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Pauwels CG, Klerx WN, Pennings JL, Boots AW, van Schooten FJ, Opperhuizen A, Talhout R. Cigarette Filter Ventilation and Smoking Protocol Influence Aldehyde Smoke Yields. Chem Res Toxicol 2018; 31:462-471. [PMID: 29727173 PMCID: PMC6008735 DOI: 10.1021/acs.chemrestox.7b00342] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Indexed: 11/29/2022]
Abstract
The WHO study group on tobacco product regulation (TobReg) advised regulating and lowering toxicant levels in cigarette smoke. Aldehydes are one of the chemical classes on the TobReg smoke toxicants priority list. To provide insight in factors determining aldehyde yields, the levels of 12 aldehydes in mainstream cigarette smoke of 11 Dutch brands were quantified. Variations in smoking behavior and cigarette design affecting human exposure to aldehydes were studied by using four different machine testing protocols. Machine smoking was based on the International Standardization Organization (ISO) and Health Canada Intense (HCI) regime, both with and without taping the filter vents. The 11 cigarette brands differed in (i) design and blend characteristics; (ii) tar, nicotine, and carbon monoxide (TNCO) levels; (iii) popularity; and (iv) manufacturer. Cigarette smoke was trapped on a Cambridge filter pad and carboxen cartridge. After being dissolved in methanol/CS2 and derivatization with DNPH, the aldehyde yields were determined using HPLC-DAD. Using an intense smoking regime (increased puff volume, shorter puff interval) significantly increased aldehyde yields, following the pattern: ISO < ISO-taped < HCI-untaped < HCI. For all of the regimes, acetaldehyde and acrolein yields were strongly correlated ( r = 0.804). The difference in TNCO and aldehyde levels between regular and highly ventilated low-TNCO cigarettes (as measured using ISO) diminished when smoking intensely; this effect is stronger when combined with taping filter vents. The highly ventilated low-TNCO brands showed six times more aldehyde production per mg nicotine for the intense smoking regimes. In conclusion, acetaldehyde and acrolein can be used as representatives for the class of volatile aldehydes for the different brands and smoking regimes. The aldehyde-to-nicotine ratio increased when highly ventilated cigarettes were smoked intensely, similar to real smokers. Thus, a smoker of highly ventilated low-TNCO cigarettes has an increased potential for higher aldehyde exposures compared to a smoker of regular cigarettes.
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Affiliation(s)
- Charlotte G.G.M. Pauwels
- Department
of Pharmacology and Toxicology, NUTRIM School of Nutrition and Translational
Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
- Centre
for Health Protection, National Institute
for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands
| | - Walther N.M. Klerx
- Centre
for Health Protection, National Institute
for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands
| | - Jeroen L.A. Pennings
- Centre
for Health Protection, National Institute
for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands
| | - Agnes W. Boots
- Department
of Pharmacology and Toxicology, NUTRIM School of Nutrition and Translational
Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Frederik J. van Schooten
- Department
of Pharmacology and Toxicology, NUTRIM School of Nutrition and Translational
Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Antoon Opperhuizen
- Department
of Pharmacology and Toxicology, NUTRIM School of Nutrition and Translational
Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
- Office
of Risk Assessment and Research, Netherlands
Food and Consumer Product Safety Authority (NVWA), P.O. Box 8433, 3503 RK Utrecht, The Netherlands
| | - Reinskje Talhout
- Centre
for Health Protection, National Institute
for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands
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Skaczkowski G, Durkin S, Kashima Y, Wakefield M. Influence of premium vs masked cigarette brand names on the experienced taste of a cigarette after tobacco plain packaging in Australia: an experimental study. BMC Public Health 2018. [PMID: 29526164 PMCID: PMC5846234 DOI: 10.1186/s12889-018-5200-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Few studies have experimentally assessed the contribution of branding to the experience of smoking a cigarette, compared with the inherent properties of the product. This study examined the influence of cigarette brand name on the sensory experience of smoking a cigarette. Methods Seventy-five Australian smokers aged 18–39 years smoked two ‘premium’ cigarettes, one with the brand variant name shown and one with the brand variant name masked (which provided ‘objective’ ratings). Unknown to participants, the two cigarettes were identical. At recruitment, participants rated their expected enjoyment, quality and harshness of several premium cigarette brands. Results Branded cigarettes were rated as having a significantly more favorable taste (M(SE) = 64.14(2.21)) than masked cigarettes (M(SE) = 58.53(2.26), p = .031). Branded cigarettes were also rated as being less stale (M(SE) = 36.04(2.62)) than masked cigarettes (M(SE) = 43.90(2.60), p = .011). Purchase intent tended to be higher among those shown the branded cigarette compared to the masked cigarette (χ2 (1) = 3.00, p = .083). Expected enjoyment and quality of the brand variant (enjoyment: b = 0.31, 95%CI = 0.11, 0.51, p < .01; quality: b = 0.46, 95%CI = 0.21, 0.72, p < .01) contributed to the perceived smoking experience more than the objective enjoyment and quality of the cigarette (enjoyment: b = 0.23, 95%CI = 0.05, 0.41, p < .05; quality: b = 0.08, 95%CI = − 0.13, 0.30, p > .05). This pattern was not observed for cigarette harshness. Conclusions A premium brand variant name can enhance the subjective experience of a cigarette. Further, smokers’ expectations of such brand variants contribute to the smoking experience as much, if not more than, the actual qualities of the product.
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Affiliation(s)
- Gemma Skaczkowski
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Sarah Durkin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Yoshihisa Kashima
- University of Melbourne, School of Psychological Sciences, Redmond Barry Building, Parkville, Melbourne, VIC, 3010, Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC, 3004, Australia.
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Ziedonis D, Das S, Larkin C. Tobacco use disorder and treatment: new challenges and opportunities. DIALOGUES IN CLINICAL NEUROSCIENCE 2018. [PMID: 29302224 PMCID: PMC5741110 DOI: 10.31887/dcns.2017.19.3/dziedonis] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Tobacco use remains a global problem, and options for consumers have increased with the development and marketing of e-cigarettes and other new nicotine and tobacco products, such as “heat-not-burn” tobacco and dissolvable tobacco. The increased access to these new products is juxtaposed with expanding public health and clinical intervention options, including mobile technologies and social media. The persistent high rate of tobacco-use disorders among those with psychiatric disorders has gathered increased global attention, including successful approaches to individual treatment and organizational-level interventions. Best outcomes occur when medications are integrated with behavioral therapies and community-based interventions. Addressing tobacco in mental health settings requires training and technical assistance to remove old cultural barriers that restricted interventions. There is still “low-hanging fruit” to be gained in educating on the proper use of nicotine replacement medications, how smoking cessation can change blood levels of specific medications and caffeine, and how to connect with quitlines and mobile technology options. Future innovations are likely to be related to pharmacogenomics and new technologies that are human-, home-, and community-facing.
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Affiliation(s)
| | - Smita Das
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine and Director of Addiction Treatment Services, Department of Psychiatry, Veterans Administration Palo Alto Health System, Stanford, California, USA
| | - Celine Larkin
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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Abstract
Objectives This paper describes the effects of non-tobacco, physical cigarette design features on smoke emissions, product appeal, and smoking behaviors - 3 factors that determine smoker's exposure and related health risks. Methods We reviewed available evidence for the impact of filter ventilation, new filter types, and cigarettes dimensions on toxic emissions, smoker's perceptions, and behavior. For evidence sources we used scientific literature and websites providing product characteristics and marketing information. Results Whereas filter ventilation results in lower machine-generated emissions, it also leads to perceptions of lighter taste and relative safety in smokers who can unwittingly employ more intense smoking behavior to obtain the desired amount of nicotine and sensory appeal. Filter additives that modify smoke emissions can also modify sensory cues, resulting in changes in smoking behavior. Flavor capsules increase the cigarette's appeal and novelty, and lead to misperceptions of reduced harm. Slim cigarettes have lower yields of some smoke emissions, but smoking behavior can be more intense than with standard cigarettes. Conclusions Physical design features significantly impact machine-measured emission yields in cigarette smoke, product appeal, smoking behaviors, and exposures in smokers. The influence of current and emerging design features is important in understanding the effectiveness of regulatory actions to reduce smoking-related harm.
