Toxicological assessment of kretek cigarettes: Part 1: background, assessment approach, and summary of findings

This publication introduces a series of six other publications describing the toxicological assessment of kretek cigarettes, i.e., cigarettes characterized primarily by the use of a significant amount of cloves as an ingredient added to the tobacco. This paper presents background information on kretek cigarettes, describes the general approach of the in vitro and in vivo toxicological assessment of mainstream smoke from kretek cigarettes, presents the methodology used, and summarizes the results of the assessment program. In summary, the smoke from kretek cigarettes gives rise to the typical cigarette smoke-related effects known from American-blended cigarettes, does not reveal any novel toxicity, and exhibits an unexpected distinct attenuation of pulmonary inflammation. Based on equal amounts of smoke total particulate matter (TPM), kretek cigarettes deliver less toxicants when compared to American-blended cigarettes; when assessed in vitro, the smoke from kretek cigarettes is less cytotoxic (gas/vapor phase) and less mutagenic (TPM). When assessed in vivo, kretek cigarette smoke shows lower toxicity in the respiratory tract. When based on an equal nicotine basis, several of the toxicity endpoints in kretek cigarettes become equivalent to American-blended cigarettes. The data do not indicate an increased hazard potential of kreteks compared to American-blended cigarettes.