Effect of filter vent blocking on carbon monoxide exposure from selected lower tar cigarette brands

Cigarette filter ventilation, smoking topography, and subjective effects: A mediational analysis

BACKGROUND

Filter ventilation in cigarettes has been associated with alterations in smoking topography in order to compensate for the lower nicotine yields. Subjective effects of cigarettes include sensations, which can be affected by how a person smokes a cigarette. We look at smoking topography as a mediator in the relationship between filter ventilation levels and subjective effects.

METHODS

Smoking topography and subjective effects data come from the baseline usual cigarette brand laboratory visits of participants (N = 607) in a randomized clinical trial on reduced nicotine cigarettes. Conditional process analysis was done using PROCESS macro version 3.5 in SPSS.

RESULTS

There was a positive indirect effect of ventilation on satisfaction through total puff volume (0.004, 95% CI: 0.002, 0.007]) as well as ventilation on satisfaction through puff count then total puff volume, sequentially (0.001, 95% CI: [0.000, 0.003]). There was a positive indirect effect of ventilation on enjoyment through puff count for individuals less than 43 years of age (0.01, 95% CI: [0.002, 0.013]). There was a positive indirect effect of ventilation on enjoyment through total puff volume for individuals who smoke less than 14.33 cigarettes per day (0.009, 95% CI: [0.004, 0.015]).

CONCLUSIONS

We found preliminary evidence that topography measures (puff count and total puff volume), mediate the relationship between filter ventilation and specific subjective effects of smoking (satisfaction and enjoyment). Age and cigarettes smoked per day moderated these relationships. These results could have implications regarding filter ventilation restrictions and smokers' perceptions of using such cigarettes.

A Low-Cost, High-Throughput Digital Image Analysis of Stain Patterns on Smoked Cigarette Filter Butts to Estimate Mainstream Smoke Exposure

Standard machine smoking protocols provide useful information for examining the impact of design parameters, such as filter ventilation, on mainstream smoke delivery. Unfortunately, their results do not accurately reflect human smoke exposure. Clinical research and topography devices in human studies yield insights into how products are used, but a clinical setting or smoking a cigarette attached to such a device may alter smoking behavior. To better understand smokers' use of filtered cigarette products in a more natural environment, we developed a low-cost, high-throughput approach to estimate mainstream cigarette smoke exposure on a per-cigarette basis. This approach uses an inexpensive flatbed scanner to scan smoked cigarette filter butts and custom software to analyze tar-staining patterns. Total luminosity, or optical staining density, of the scanned images provides quantitative information proportional to mainstream smoke-constituent deliveries on a cigarette-by-cigarette basis. Duplicate sample analysis using this new approach and our laboratory's gold-standard liquid chromatography/tandem mass spectrometry (LC/MS/MS) solanesol method yielded comparable results (+7% bias) from the analysis of 20 commercial cigarettes brands (menthol and nonmentholated). The brands varied in design parameters such as length, filter ventilation, and diameter. Plots correlating the luminosity to mainstream smoked-nicotine deliveries on a per-cigarette basis for these cigarette brands were linear (average R2 > 0.91 for nicotine and R2 > 0.83 for the tobacco-specific nitrosamine NNK), on a per-brand basis, with linearity ranging from 0.15 to 3.00 mg nicotine/cigarette. Analysis of spent cigarette filters allows exposures to be characterized on a per-cigarette basis or a "daily dose" via summing across results from all filter butts collected over a 24 h period. This scanner method has a 100-fold lower initial capital cost for equipment than the LC/MS/MS solanesol method and provides high-throughput results (~200 samples per day). Thus, this new method is useful for characterizing exposure related to filtered tobacco-product use.

Tobacco harm reduction: Past history, current controversies and a proposed approach for the future

Tobacco harm reduction remains a controversial topic in tobacco control. Tobacco harm reduction involves providing tobacco users who are unwilling or unable to quit using nicotine products with less harmful nicotine-containing products for continued use. The skepticism towards harm reduction is based in part on the experience with low-yield tar/nicotine cigarettes, which were presumed to be associated with lower health risks than higher yield cigarettes and marketed as such by cigarette manufacturers. Only later did the field learn that these cigarettes were a deceptive way for cigarette manufacturers to allay the health concerns over cigarette smoking. Since this experience, there has been a proliferation of tobacco products that might potentially serve as a means to reduce tobacco harm. Some members of the tobacco control community believe that these products have great potential to reduce mortality and morbidity among smokers who completely switch to them. Others believe that we will be addicting another generation to tobacco products. This paper reviews the past history, the current tobacco landscape and controversies, and an approach that might rapidly reduce the yearly half-million deaths associated with cigarette smoking in the U.S.