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Caraway JW, Ashley M, Bowman SA, Chen P, Errington G, Prasad K, Nelson PR, Shepperd CJ, Fearon IM. Influence of cigarette filter ventilation on smokers' mouth level exposure to tar and nicotine. Regul Toxicol Pharmacol 2017; 91:235-239. [PMID: 29097238 DOI: 10.1016/j.yrtph.2017.10.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/08/2017] [Accepted: 10/23/2017] [Indexed: 11/22/2022]
Abstract
Cigarette filter ventilation allows air to be drawn into the filter, diluting the cigarette smoke. Although machine smoking reveals that toxicant yields are reduced, it does not predict human yields. The objective of this study was to investigate the relationship between cigarette filter ventilation and mouth level exposure (MLE) to tar and nicotine in cigarette smokers. We collated and reviewed data from 11 studies across 9 countries, in studies performed between 2005 and 2013 which contained data on MLE from 156 products with filter ventilation between 0% and 87%. MLE among 7534 participants to tar and nicotine was estimated using the part-filter analysis method from spent filter tips. For each of the countries, MLE to tar and nicotine tended to decrease as filter ventilation increased. Across countries, per-cigarette MLE to tar and nicotine decreased as filter ventilation increased from 0% to 87%. Daily MLE to tar and nicotine also decreased across the range of increasing filter ventilation. These data suggest that on average smokers of highly ventilated cigarettes are exposed to lower amounts of nicotine and tar per cigarette and per day than smokers of cigarettes with lower levels of ventilation.
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Affiliation(s)
| | - Madeleine Ashley
- British American Tobacco (Investments) Limited, Research and Development, Regents Park Road, Southampton, SO15 8TL, UK
| | | | - Peter Chen
- RAI Services Company, Winston-Salem, NC, USA
| | - Graham Errington
- British American Tobacco (Investments) Limited, Research and Development, Regents Park Road, Southampton, SO15 8TL, UK
| | - Krishna Prasad
- British American Tobacco (Investments) Limited, Research and Development, Regents Park Road, Southampton, SO15 8TL, UK
| | | | - Christopher J Shepperd
- British American Tobacco (Investments) Limited, Research and Development, Regents Park Road, Southampton, SO15 8TL, UK
| | - Ian M Fearon
- British American Tobacco (Investments) Limited, Research and Development, Regents Park Road, Southampton, SO15 8TL, UK.
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Alpert HR, Carpenter D, Connolly GN. Tobacco industry response to a ban on lights descriptors on cigarette packaging and population outcomes. Tob Control 2017; 27:390-398. [PMID: 28778970 DOI: 10.1136/tobaccocontrol-2017-053683] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 06/02/2017] [Accepted: 06/14/2017] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The WHO Framework Convention on Tobacco Control and its Guidelines recommend nations ban the use of misleading terms, such as 'light' and 'mild' on tobacco product advertising, packaging and labelling. Many nations, including the USA, have implemented such bans and some have introduced or passed legislation requiring plain packaging on tobacco products. We previously reported that manufacturers in the USA responded by replacing lights terms with colour terms and related colour-coding of packages. This study examines population outcomes and public health impact of the US ban. METHODS We examined available data regarding a) per cent filter ventilation strata used to designate lights subbrand categories; b) market share per tar yield; c) initiation and use of cigarettes by lights categories and d) overall cigarette consumption to identify changes from before to after the ban. We used interrupted time series multivariable logistic regression and joinpoint regression models to test for changes in rates and temporal trends associated with the ban. RESULTS The per cent filter ventilation strata used to designate lights subbrand categories were maintained in the colour named subbrands. No change was observed following the ban in lights market share, relative prevalence of lights versus non-lights smoking or relative smoking initiation on lights versus non-lights among all ages or among youth in particular. The rate of decline in per capita cigarette consumption slowed by 37% from the period 2007-2010 to 2010-2014. CONCLUSIONS This study strongly suggests that manufacturers' circumvention prevented the lights descriptor ban from succeeding as intended, most likely perpetuating the misleading consumer perceptions about relative risks, while failing to increase smoking cessation and reduce initiation. Laws requiring generic (plain) and elimination of subbrand descriptors should prevent evasion of legislation banning the use of specific terms through marketing, regulatory and legal challenges.
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Affiliation(s)
- Hillel R Alpert
- School of Law, Northeastern University, Boston, Massachusetts, USA
| | - Daniel Carpenter
- Department of Government, Center for Government and International Studies, Harvard University, Cambridge, Massachusetts, USA
| | - Gregory N Connolly
- School of Health Sciences and School of Law, Northeastern University, Boston, Massachusetts, USA
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Song MA, Benowitz NL, Berman M, Brasky TM, Cummings KM, Hatsukami DK, Marian C, O'Connor R, Rees VW, Woroszylo C, Shields PG. Cigarette Filter Ventilation and its Relationship to Increasing Rates of Lung Adenocarcinoma. J Natl Cancer Inst 2017; 109:3836090. [PMID: 28525914 DOI: 10.1093/jnci/djx075] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 03/23/2017] [Indexed: 01/09/2023] Open
Abstract
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.
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Affiliation(s)
- Min-Ae Song
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Neal L Benowitz
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Micah Berman
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Theodore M Brasky
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - K Michael Cummings
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Dorothy K Hatsukami
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Catalin Marian
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Richard O'Connor
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Vaughan W Rees
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Casper Woroszylo
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Peter G Shields
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
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O'Connor RJ, Hammond D. Cigarette package colour is associated with level of filter ventilation. Tob Control 2017; 27:337-338. [PMID: 28667095 DOI: 10.1136/tobaccocontrol-2017-053730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 04/04/2017] [Accepted: 04/11/2017] [Indexed: 11/04/2022]
Affiliation(s)
- Richard J O'Connor
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
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Morabito JA, Holman MR, Ding YS, Yan X, Chan M, Chafin D, Perez J, Mendez MI, Cardenas RB, Watson C. The use of charcoal in modified cigarette filters for mainstream smoke carbonyl reduction. Regul Toxicol Pharmacol 2017; 86:117-127. [PMID: 28238852 PMCID: PMC5448414 DOI: 10.1016/j.yrtph.2017.02.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 02/13/2017] [Accepted: 02/20/2017] [Indexed: 11/29/2022]
Abstract
Carbonyls are harmful and potentially harmful constituents (HPHCs) in mainstream cigarette smoke (MSS). Carbonyls, including formaldehyde and acrolein, are carcinogenic or mutagenic in a dose-dependent manner. Past studies demonstrate significant reduction of HPHCs by charcoal filtration. However, limits of charcoal filtration and cigarette design have not yet been investigated in a systematic manner. Objective data is needed concerning the feasibility of HPHC reduction in combustible filtered cigarettes. This systematic study evaluates the effect of charcoal filtration on carbonyl reduction in MSS. We modified filters of ten popular cigarette products with predetermined quantities (100-400 mg) of charcoal in a plug-space-plug configuration. MSS carbonyls, as well as total particulate matter, tar, nicotine, carbon monoxide (TNCO), and draw resistance were quantified. Significant carbonyl reductions were observed across all cigarette products as charcoal loading increased. At the highest charcoal loadings, carbonyls were reduced by nearly 99%. Tar and nicotine decreased modestly (<20%) compared to reductions in carbonyls. Increased draw resistance was significant at only the highest charcoal loadings. This work addresses information gaps in the science base that can inform the evaluation of charcoal filtration as an available technological adaptation to cigarette design which reduces levels of carbonyls in MSS.
