inhalation of particulates
observed with small rodents vs. man."

  "I think what they (Huntingdon Research Centre researchers) have
done is an appropriate beginning and I anxiously await both details
on the study and further studies to evaluate just how dangerous
clove cigarettes are," said LaVoie.  "Like cigarettes, they do
adversely affect health, we just don't know how severe the degree."

  As Guidotti said, "We'll be going back and forth for years on the
inhalation toxicology."

(end of article)