Cigarette Filter Ventilation and its Relationship to Increasing Rates of Lung Adenocarcinoma

The 2014 Surgeon General's Report on smoking and health concluded that changing cigarette designs have caused an increase in lung adenocarcinomas, implicating cigarette filter ventilation that lowers smoking machine tar yields. The Food and Drug Administration (FDA) now has the authority to regulate cigarette design if doing so would improve public health. To support a potential regulatory action, two weight-of-evidence reviews were applied for causally relating filter ventilation to lung adenocarcinoma. Published scientific literature (3284 citations) and internal tobacco company documents contributed to causation analysis evidence blocks and the identification of research gaps. Filter ventilation was adopted in the mid-1960s and was initially equated with making a cigarette safer. Since then, lung adenocarcinoma rates paradoxically increased relative to other lung cancer subtypes. Filter ventilation 1) alters tobacco combustion, increasing smoke toxicants; 2) allows for elasticity of use so that smokers inhale more smoke to maintain their nicotine intake; and 3) causes a false perception of lower health risk from "lighter" smoke. Seemingly not supportive of a causal relationship is that human exposure biomarker studies indicate no reduction in exposure, but these do not measure exposure in the lung or utilize known biomarkers of harm. Altered puffing and inhalation may make smoke available to lung cells prone to adenocarcinomas. The analysis strongly suggests that filter ventilation has contributed to the rise in lung adenocarcinomas among smokers. Thus, the FDA should consider regulating its use, up to and including a ban. Herein, we propose a research agenda to support such an effort.

Smoking Behavior and Smoke Constituents from Cigarillos and Little Cigars

OBJECTIVE

Although most cigarillos and little cigars smokers also smoke cigarettes (dual use), there are few studies comparing toxicant exposure and smoking behavior in cigars and cigarettes.

METHODS

Two groups of dual users smoked their usual brand of cigarette and either a Winchester unflavored little cigar (N = 21) or a Black & Mild cigarillo (N = 23). Acute exposure of nicotine and exhaled carbon monoxide (CO) and puffing topography parameters were collected. Individual cigar puffing data were used to machine-replicate smoking for analysis of volatile organic compounds (VOC) and semi-volatile organic compounds (SVOC) in mainstream smoke.

RESULTS

There were significant differences in puff topography, plasma nicotine and exhaled CO after cigarettes, little cigars, and cigarillos. Puff topography differences between cigarillos and cigarettes were due to the difference in the size of the article. Mainstream cigar and cigarette smoke was qualitatively similar; the yield was dependent on the smoking behavior. When smoke yield was adjusted for weight of tobacco burned or puff volume, exposure differences decreased.

CONCLUSIONS

There is a wide range of delivery of both SVOC and VOC components of cigar and cigarillo smoke. The difference in exposure is largely dependent on the article size and the amount consumed.

Multivariate Statistical Analysis of Cigarette Design Feature Influence on ISO TNCO Yields

The aim of this study is to explore how differences in cigarette physical design parameters influence tar, nicotine, and carbon monoxide (TNCO) yields in mainstream smoke (MSS) using the International Organization of Standardization (ISO) smoking regimen. Standardized smoking methods were used to evaluate 50 U.S. domestic brand cigarettes and a reference cigarette representing a range of TNCO yields in MSS collected from linear smoking machines using a nonintense smoking regimen. Multivariate statistical methods were used to form clusters of cigarettes based on their ISO TNCO yields and then to explore the relationship between the ISO generated TNCO yields and the nine cigarette physical design parameters between and within each cluster simultaneously. The ISO generated TNCO yields in MSS are 1.1-17.0 mg tar/cigarette, 0.1-2.2 mg nicotine/cigarette, and 1.6-17.3 mg CO/cigarette. Cluster analysis divided the 51 cigarettes into five discrete clusters based on their ISO TNCO yields. No one physical parameter dominated across all clusters. Predicting ISO machine generated TNCO yields based on these nine physical design parameters is complex due to the correlation among and between the nine physical design parameters and TNCO yields. From these analyses, it is estimated that approximately 20% of the variability in the ISO generated TNCO yields comes from other parameters (e.g., filter material, filter type, inclusion of expanded or reconstituted tobacco, and tobacco blend composition, along with differences in tobacco leaf origin and stalk positions and added ingredients). A future article will examine the influence of these physical design parameters on TNCO yields under a Canadian Intense (CI) smoking regimen. Together, these papers will provide a more robust picture of the design features that contribute to TNCO exposure across the range of real world smoking patterns.