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Affiliation(s)
| | | | - Yan S Ding
- Centers for Disease Control and Prevention, United States
| | - Xizheng Yan
- Centers for Disease Control and Prevention, United States
| | - Michele Chan
- Centers for Disease Control and Prevention, United States
| | - Dana Chafin
- Centers for Disease Control and Prevention, United States
| | - Jose Perez
- Centers for Disease Control and Prevention, United States
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Epperson AE, Henriksen L, Prochaska JJ. Natural American Spirit Brand Marketing Casts Health Halo Around Smoking. Am J Public Health 2017; 107:668-670. [PMID: 28398789 PMCID: PMC5388969 DOI: 10.2105/ajph.2017.303719] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2017] [Indexed: 11/04/2022]
Affiliation(s)
- Anna E Epperson
- Anna E. Epperson, Lisa Henriksen, and Judith J. Prochaska are with the Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Lisa Henriksen
- Anna E. Epperson, Lisa Henriksen, and Judith J. Prochaska are with the Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Judith J Prochaska
- Anna E. Epperson, Lisa Henriksen, and Judith J. Prochaska are with the Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA
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Affiliation(s)
- Timothy Dewhirst
- Department of Marketing and Consumer Studies, University of Guelph, Guelph, Canada
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Reduced nicotine content cigarette advertising: How false beliefs and subjective ratings affect smoking behavior. Drug Alcohol Depend 2017; 173:99-106. [PMID: 28214392 PMCID: PMC5366263 DOI: 10.1016/j.drugalcdep.2016.12.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 12/06/2016] [Accepted: 12/21/2016] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Tobacco advertising can create false beliefs about health harms that are reinforced by product design features. Reduced nicotine content (RNC) cigarettes may reduce harm, but research has not addressed advertising influences. This study examined RNC cigarette advertising effects on false harm beliefs, and how these beliefs - along with initial subjective ratings of RNC cigarettes - affect subsequent smoking behaviors. We further explored whether subjective ratings moderate associations between false beliefs and behavior. METHODS Seventy-seven daily, non-treatment-seeking smokers (66.2% male) participated in the first 15days of a randomized, controlled, open-label RNC cigarette trial. Participants viewed an RNC cigarette advertisement at baseline before completing a 5-day period of preferred brand cigarette use, followed by a 10-day period of RNC cigarette use (0.6mg nicotine yield). Participants provided pre- and post-advertisement beliefs, and subjective ratings and smoking behaviors for cigarettes smoked during laboratory visits. RESULTS Viewing the advertisement increased beliefs that RNC cigarettes contain less nicotine and are healthier than regular cigarettes (p's<0.001 and 0.011), and decreased the belief that they are less likely to cause cancer (p=0.046). Neither false beliefs nor subjective ratings directly affected smoking behaviors. Significant interactions of strength and taste ratings with beliefs (p's<0.001), however, indicated that among smokers with less negative initial subjective ratings, greater false beliefs were associated with greater RNC cigarette consumption. CONCLUSIONS Smokers may misconstrue RNC cigarettes as less harmful than regular cigarettes. These beliefs, in conjunction with favorable subjective ratings, may increase product use.
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Wallbank LA, MacKenzie R, Beggs PJ. Environmental impacts of tobacco product waste: International and Australian policy responses. AMBIO 2017; 46:361-370. [PMID: 27844421 PMCID: PMC5347528 DOI: 10.1007/s13280-016-0851-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 10/27/2016] [Accepted: 10/31/2016] [Indexed: 05/19/2023]
Abstract
The health risks of tobacco consumption are well established, but there is less awareness of the global environmental impacts of smoking. The by-products of the 6.3 trillion cigarettes smoked annually are filters (butts) that contain benzene, nicotine, cadmium, and dozens of other chemicals. It is estimated that between one- and two-thirds of all filters are discarded on roads, pavements, and green spaces. Butt litter as an environmental and public health hazard is a relatively new field of study, but recent research and findings have clear global implications. While this article focuses specifically on the situation in Australia, where cigarette butts are consistently the most littered item identified in national clean-up campaigns, the material reviewed has clear international environmental implications. The article first reviews existing literature on filter composition and toxicology, clean-up costs, regulatory response, and key policy actors. It then describes the scale of the butt litter problem in Australia using existing data, and analyses potential remedies at both the domestic and international levels.
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Affiliation(s)
- Lucinda A. Wallbank
- Department of Environmental Sciences, Faculty of Science and Engineering, Macquarie University, Sydney, NSW 2109 Australia
| | - Ross MacKenzie
- Department of Psychology, Faculty of Human Sciences, Macquarie University, Sydney, NSW 2109 Australia
| | - Paul J. Beggs
- Department of Environmental Sciences, Faculty of Science and Engineering, Macquarie University, Sydney, NSW 2109 Australia
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Abstract
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.
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O’Connor RJ, Schneller LM, Kozlowski LT. Do brand characteristics contribute significantly to variability in toxicant exposure in smokers? Data from NHANES 2007-2012. Tob Prev Cessat 2017; 3:4. [PMID: 32432179 PMCID: PMC7232793 DOI: 10.18332/tpc/67966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 12/13/2016] [Accepted: 12/20/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study sought to quantify the difference in serum cotinine and other biomarkers indicative of cigarette smoking in current US cigarette smokers attributable to brand level versus individual level factors. METHODS A total of 2,558 daily exclusive smokers, 20 years and older in the United States participated in the National Health and Nutrition Examination Surveys 2007-2012 and provided biospecimens and cigarette brand information. Biomakers of interest were serum cotinine, and urinary NNAL, PAHs, and heavy metals. Adjustments were made for person-level factors (e.g., sex, age, race, education), smoking behavior (cigarettes per day), brand, tar group (≤ 6mg, >6-15mg, >15mg), and menthol status. RESULTS The most commonly reported brands of US cigarettes were Marlboro, Newport, Camel, and Pall Mall. Cotinine levels differed by age (p=0.0065), race (p<0.0001), and cigarettes smoked per day (p<0.0001) but not brand, tar or menthol. Brand family was significantly associated with urinary levels of NNAL, 1HP, HFs, and HPHs. For NNAL. Person-level factors accounted for some of these differences. No consistent differences in metal exposure by brand were noted. Overall, brand information accounted for 2-8% of variance depending on the marker. Together, age, sex, race, education, and cigarettes smoked per day accounted for 20% in variance in cotinine levels, and adding the brand information (brand family, tar group, menthol) to the model accounted for an additional 0.5% (p<0.0948). In the full multivariate model, no significant difference in cotinine was seen by brand (p=0.2205), tar (p=0.2987) or menthol (p=0.1583). CONCLUSIONS Brand to brand differences seen in serum cotinine levels and other biomarkers indicative of cigarette smoking between the top US cigarette brands from 2007-2012 are primarily driven by individual differences among smokers, and to a lesser extent by differences among products.
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Affiliation(s)
| | | | - Lynn T Kozlowski
- University at Buffalo, State University of New York, Buffalo, New York, USA
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66
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Donny EC, Walker N, Hatsukami D, Bullen C. Reducing the nicotine content of combusted tobacco products sold in New Zealand. Tob Control 2016; 26:e37-e42. [DOI: 10.1136/tobaccocontrol-2016-053186] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 08/25/2016] [Accepted: 09/06/2016] [Indexed: 11/04/2022]
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Pazo DY, Moliere F, Sampson MM, Reese CM, Agnew-Heard KA, Walters MJ, Holman MR, Blount BC, Watson CH, Chambers DM. Mainstream Smoke Levels of Volatile Organic Compounds in 50 U.S. Domestic Cigarette Brands Smoked With the ISO and Canadian Intense Protocols. Nicotine Tob Res 2016; 18:1886-94. [PMID: 27113015 PMCID: PMC5687062 DOI: 10.1093/ntr/ntw118] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 04/19/2016] [Indexed: 11/14/2022]
Abstract
INTRODUCTION A significant portion of the increased risk of cancer and respiratory disease from exposure to cigarette smoke is attributed to volatile organic compounds (VOCs). In this study, 21 VOCs were quantified in mainstream cigarette smoke from 50U.S. domestic brand varieties that included high market share brands and 2 Kentucky research cigarettes (3R4F and 1R5F). METHODS Mainstream smoke was generated under ISO 3308 and Canadian Intense (CI) smoking protocols with linear smoking machines with a gas sampling bag collection followed by solid phase microextraction/gas chromatography/mass spectrometry (SPME/GC/MS) analysis. RESULTS For both protocols, mainstream smoke VOC amounts among the different brand varieties were strongly correlated between the majority of the analytes. Overall, Pearson correlation (r) ranged from 0.68 to 0.99 for ISO and 0.36 to 0.95 for CI. However, monoaromatic compounds were found to increase disproportionately compared to unsaturated, nitro, and carbonyl compounds under the CI smoking protocol where filter ventilation is blocked. CONCLUSIONS Overall, machine generated "vapor phase" amounts (µg/cigarette) are primarily attributed to smoking protocol (e.g., blocking of vent holes, puff volume, and puff duration) and filter ventilation. A possible cause for the disproportionate increase in monoaromatic compounds could be increased pyrolysis under low oxygen conditions associated with the CI protocol. IMPLICATIONS This is the most comprehensive assessment of volatile organic compounds (VOCs) in cigarette smoke to date, encompassing 21 toxic VOCs, 50 different cigarette brand varieties, and 2 different machine smoking protocols (ISO and CI). For most analytes relative proportions remain consistent among U.S. cigarette brand varieties regardless of smoking protocol, however the CI smoking protocol did cause up to a factor of 6 increase in the proportion of monoaromatic compounds. This study serves as a basis to assess VOC exposure as cigarette smoke is a principle source of overall population-level VOC exposure in the United States.
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Affiliation(s)
- Daniel Y Pazo
- Division of Laboratory Sciences, National Center for Environmental Health, U.S. Centers for Disease Control & Prevention, Atlanta, GA
| | - Fallon Moliere
- Division of Laboratory Sciences, National Center for Environmental Health, U.S. Centers for Disease Control & Prevention, Atlanta, GA
| | - Maureen M Sampson
- Division of Laboratory Sciences, National Center for Environmental Health, U.S. Centers for Disease Control & Prevention, Atlanta, GA
| | - Christopher M Reese
- Division of Laboratory Sciences, National Center for Environmental Health, U.S. Centers for Disease Control & Prevention, Atlanta, GA
| | - Kimberly A Agnew-Heard
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Rockville, MD
| | - Matthew J Walters
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Rockville, MD
| | - Matthew R Holman
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Rockville, MD
| | - Benjamin C Blount
- Division of Laboratory Sciences, National Center for Environmental Health, U.S. Centers for Disease Control & Prevention, Atlanta, GA
| | - Clifford H Watson
- Division of Laboratory Sciences, National Center for Environmental Health, U.S. Centers for Disease Control & Prevention, Atlanta, GA
| | - David M Chambers
- Division of Laboratory Sciences, National Center for Environmental Health, U.S. Centers for Disease Control & Prevention, Atlanta, GA;
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Tidey JW, Cassidy RN, Miller ME. Smoking Topography Characteristics of Very Low Nicotine Content Cigarettes, With and Without Nicotine Replacement, in Smokers With Schizophrenia and Controls. Nicotine Tob Res 2016; 18:1807-12. [PMID: 26995794 PMCID: PMC4978982 DOI: 10.1093/ntr/ntw089] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 03/09/2016] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Reducing the nicotine content of cigarettes to a minimally addictive level has been proposed as a regulatory strategy for reducing tobacco dependence. However, smokers with schizophrenia (SS) may be prone to changing their smoking topography in efforts to compensate for the reduction in nicotine content. The aims of this study were to compare smoking topography characteristics of usual-brand and very low nicotine content (VLNC) cigarettes in SS and control smokers without psychiatric illness (CS), and to determine whether nicotine replacement reversed any changes in topography produced by VLNC cigarettes. METHODS Using a within-subjects, counter-balanced design, SS (n = 27) and CS (n = 23) smoked usual brand cigarettes, VLNC cigarettes while wearing placebo patches (VLNC + PLA), or VLNC cigarettes while wearing transdermal nicotine patches totaling 42mg (VLNC + NIC) during 5-hour ad libitum smoking sessions. Cigarettes were smoked through topography measurement devices. RESULTS Across conditions, SS smoked more puffs per session and per cigarette, had higher cigarette volumes, and had shorter inter-puff intervals than CS (Ps < .01). During VLNC cigarette sessions, puff duration increased and time between puffs decreased, but participants smoked fewer puffs, resulting in a net decrease in cigarette and total session volume (Ps < .001). There were no significant interactions between group and condition. CONCLUSIONS These findings indicate that acute use of VLNC cigarettes does not increase intensity of smoking in SS, and support the feasibility of a nicotine reduction policy. IMPLICATIONS Reducing the nicotine in cigarettes to a minimally addictive level has been proposed as a means of reducing tobacco dependence. However, smokers, particularly those with schizophrenia (SS) may alter their puffing in an attempt to extract more nicotine from VLNC cigarettes. This study compared smoking topography of usual brand versus VLNC cigarettes, combined with placebo or transdermal nicotine patches, in SS and controls. Although some changes in topography were indicative of compensatory smoking, total puffs and total cigarette volume were reduced with VLNC cigarettes, indicating that acute VLNC cigarette use does not increase smoking in SS.
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Affiliation(s)
- Jennifer W Tidey
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI
| | - Rachel N Cassidy
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI
| | - Mollie E Miller
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI
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Agnew-Heard KA, Lancaster VA, Bravo R, Watson C, Walters MJ, Holman MR. Multivariate Statistical Analysis of Cigarette Design Feature Influence on ISO TNCO Yields. Chem Res Toxicol 2016; 29:1051-63. [PMID: 27222918 DOI: 10.1021/acs.chemrestox.6b00096] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
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.
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Affiliation(s)
- Kimberly A Agnew-Heard
- Center for Tobacco Products, U.S. Food and Drug Administration , 10903 New Hampshire Avenue, Silver Spring, Maryland 20993, United States
| | - Vicki A Lancaster
- Center for Tobacco Products, U.S. Food and Drug Administration , 10903 New Hampshire Avenue, Silver Spring, Maryland 20993, United States
| | - Roberto Bravo
- National Center for Environmental Health, Centers For Disease Control and Prevention , 4770 Buford Highway, NE, Atlanta, Georgia 30341, United States
| | - Clifford Watson
- National Center for Environmental Health, Centers For Disease Control and Prevention , 4770 Buford Highway, NE, Atlanta, Georgia 30341, United States
| | - Matthew J Walters
- Center for Tobacco Products, U.S. Food and Drug Administration , 10903 New Hampshire Avenue, Silver Spring, Maryland 20993, United States
| | - Matthew R Holman
- Center for Tobacco Products, U.S. Food and Drug Administration , 10903 New Hampshire Avenue, Silver Spring, Maryland 20993, United States
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Obsolete tobacco control themes can be hazardous to public health: the need for updating views on absolute product risks and harm reduction. BMC Public Health 2016; 16:432. [PMID: 27221096 PMCID: PMC4878038 DOI: 10.1186/s12889-016-3079-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 04/29/2016] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Leading themes have guided tobacco control efforts, and these themes have changed over the decades. When questions arose about health risks of tobacco, they focused on two key themes: 1) how bad is the problem (i.e., absolute risk) and 2) what can be done to reduce the risk without cessation (i.e., prospects for harm reduction). Using the United States since 1964 as an example, we outline the leading themes that have arisen in response to these two questions. Initially, there was the recognition that "cigarettes are hazardous to health" and an acceptance of safer alternative tobacco products (cigars, pipes, light/lower-tar cigarettes). In the 1980s there was the creation of the seminal theme that "Cigarettes are lethal when used as intended and kill more people than heroin, cocaine, alcohol, AIDS, fires, homicide, suicide, and automobile crashes combined." By around 2000, support for a less-dangerous light/lower tar cigarette was gone, and harm reduction claims were avoided for products like cigars and even for smokeless tobacco which were summarized as "unsafe" or "not a safe alternative to cigarettes." DISCUSSION The Surgeon General in 2014 concluded that by far the greatest danger to public health was from cigarettes and other combusted products. At the same time the evidence base for smokeless tobacco and alternative nicotine delivery systems (ANDS) had grown. Product innovation and tobacco/nicotine bio-behavioral, epidemiological and public health sciences demonstrate that low nitrosamine smokeless tobacco (e.g., Swedish snus), and ANDS have substantially lower harms than cigarettes. Going forward, it is important to sharpen themes and key messages of tobacco control, while continuing to emphasize the extreme lethality of the inhaled smoke from cigarettes or from use of any combusting tobacco product. Implications of updating the leading themes for regulation, policymaking and advocacy in tobacco control are proposed as an important next step. A new reframing can align action plans to more powerfully and rapidly achieve population-level benefit and minimize harm to eliminate in our lifetime the use of the most deadly combustible tobacco products and thus prevent the premature deaths of 1 billion people projected to occur worldwide by 2100.
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Mercincavage M, Souprountchouk V, Tang KZ, Dumont RL, Wileyto EP, Carmella SG, Hecht SS, Strasser AA. A Randomized Controlled Trial of Progressively Reduced Nicotine Content Cigarettes on Smoking Behaviors, Biomarkers of Exposure, and Subjective Ratings. Cancer Epidemiol Biomarkers Prev 2016; 25:1125-33. [PMID: 27197288 DOI: 10.1158/1055-9965.epi-15-1088] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 04/18/2016] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The U.S. FDA has the authority to reduce cigarette nicotine content if found to benefit public health. Reduced nicotine content (RNC) cigarette use does not appear to increase harm exposure, but studies have not rigorously assessed smoking behavior or used a comprehensive panel of biomarkers. This study examined the effects of progressively decreasing RNC cigarettes on smoking behaviors, biomarkers of exposure, and subjective ratings. METHODS One hundred and fifty-eight daily, non-treatment-seeking smokers participated in a 35-day randomized, unblinded, parallel study. After a 5-day baseline period, participants were randomly assigned to an experimental group (n = 80) that smoked progressively decreasing RNC cigarettes during three 10-day periods, or control group (n = 78) that smoked their own brand throughout the study. RESULTS Daily cigarette consumption significantly increased for the intermediate RNCs (P's < 0.001) but approached baseline rate for the lowest RNC (P = 0.686); in contrast, puffing behavior significantly decreased at intermediate levels and increased for the lowest RNC (P's < 0.001). Cotinine and NNAL significantly decreased by RNC period (P's ≤ 0.001-0.02), whereas CO boost initially increased (P's = 0.001-0.005). 1-HOP did not change by period (P = 0.109). CONCLUSIONS Smoking behaviors changed by RNC period via CPD and puffing behavior. Biomarkers of exposure generally decreased with nicotine content. IMPACT Findings suggest that RNC use does not ubiquitously reduce smoking behaviors or biomarkers, yet the lowest RNC level tested may reduce harm exposure. This emphasizes the importance of using multiple behavioral and biologic measures to address the impact of RNC cigarette smoking. Cancer Epidemiol Biomarkers Prev; 25(7); 1125-33. ©2016 AACR.