Reconciling human smoking behavior and machine smoking patterns: implications for understanding smoking behavior and the impact on laboratory studies

BACKGROUND

Recent Food and Drug Administration legislation enables the mandating of product performance standards for cigarette smoke and the evaluation of manufacturers' health claims for modified tobacco products. Laboratory studies used for these evaluations and also for understanding tobacco smoke toxicology use machines to generate smoke. The goal of this review is to critically evaluate methods to assess human smoking behavior and replicate this in the laboratory.

METHODS

Smoking behavior and smoking machine studies were identified using PubMed and publicly available databases for internal tobacco company documents.

RESULTS

The smoking machine was developed to generate smoke to allow for comparing cigarette tar and nicotine yields. The intent was to infer relative human disease risk, but this concept was flawed because humans tailor their smoking to the product, and chemical yields and toxicologic effects change with different smoking profiles. Although smoking machines also allow for mechanistic assessments of smoking-related diseases, the interpretations also are limited. However, available methods to assess how humans puff could be used to provide better laboratory assessments, but these need to be validated. Separately, the contribution of smoke mouth-holding and inhalation to dose need to be assessed, because these parts of smoking are not captured by the smoking machine. Better comparisons of cigarettes might be done by tailoring human puff profiles to the product based on human studies and comparing results across regimens.

CONCLUSIONS

There are major research gaps that limit the use of smoking machine studies for informing tobacco control regulation and mechanistic studies.

Behavioral filter vent blocking on the first cigarette of the day predicts which smokers of light cigarettes will increase smoke exposure from blocked vents

Filter vent blocking on best-selling light cigarettes increases smoke yield during standard machine testing but not in clinical investigations of smokers. The purpose of the study was to investigate the effect of (a) manipulating cigarette filter vent blocking and (b) blocking status of first cigarette of the day on carbon monoxide (CO) boost. Participants (n = 25; Marlboro Lights nonmenthol cigarette smokers, age range 21-60 years, minimum 15 daily cigarettes, and daily smoking for a minimum 5 years) completed the laboratory-based, within-subject, double-blind, cross-over design of 2 smoking sessions, one utilizing a smoking topography device, one without. Each session consisted of smoking 4 cigarettes; 2 with filter vents blocked and 2 with filter vents unblocked. Spent first daily cigarette filters collected between sessions were scored for evidence of filter vent blocking. Smoking cigarettes with blocked filter vents significantly increased CO boost in both laboratory sessions (p < .001). Those who blocked their first cigarette of the day (n = 10) had significantly greater CO boost when smoking a blocked cigarette, in relation to smoking an unblocked cigarette and in comparison with nonblockers (p = .04). Total puff volume was a significant predictor of CO boost when smoking unblocked and blocked cigarettes (ps < .04). Blocking filter vents significantly increased smoke exposure in relation to when filter vents are not blocked, particularly for those who block filter vents on their first cigarette of the day. Total puff volume predicted CO boost, and results suggest that smokers adjust their smoking behavior by cigarette blocking status. Those smokers who block filter vents may be increasing their exposure by 30%.

Maximum yields might improve public health--if filter vents were banned: a lesson from the history of vented filters

Filter ventilation is the dominant design feature of the modern cigarette that determines yields of tar, nicotine, and carbon monoxide on smoking machine tests. The commercial use of filter ventilation was precipitated by the 1964 United States Surgeon-General's report, further advanced by the adoption of an official Federal Trade Commission test in 1967, and still further advanced by the inclusion of a gas phase (carbon monoxide) measure in 1979. The first vented-filter brand on the market in the United States (Carlton) in 1964 and the second major vented-filter brand (True) in 1966 illustrate this. Ultimately, filter ventilation became a virtually required way to make very low tar cigarettes (less than 10 mg or, even more so, less than 5 mg tar). The key to the lower tar cigarette was not, in effect, the advanced selective filtration design characteristics or sophisticated tobacco selection or processing as envisioned by experts (although these techniques were and are used); the key to the very much lower tar cigarette was simply punching holes in the filter. We propose that the banning of filter vents, coupled with low maximum standard tar, nicotine, and carbon monoxide yields, would contribute to making cigarettes much less palatable and foster smoking cessation or the use of clearly less hazardous nicotine delivery systems. It may be necessary to link low maximum yields with the banning of filter ventilation to achieve public health benefit from such maxima.