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Affiliation(s)
- Melissa Mercincavage
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Valentina Souprountchouk
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Kathy Z Tang
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Rachel L Dumont
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - E Paul Wileyto
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Steven G Carmella
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Stephen S Hecht
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Andrew A Strasser
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
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Yong HH, Borland R, Cummings KM, Lindblom EN, Li L, Bansal-Travers M, O'Connor RJ, Elton-Marshall T, Thrasher JF, Hammond D, Thompson ME, Partos TR. US Smokers' Beliefs, Experiences and Perceptions of Different Cigarette Variants Before and After the FSPTCA Ban on Misleading Descriptors Such as "Light," "Mild," or "Low". Nicotine Tob Res 2016; 18:2115-2123. [PMID: 27083215 DOI: 10.1093/ntr/ntw107] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 04/08/2016] [Indexed: 12/12/2022]
Abstract
INTRODUCTION In December 2008, the Federal Trade Commission (FTC) took action that prompted the removal of nicotine and tar listings from cigarette packs and ads. As of June 2010, the US Family Smoking Prevention and Tobacco Control Act prohibited the use of explicit or implicit descriptors on tobacco packaging or in advertising that convey messages of reduced risk or exposure, specifically including terms like "light," "mild," and "low" and similar descriptors. This study evaluates the effect of these two policy changes on smokers' beliefs, experiences and perceptions of different cigarettes. METHODS Using generalized estimating equations models, this study analyzed survey data collected between 2002 and 2013 by the International Tobacco Control Policy Evaluation Study regarding US smokers' beliefs, experiences, and perceptions of different cigarettes. RESULTS Between 2002 and 2013, smoker misperceptions about "light" cigarettes being less harmful did not change significantly and remained substantial, especially among those who reported using lower-strength cigarettes. After the two policy changes, reported reliance on pack colors, color terms, and other product descriptors like "smooth" to determine cigarette strength style trended upward. CONCLUSIONS Policies implemented to reduce smoker misperceptions that some cigarettes are safer than others appear to have had little impact. Because of pack colors, color terms, descriptors such as "smooth," cigarette taste or feel, and possibly other characteristics, millions of smokers continue to believe, inaccurately, that they can reduce their harms and risks by smoking one cigarette brand or sub-brand instead of another, which may be delaying or reducing smoking cessation. IMPLICATIONS What this study adds: This study confirms that US policies to reduce smoker misperceptions that some cigarettes are less harmful than others have not been successful. Following the removal of light/low descriptors and tar and nicotine numbers from cigarette packs and ads, pack colors, color words, other descriptors (eg, smooth), and sensory experiences of smoother or lighter taste have helped smokers to continue to identify their preferred cigarette brand styles and otherwise distinguish between which brands and styles they consider "lighter" or lower in tar and, mistakenly, less harmful than others. These findings provide additional evidence to support new enforcement or regulatory action to stop cigarettes and their packaging from misleading smokers about relative risk, which may be reducing or delaying quit attempts.
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Affiliation(s)
- Hua-Hie Yong
- Nigel Gray Fellowship Group, Cancer Council Victoria , Melbourne , Australia
| | - Ron Borland
- Nigel Gray Fellowship Group, Cancer Council Victoria , Melbourne , Australia
| | - K Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina , Charleston, SC
| | - Eric N Lindblom
- O'Neill Institute for National and Global Health Law, Georgetown University Law Center , Washington, DC
| | - Lin Li
- Nigel Gray Fellowship Group, Cancer Council Victoria , Melbourne , Australia
| | | | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Cancer Institute , Buffalo, NY
| | - Tara Elton-Marshall
- Social and Epidemiological Research, Centre for Addiction and Mental Health, London, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,School of Health Studies, Western University, London, ON, Canada
| | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina , Columbia, SC
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo , Waterloo, ON , Canada
| | - Mary E Thompson
- Department of Statistics and Actuarial Science, University of Waterloo , Waterloo, ON , Canada
| | - Timea R Partos
- Institute of Psychiatry, King's College London , London , UK
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Abstract
OBJECTIVE To provide researchers an extensive characterization of the SPECTRUM variable nicotine research cigarettes. METHODS Data on cigarette physical properties, nicotine content, harmful and potentially harmful constituents in the tobacco filler was compiled. RESULTS Data on physical properties, concentrations of menthol, nicotine and minor alkaloids, tobacco-specific nitrosamines, polycyclic aromatic hydrocarbons, ammonia, and toxic metals in the filler tobacco for all available varieties of Spectrum research cigarettes are provided. The similarity in the chemistry and physical properties of SPECTRUM cigarettes to commercial cigarettes renders them acceptable for use in behavioral studies. Baseline information on harmful and potentially harmful constituents in research tobacco products, particularly constituent levels such as minor alkaloids that fall outside typical ranges reported for commercial, provide researchers with the opportunity to monitor smoking behavior and to identify biomarkers that will inform efforts to understand the role of nicotine in creating and sustaining addiction. CONCLUSIONS Well characterized research cigarettes suitable for human consumption are an important tool in clinical studies for investigating the physiological impacts of cigarettes delivering various levels of nicotine, the impact of reduced nicotine cigarettes on nicotine addiction, and the relationship between nicotine dose and smoking behavior.
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Higashi T, Mai Y, Mazaki Y, Horinouchi T, Miwa S. A Standardized Method for the Preparation of a Gas Phase Extract of Cigarette Smoke. Biol Pharm Bull 2016; 39:898-902. [PMID: 27251490 DOI: 10.1248/bpb.b16-00062] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2023]
Abstract
The gas phase of cigarette smoke is important from the viewpoint of human health, because it can pass through alveolar epithelium and enter the circulation. There is no standard method for the preparation of a gas phase extract of cigarette smoke (CSE), although CSE is widely used for research instead of whole cigarette smoke. We have established a standard method for the preparation of CSE. One cigarette per trial is continuously combusted under a reduced pressure generated by an aspiration pump with a velocity of 1.050 L/min: the main stream of the smoke is passed through a Cambridge filter to remove tar, and subsequently, bubbled through a glass ball filter (pore size, 20-30 µm) into 15 mL of phosphate-buffered saline (PBS). To express the concentration of CSE, a virtual tar concentration is introduced, which is calculated assuming that tar trapped on the Cambridge filter is dissolved in the PBS. CSEs prepared from smaller numbers of cigarettes (original virtual tar concentration≤15 mg/mL) show similar concentration-response curves for cytotoxicity versus virtual tar concentrations. CSEs prepared from various brands of cigarettes and by different smoking regimes (continuous and puff smoking) show similar cytotoxic potency if the virtual tar concentrations are the same. In conclusion, using the standardized method for CSE preparation in combination with the virtual tar concentration, it becomes possible to simply and rapidly prepare standard CSEs with defined concentrations from any brand of cigarettes, which are toxicologically equivalent to CSE prepared by puff smoking.
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Affiliation(s)
- Tsunehito Higashi
- Department of Cellular Pharmacology, Graduate School of Medicine, Hokkaido University
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75
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Abstract
OBJECTIVES The goal of this review was to evaluate which standard machine-smoking regimen may be most appropriate to inform tobacco product regulation based on the fraction of cigarette smoke yields that best represents the range of human smoke exposures. METHODS We searched PubMed and Web of Science to identify peer-reviewed studies that reported percentages of smokers who smoked more or less like a particular machine-smoking regimen based on human mouth level exposure (MLE) tobacco constituent yields. RESULTS Three studies met our inclusion criteria and were reviewed. Studies found that Canadian Intense (CI) yields were equal to or greater than 86% to 97% of smokers' nicotine and tar MLE yields. CONCLUSIONS MLE yields indicate that a small percentage of individuals (less than 14%) are exposed to nicotine and tar yields equal to or greater than those measured by the CI regimen. Whereas no machine-smoking regimen reflects human puffing behavior with complete accuracy, based on MLE data, CI constituent yields constitute the best representation of exposure that encompasses the majority of smokers, and may be the most informative for regulatory purposes.
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76
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Maddox R, Durkin S, Lovett R. Plain packaging implementation: perceptions of risk and prestige of cigarette brands among Aboriginal and Torres Strait Islander people. Aust N Z J Public Health 2015; 40:221-5. [PMID: 26713418 DOI: 10.1111/1753-6405.12489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 07/01/2015] [Accepted: 09/01/2015] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To assess the impact of plain packaging with larger graphic health warnings on perceptions of risk and prestige related to different cigarette brands among Aboriginal and Torres Strait Islander people in the Australian Capital Territory. We hypothesised that the changes would decrease perceptions that 'some cigarette brands are more harmful than others', and that 'some brands are more prestigious than others', and this would be stronger among participants aged ≤35 years, and among smokers compared with non-smokers. METHODS Participants completed the survey prior to packaging changes, and were followed up 12 months later (n=98). Repeated measures ANCOVAs assessed perception changes. RESULTS Following plain packaging implementation, there was a significant reduction in perceptions that 'some cigarette brands are more harmful than others'. There was no overall change in perceptions of prestige. However, there was a significant interaction for age. Analyses indicated a reduction in perceptions that 'some cigarette brands are more prestigious than others' among younger participants (p=0.05), but no change among older participants (p>0.20). There was no interaction for smoking status for perceptions of prestige, indicating smokers' and non-smokers' perceptions did not differ on this measure. CONCLUSIONS These findings provide support for the packaging changes.
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Affiliation(s)
- Raglan Maddox
- Centre for Research on Inner City Health, St. Michael's Hospital, Ontario, Canada.,Centre for Research and Action in Public Health, Faculty of Health, University of Canberra, Australian Capital Territory
| | - Sarah Durkin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria
| | - Ray Lovett
- National Centre for Epidemiology and Population Health, Australian National University, Australian Capital Territory
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O'Connor RJ, Bansal-Travers M, Cummings KM, Hammond D, Thrasher JF, Tworek C. Filter presence and tipping paper color influence consumer perceptions of cigarettes. BMC Public Health 2015; 15:1279. [PMID: 26695774 PMCID: PMC4688990 DOI: 10.1186/s12889-015-2643-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Accepted: 12/17/2015] [Indexed: 11/10/2022] Open
Abstract
Background Cigarettes are marketed in a wide array of packaging and product configurations, and these may impact consumers’ perceptions of product health effects and attractiveness. Filtered cigarettes are typically perceived as less hazardous and white tipping paper (as opposed to cork) often conveys ‘lightness’. Methods This study examined cigarette-related perceptions among 1220 young adult (age 18-35) current, ever, and never smokers recruited from three eastern U.S. cities (Buffalo NY, Columbia SC, Morgantown WV). Participants rated three cigarette sticks: two filtered cigarettes 85 mm in length, differing only in tipping paper color (cork versus white), and an unfiltered 70 mm cigarette. Results Overall, the cork-tipped cigarette was most commonly selected on taste and attractiveness, the white-tipped on least dangerous, and the unfiltered on most dangerous. Current smokers were more likely to select white-tipped (OR = 1.98) and cork-tipped (OR = 3.42) cigarettes, while ever smokers more commonly selected the cork-tipped (OR = 1.96), as most willing to try over the other products. Those willing to try the filtered white-tipped cigarette were more likely to have rated that cigarette as best tasting (OR = 11.10), attracting attention (OR = 17.91), and lowest health risk (OR = 1.94). Similarly, those willing to try cork tipped or unfiltered cigarettes rated those as best testing, attracting attention, and lowest health risk, respectively. Conclusions Findings from this study demonstrate that consumer product perceptions can be influenced by elements of cigarette design, such as the presence and color of the filter tip.
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Affiliation(s)
- Richard J O'Connor
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY, 14263, USA.
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY, 14263, USA.
| | - K Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
| | - James F Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Cindy Tworek
- Department of Pharmaceutical Systems and Policy, West Virginia University, Morgantown, WV, USA.
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Green AC, Fong GT, Borland R, Quah ACK, Seo HG, Kim Y, Elton-Marshall T. The importance of the belief that "light" cigarettes are smoother in misperceptions of the harmfulness of "light" cigarettes in the Republic of Korea: a nationally representative cohort study. BMC Public Health 2015; 15:1108. [PMID: 26547549 PMCID: PMC4637138 DOI: 10.1186/s12889-015-2472-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 11/03/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND A number of countries have banned misleading cigarette descriptors such as "light" and "low-tar" as called for by the WHO Framework Convention on Tobacco Control. These laws, however, do not address the underlying cigarette design elements that contribute to misperceptions about harm. This is the first study to examine beliefs about "light" cigarettes among Korean smokers, and the first to identify factors related to cigarette design that are associated with the belief that "light" cigarettes are less harmful. METHODS We analysed data from Wave 3 of the ITC Korea Survey, a telephone survey of a nationally representative sample of 1,753 adult smokers, conducted October - December 2010. A multinomial logistic regression was used to examine which factors were associated with the belief that "light" cigarettes are less harmful than regular cigarettes. RESULTS One quarter (25.0 %) of smokers believed that "light" cigarettes are less harmful than regular cigarettes, 25.8 % believed that smokers of "light" brands take in less tar, and 15.5 % held both of these beliefs. By far the strongest predictor of the erroneous belief that "light" cigarettes are less harmful was the belief that "light" cigarettes are smoother on the throat and chest (p < 0.001, OR = 44.8, 95 % CI 23.6-84.9). CONCLUSIONS The strong association between the belief that "light" cigarettes are smoother on the throat and chest and the belief that "light" cigarettes are less harmful, which is consistent with previous research, provides further evidence of the need to not only ban "light" descriptors, but also prohibit cigarette design and packaging features that contribute to the perception of smoothness.
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Affiliation(s)
- Annika C Green
- Department of Psychology, University of Waterloo, 200 University Ave West, Waterloo, Ontario, N2L 3G1, Canada.
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, 200 University Ave West, Waterloo, Ontario, N2L 3G1, Canada.
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada.
| | - Ron Borland
- The Cancer Council, Melbourne, Victoria, Australia.
| | - Anne C K Quah
- Department of Psychology, University of Waterloo, 200 University Ave West, Waterloo, Ontario, N2L 3G1, Canada.
| | - Hong Gwan Seo
- Center for Cancer Prevention and Detection, National Cancer Center, Goyang, Republic of Korea.
| | - Yeol Kim
- Division of Cancer Management and Policy, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea.
| | - Tara Elton-Marshall
- Social and Epidemiological Research Department, Centre for Addiction and Mental Health, London, Ontario, Canada.
- Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
- School of Health Studies, Western University, London, Canada.
- Department of Epidemiology and Biostatistics, Western University, London, Canada.
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79
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Schneller LM, Zwierzchowski BA, Caruso RV, Li Q, Yuan J, Fong GT, O'Connor RJ. Changes in tar yields and cigarette design in samples of Chinese cigarettes, 2009 and 2012. Tob Control 2015; 24 Suppl 4:iv60-3. [PMID: 25352560 PMCID: PMC4693290 DOI: 10.1136/tobaccocontrol-2014-051803] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 09/10/2014] [Indexed: 11/04/2022]
Abstract
BACKGROUND China is home to the greatest number of smokers as well as the greatest number of smoking-related deaths. An active and growing market of cigarettes marketed as 'light' or 'low tar' may keep health-concerned smokers from quitting, wrongly believing that such brands are less harmful. OBJECTIVE This study sought to observe changes in cigarette design characteristics and reported tar, nicotine and carbon monoxide (TNCO) levels in a sample of cigarette brands obtained in seven Chinese cities from 2009 to 2012. METHODS Cigarettes were purchased and shipped to Roswell Park Cancer Institute, where 91 pairs of packs were selected for physical cigarette design characteristic testing and recording of TNCO values. Data analysis was conducted using SPSS, and was initially characterised using descriptive statistics, correlations and generalised estimating equations to observe changes in brand varieties over time. FINDINGS Reported TNCO values on packs saw mean tar, nicotine and CO levels decrease from 2009 to 2012 by 7.9%, 4.5% and 6.0%, respectively. Ventilation was the only cigarette design feature that significantly changed over time (p<0.001), with an increase of 31.7%. Significant predictors of tar and CO yield overall were ventilation and per-cigarette tobacco weight, while for nicotine tobacco moisture was also an independent predictor of yield. CONCLUSIONS The use of ventilation to decrease TNCO emissions is misleading smokers to believe that they are smoking a 'light/low' tar cigarette that is healthier, and is potentially forestalling the quitting behaviours that would begin to reduce the health burden of tobacco in China, and so should be prohibited.