The effect of filter vent blocking and smoking topography on carbon monoxide levels in smokers

Two studies were conducted to examine the effect of filter vent blocking and smoking topography on carbon monoxide (CO) levels in smokers. In Study 1, 12 participants smoked two types of cigarettes (Marlboro Light and Carlton 100) under two types of blocking conditions (unblocked and half-blocked) while using a smoking topography device. Participants were restricted to 8 puffs, separated by 45 s. Significant main effects of CO boost for cigarette type and blocking condition replicated previous findings. A significant increase in CO boost for the Marlboro Light blocked condition is a novel finding for this best-selling brand. That result and the finding that topography measures did not predict CO boost made us question the reliability of CO boost. In Study 2, we examined the reliability of CO boost by recruiting 12 participants to smoke three unblocked Carlton 100 cigarettes in one session and three half-blocked in another. CO boost was significantly greater for the blocked sessions compared to the unblocked and CO boost did not differ within session, thus supporting the reliability of the measure. When participants do not switch brands within a session, smoking topography measures are predictive of CO boost.

The unbearable lightness of "light" cigarettes: a comparison of smoke yields in six varieties of Canadian "light" cigarettes

BACKGROUND

Labelling cigarettes as "light" or "mild" is claimed to be one of the biggest marketing scams in Canadian history. Arguably, such labelling implies that these varieties of cigarettes are less harmful than "regular" cigarettes. In Canada, a food product can be labelled "light" if there is a 25% reduction from the "reference food" and if the constituent being reduced is clearly identified (e.g., light in fat). Cigarette labelling does not comply with these regulations, however. To examine whether or not some tobacco constituents meet the 25% reduction criterion, we compared yields of 41 toxic and/or carcinogenic smoke constituents in six varieties of "light" cigarettes to the yields of "regular" cigarettes. We selected cigarettes from the two most popular Canadian brands, Du Maurier and Players.

METHODS

Using a set of data provided by Imperial Tobacco Canada and made available to the public by the Government of British Columbia, we compared yields measured under a laboratory protocol (modified ISO) that was designed to provide a more rigorous evaluation of the differences between varieties of cigarettes and a more accurate assessment of smokers' potential smoke intake than the traditional protocol (standard ISO).

FINDINGS

For all six varieties of "light" cigarettes, the yields of nicotine were higher by an average of 5% (range: 1% to 13%). The 25% reduction criterion was not met for any variety of "light" cigarettes concerning yields of tar. For all cigarettes tested, yields of tar were reduced on average by only 16% (range: 5% to 22%). For carbon monoxide (CO), only Player's Smooth Light had an over 25% reduction (30%) compared with Player's Regular. Conversely, yield of CO was 24% higher for Du Maurier Lights compared with Du Maurier Regular. As for the other smoke constituents, the majority (75%) were not reduced by 25% or more in "light" cigarettes, and a sizeable proportion of yields (e.g., acrylonitrile, benzene, chromium, m+p cresol, mercury, nickel, toluene) were larger in these varieties of cigarettes. Only yields of formaldehyde, crotonaldehyde, 1-aminonaphtalene, and proprionaldehyde were systematically reduced in all varieties of "light" cigarettes.

CONCLUSION

The six varieties of "light" cigarettes examined in this study do not differ substantially from "regular" cigarettes in terms of smoke yields. We argue that the modified ISO protocol should be implemented for a more valid comparison of potential smoke yields in all varieties of cigarettes and that labelling based on this protocol should be promoted.