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Affiliation(s)
- Liane M. Schneller
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY, USA
| | | | - Rosalie V. Caruso
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Qiang Li
- Department of Psychology, University of Waterloo, Ontario, Canada
- Chinese Centers for Disease Control and Prevention, Beijing, PRC
| | - Jiang Yuan
- Chinese Centers for Disease Control and Prevention, Beijing, PRC
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Richard J. O'Connor
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY, USA
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Donny EC, Denlinger RL, Tidey JW, Koopmeiners JS, Benowitz NL, Vandrey RG, al'Absi M, Carmella SG, Cinciripini PM, Dermody SS, Drobes DJ, Hecht SS, Jensen J, Lane T, Le CT, McClernon FJ, Montoya ID, Murphy SE, Robinson JD, Stitzer ML, Strasser AA, Tindle H, Hatsukami DK. Randomized Trial of Reduced-Nicotine Standards for Cigarettes. N Engl J Med 2015; 373:1340-9. [PMID: 26422724 PMCID: PMC4642683 DOI: 10.1056/nejmsa1502403] [Citation(s) in RCA: 294] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND The Food and Drug Administration can set standards that reduce the nicotine content of cigarettes. METHODS We conducted a double-blind, parallel, randomized clinical trial between June 2013 and July 2014 at 10 sites. Eligibility criteria included an age of 18 years or older, smoking of five or more cigarettes per day, and no current interest in quitting smoking. Participants were randomly assigned to smoke for 6 weeks either their usual brand of cigarettes or one of six types of investigational cigarettes, provided free. The investigational cigarettes had nicotine content ranging from 15.8 mg per gram of tobacco (typical of commercial brands) to 0.4 mg per gram. The primary outcome was the number of cigarettes smoked per day during week 6. RESULTS A total of 840 participants underwent randomization, and 780 completed the 6-week study. During week 6, the average number of cigarettes smoked per day was lower for participants randomly assigned to cigarettes containing 2.4, 1.3, or 0.4 mg of nicotine per gram of tobacco (16.5, 16.3, and 14.9 cigarettes, respectively) than for participants randomly assigned to their usual brand or to cigarettes containing 15.8 mg per gram (22.2 and 21.3 cigarettes, respectively; P<0.001). Participants assigned to cigarettes with 5.2 mg per gram smoked an average of 20.8 cigarettes per day, which did not differ significantly from the average number among those who smoked control cigarettes. Cigarettes with lower nicotine content, as compared with control cigarettes, reduced exposure to and dependence on nicotine, as well as craving during abstinence from smoking, without significantly increasing the expired carbon monoxide level or total puff volume, suggesting minimal compensation. Adverse events were generally mild and similar among groups. CONCLUSIONS In this 6-week study, reduced-nicotine cigarettes versus standard-nicotine cigarettes reduced nicotine exposure and dependence and the number of cigarettes smoked. (Funded by the National Institute on Drug Abuse and the Food and Drug Administration Center for Tobacco Products; ClinicalTrials.gov number, NCT01681875.).
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Affiliation(s)
- Eric C Donny
- From the Departments of Psychology (E.C.D., R.L.D., S.S.D., T.L.) and Medicine (H.T.), University of Pittsburgh, Pittsburgh; the Center for Alcohol and Addiction Studies, Brown University, Providence, RI (J.W.T.); the Division of Biostatistics, School of Public Health (J.S.K., C.T.L.), the Departments of Biochemistry, Molecular Biology, and Biophysics (S.E.M.) and Psychiatry (D.K.H.) and the Masonic Cancer Center (J.S.K., S.G.C., S.S.H., J.J., C.T.L., S.E.M., D.K.H.), University of Minnesota, Minneapolis, and the University of Minnesota Medical School, Duluth (M.A.) - all in Minnesota; the Departments of Medicine and Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco (N.L.B.); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (R.G.V., M.L.S.), and National Institute on Drug Abuse, Bethesda (I.D.M.) - both in Maryland; the Department of Behavioral Science, University of Texas M.D. Anderson Cancer Center, Houston (P.M.C., J.D.R.); the Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL (D.J.D.); the Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC (F.J.M.); and the Department of Psychiatry, Perelman School of Medicine, and Abramson Cancer Center, University of Pennsylvania, Philadelphia (A.A.S.)
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81
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Kiviniemi MT, Kozlowski LT. Deficiencies in public understanding about tobacco harm reduction: results from a United States national survey. Harm Reduct J 2015; 12:21. [PMID: 26135116 PMCID: PMC4487951 DOI: 10.1186/s12954-015-0055-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 06/25/2015] [Indexed: 01/19/2023] Open
Abstract
Background Tobacco products differ in their relative health harms. The need for educating consumers about such harms is growing as different tobacco products enter the marketplace and as the FDA moves to regulate and educate the public about different products. However, little is known about the patterns of the public’s knowledge of relative harms. Methods Data were analyzed from the Health Information National Trends Survey (HINTS) 4 Cycle 2, a population-representative survey of US adults conducted between October 2012 and January 2013 (N = 3630). Participants reported their perceptions of the relative risks of e-cigarettes, smokeless tobacco, and different types of cigarettes compared to “traditional” cigarettes. Relative risk perceptions for each product type, as well as the consistency and accuracy of harm reduction beliefs, were analyzed. Results About 65 % of the respondents accurately reported that no cigarettes were less harmful than any others. Slightly more than half of US adults perceived e-cigarettes to be safer than regular cigarettes, a belief in line with current scientific evidence. By contrast, only 9 % of respondents perceived some smokeless tobacco products to be safer, a belief strongly supported by the evidence. Only 3.5 % of respondents had patterns of relative risk perceptions in line with current scientific evidence for all three modalities. Conclusions The discrepancy between current evidence and public perceptions of relative risk of various tobacco/nicotine products was marked; for most tobacco types, a large proportion of the population held inaccurate harm reduction beliefs. Although there was substantial awareness that no cigarettes were safer than any other cigarettes, there could be benefits from increasing the percentage of the public that appreciates this fact, especially among current smokers. Given the potential benefits of tobacco risk reduction strategies, public health education efforts to increase understanding of basic harm reduction principles are needed to address these misperceptions.
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Affiliation(s)
- Marc T Kiviniemi
- Department of Community Health and Health Behavior, University at Buffalo, State University of New York, School of Public Health and Health Professions, 3425 Main Street, Buffalo, NY, 14214, USA.
| | - Lynn T Kozlowski
- Department of Community Health and Health Behavior, University at Buffalo, State University of New York, School of Public Health and Health Professions, 3425 Main Street, Buffalo, NY, 14214, USA.
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82
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Prospects for a nicotine-reduction strategy in the cigarette endgame: Alternative tobacco harm reduction scenarios. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 26:543-7. [PMID: 25795345 DOI: 10.1016/j.drugpo.2015.02.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 02/13/2015] [Accepted: 02/15/2015] [Indexed: 11/21/2022]
Abstract
Some major national and international tobacco control organisations favour mandating a reduction in nicotine content of cigarettes to non-addictive levels as a tobacco control tool. Reducing nicotine content, it is argued, will make tobacco smoking less attractive. The 2009 U.S. Food and Drug Administration's regulation of cigarettes appears to have the power to reduce nicotine to non-addictive levels provided it is not taken to zero. A consideration of the U.S. context, however, raises doubts about (a) whether this will ever be practicable and (b), if practicable, how long it will take to implement. Current versions of the nicotine-reducing strategy propose the systematic, incentivised use of less harmful nicotine/tobacco products as elements of the mandatory cigarette nicotine-reduction strategy. Time will tell if and when mandatory nicotine reduction in tobacco cigarettes will occur and what impact it might have on smoking prevalence. The question posed here is "Why wait?" Resources used in implementing reduction in nicotine content have an opportunity cost. In the meantime, nicotine-maintaining harm reduction strategies can have nearer term effects on tobacco use as an individual and a public health issue.