A digital image analysis system for identifying filter vent blocking on ultralight cigarettes

Filter ventilation is the dominant design feature on modern cigarettes, diluting the mainstream smoke with air and reducing tar and nicotine yields in the standard assay. Smokers are generally unaware of vent holes and often cover them with lips or fingers while smoking, reducing or eliminating the air dilution effect and increasing intake of tar and nicotine particularly on ultra-low tar brands. A digital imaging and analysis system for the detection of vent blocking was developed. Two studies were designed to evaluate the effectiveness of three color measures (hue, saturation, and value) at discriminating whether at least 50% blocking had occurred. In study 1, saturation showed perfect discrimination between unblocked Carlton butts and butts with at least 50% of the vents blocked during syringe smoking. In study 2, saturation showed 95% accuracy at identifying Marlboro Ultra Light butts with at least four puffs blocked by smokers' lips. The results indicate that the pattern of color saturation is related to vent blocking. Implications for tobacco control research and policy are discussed.

Cigarette filter ventilation is a defective design because of misleading taste, bigger puffs, and blocked vents

OBJECTIVE

To review tobacco industry documents on filter ventilation in light of published studies and to explore the role of filter ventilation in the design of cigarettes that deliver higher smoke yields to smokers than would be expected from standard machine smoked tests (Federal Trade Commission (FTC), International Organization for Standardization (ISO)).

DATA SOURCES

Searched from November 1999 to November 2000 internet databases of industry documents (www.pmdocs.com, www.rjrtdocs.com, www.lorillarddocs.com, www.bw.aalatg.com, www.cdc.gov/tobacco/industrydocs, www.tobaccodocuments.org, www.tobaccopapers.org, www.hlth.gov.bc.ca/Guildford, www.cctc.ca/ncth/Guildford, www.cctc.ca/ncth/Guildford2) for documents related to filter ventilation. Documents found dated from 1955 through 1994.

STUDY SELECTION

Those documents judged to contain the most relevant information or data on filter ventilation related to cigarette taste and compensatory smoking, while also trying to avoid redundancy from various documents deriving from the same underlying data.

DATA SYNTHESIS

Filter ventilation is a crucial design feature creating three main problems for lower tar cigarettes as measured by official smoking machine testing. Firstly, it misleadingly makes cigarettes taste lighter and milder, and, therefore, they appear less dangerous to smokers. Secondly, it promotes compensation mainly by facilitating the taking of larger puffs. Thirdly, for very heavily ventilated cigarettes (that is, > 65% filter air dilution), behavioural blocking of vents with lips or fingers is an additional contributor to compensatory smoking. These three effects are found in industry research as well as published research.

CONCLUSIONS

Filter ventilation is a dangerous, defective technology that should be abandoned in less hazardous nicotine delivery systems. Health interested groups should test cigarettes in a way that reflects compensatory smoking. Lower tar (vented filter) cigarettes should be actively countermarketed.

Massachusetts' advertising against light cigarettes appears to change beliefs and behavior

OBJECTIVES

This study examined the effects of advertising directed against light cigarettes (lights).

METHODS

In a quasi-experimental post-test-only design, smokers and ex-smokers (

RESULTS

Compared with the U.S., the MASS sample contained more, recent ex-smokers (10% vs. 7% in the U.S.) and more smokers of higher tar cigarettes (44% vs. 35% smokers of regular cigarettes); more U.S. respondents thought lights had at least a slim chance of reducing the risk of health problems (49% vs. 32%). Within MASS, smokers who saw anti-light ads were less likely to think lights decreased the risk of health problems (26% vs. 44%) and more likely to know of filter vents (64% vs. 47%). These effects remained statistically reliable after adjusting for confounders.

CONCLUSIONS

Amidst extensive anti-smoking efforts, the MASS campaign to counter-market light cigarettes appears to promote smoking cessation and to inform smokers of the risks of light cigarettes. Further counter-marketing efforts should be encouraged.

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MESH Headings

• Adult
• Advertising
• Age Distribution
• Analysis of Variance
• Attitude to Health
• Chi-Square Distribution
• Female
• Humans
• Logistic Models
• Male
• Massachusetts/epidemiology
• Middle Aged
• Plants, Toxic
• Population Surveillance
• Sex Distribution
• Smoking/epidemiology
• Smoking Prevention
• Statistics, Nonparametric
• Surveys and Questionnaires
• Nicotiana/classification
• United States/epidemiology

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Affiliation(s)

L T Kozlowski Department of Biobehavioral Health, Pennsylvania State University , University Park, Pennsylvania 16802, USA
B Yost
M M Stine
C Celebucki

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