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83
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Behar RZ, Hua M, Talbot P. Puffing topography and nicotine intake of electronic cigarette users. PLoS One 2015; 10:e0117222. [PMID: 25664463 PMCID: PMC4321841 DOI: 10.1371/journal.pone.0117222] [Citation(s) in RCA: 150] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 12/20/2014] [Indexed: 11/19/2022] Open
Abstract
Background Prior electronic cigarette (EC) topography data are based on two video analyses with limited parameters. Alternate methods for measuring topography are needed to understand EC use and nicotine intake. Objectives This study evaluated EC topography with a CReSS Pocket device and quantified nicotine intake. Methods Validation tests on pressure drop, flow rate, and volume confirmed reliable performance of the CReSS Pocket device. Twenty participants used Blu Cigs and V2 Cigs for 10 minute intervals with a 10–15 minute break between brands. Brand order was reversed and repeated within 7 days Data were analyzed to determine puff duration, puff count, volume, flow rate, peak flow, and inter-puff interval. Nicotine intake was estimated from cartomizer fluid consumption and topography data. Results Nine patterns of EC use were identified. The average puff count and inter-puff interval were 32 puffs and 17.9 seconds. All participants, except one, took more than 20 puffs/10 minutes. The averages for puff duration (2.65 seconds/puff), volume/puff (51ml/puff), total puff volume (1,579 ml), EC fluid consumption (79.6 mg), flow rate (20 ml/s), and peak flow rate (27 ml/s) were determined for 10-minute sessions. All parameters except total puff count were significantly different for Blu versus V2 EC. Total volume for Blu versus V2 was four-times higher than for conventional cigarettes. Average nicotine intake for Blu and V2 across both sessions was 1.2 ± 0.5 mg and 1.4 ± 0.7 mg, respectively, which is similar to conventional smokers. Conclusions EC puffing topography was variable among participants in the study, but often similar within an individual between brands or days. Puff duration, inter-puff interval, and puff volume varied from conventional cigarette standards. Data on total puff volume and nicotine intake are consistent with compensatory usage of EC. These data can contribute to the development of a standard protocol for laboratory testing of EC products.
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Affiliation(s)
- Rachel Z. Behar
- Cell Molecular and Developmental Biology Graduate Program, University of California Riverside, Riverside, California, United States of America
- Department of Cell Biology and Neuroscience, University of California Riverside, Riverside, California, United States of America
| | - My Hua
- Department of Cell Biology and Neuroscience, University of California Riverside, Riverside, California, United States of America
| | - Prue Talbot
- Department of Cell Biology and Neuroscience, University of California Riverside, Riverside, California, United States of America
- * E-mail:
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84
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Caruso RV, O'Connor RJ, Travers MJ, Delnevo CD, Stephens WE. Design Characteristics and Tobacco Metal Concentrations in Filtered Cigars. Nicotine Tob Res 2015; 17:1331-6. [PMID: 25649053 DOI: 10.1093/ntr/ntu341] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 12/20/2014] [Indexed: 11/12/2022]
Abstract
INTRODUCTION While U.S. cigarette consumption has declined, cigar use has steadily increased, for reasons including price compared to cigarettes and the availability of filtered varieties resembling cigarettes, and flavors that have been banned in cigarettes (excluding menthol). Little published data exists on the design characteristics of such cigars. METHODS A variety of filtered cigar brands were tested for design characteristics such as whole cigar weight, ventilation, and per-cigar tobacco weight. Cigar sticks were then sent to the University of St. Andrews for metal concentration testing of As, Pb, Cr, Ni, and Cd. RESULTS Large and small cigars were statistically different between cigar weight (p ≤ .001), per-cigar tobacco weight (p = .001), rod diameter (p = .006), and filter diameter (p = .012). The differences in mean ventilation (overall mean = 19.6%, min. = 0.84%, max. = 57.6%) across filtered cigar brands were found to be statistically significant (p = .031), and can be compared to the ventilation of the average of 2013 U.S. Marlboro Red, Gold, and Silver packs at 29% ventilation. There were no significant differences for metal concentrations between cigar types (p = .650), with Pb and As levels being similar to U.S. 2009 cigarette concentrations, Cd cigar levels being slightly higher, and Cr and Ni levels much lower than cigarette levels. CONCLUSIONS With cigar use rising, and filtered cigars displaying substantial similarities to filtered cigarettes, more research on product characteristics is warranted. Future plans include testing tobacco alkaloid and more observation of cigar weight for tax bracket purposes.
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Affiliation(s)
- Rosalie V Caruso
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY;
| | - Mark J Travers
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY
| | - Cristine D Delnevo
- Department of Health Education and Behavioral Science, School of Public Health, Rutgers University, Piscataway, NJ
| | - W Edryd Stephens
- Department of Earth and Environmental Sciences, University of St. Andrews, Fife, UK
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Inaba Y, Uchiyama S, Kunugita N. [The need for tobacco control in Japan based on Articles 9 and 10 of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC), regulation of the contents of tobacco products, and regulation of tobacco product disclosures]. Nihon Eiseigaku Zasshi 2015; 70:15-23. [PMID: 25744789 DOI: 10.1265/jjh.70.15] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
In Japan, ultralow-nicotine cigarette brands with ventilation holes on the cigarette filters have been widely marketed to smokers. The use of these cigarette brands leads to compensation smoking. Menthol cigarette brands that have a cooling and numbing effect are also sold. In 2013, smokeless tobacco products similar to the Swedish snus, which is banned for sale in the European Union except in Sweden, were released in Japanese markets. These tobacco products have "toxicity," have a "ventilation filter," are "attractive," and promote "dependence." Tobacco smoke and smokeless tobacco are classified into "Group 1: Carcinogenic to humans" by the International Agency for Research on Cancer (IARC). The purpose of Articles 9 and 10 of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) is to regulate the contents of tobacco products as well as to regulate tobacco product disclosures. The implementation of some other articles has gradually advanced in Japan. However, that of Articles 9 and 10 is late. Japanese governmental authorities are being urged to immediately implement Articles 9 and 10.
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Affiliation(s)
- Yohei Inaba
- Department of Environmental Health, National Institute of Public Health
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86
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Ding YS, Ward J, Hammond D, Watson CH. Mouth-level intake of benzo[a]pyrene from reduced nicotine cigarettes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:11898-914. [PMID: 25411724 PMCID: PMC4245650 DOI: 10.3390/ijerph111111898] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 11/04/2014] [Accepted: 11/11/2014] [Indexed: 11/16/2022]
Abstract
Cigarette smoke is a known source of exposure to carcinogenic polycyclic aromatic hydrocarbons (PAHs), especially benzo[a]pyrene (BaP). Exposure to BaP in cigarette smoke is influenced by how a person smokes and factors, such as tobacco blend. To determine whether sustained use of reduced-nicotine cigarettes is associated with changes in exposure to nicotine and BaP, levels of BaP in spent cigarette filter butts were correlated with levels of BaP in cigarette smoke to estimate mouth-level intake (MLI) of BaP for 72 daily smokers given three progressively reduced nicotine content cigarettes. Urinary cotinine, a marker of nicotine exposure, and urinary 1-hydroxypyrene (1-HOP), a marker of PAH exposure, were measured throughout the study. Median daily BaP MLI and urine cotinine decreased in a similar manner as smokers switched to progressively lower nicotine cigarettes, despite relatively constant daily cigarette consumption. 1-HOP levels were less responsive to the use of reduced nicotine content cigarettes. We demonstrate that spent cigarette filter butt analysis is a promising tool to estimate MLI of harmful chemicals on a per cigarette or per-day basis, which partially addresses the concerns of the temporal influence of smoking behavior or differences in cigarette design on exposure.
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Affiliation(s)
- Yan S Ding
- Tobacco Analysis Laboratory, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop F-19, Atlanta, GA 30341, USA.
| | - Jennye Ward
- Tobacco Analysis Laboratory, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop F-19, Atlanta, GA 30341, USA.
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada.
| | - Clifford H Watson
- Tobacco Analysis Laboratory, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop F-19, Atlanta, GA 30341, USA.
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Elton-Marshall T, Fong GT, Yong HH, Borland R, Xu SS, Quah ACK, Feng G, Jiang Y. Smokers' sensory beliefs mediate the relation between smoking a light/low tar cigarette and perceptions of harm. Tob Control 2014; 24 Suppl 4:iv21-7. [PMID: 25370698 DOI: 10.1136/tobaccocontrol-2014-051977] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 10/15/2014] [Indexed: 11/04/2022]
Abstract
BACKGROUND The sensory belief that 'light/low tar' cigarettes are smoother can also influence the belief that 'light/low tar' cigarettes are less harmful. However, the 'light' concept is one of several factors influencing beliefs. No studies have examined the impact of the sensory belief about one's own brand of cigarettes on perceptions of harm. OBJECTIVE The current study examines whether a smoker's sensory belief that their brand is smoother is associated with the belief that their brand is less harmful and whether sensory beliefs mediate the relation between smoking a 'light/low tar' cigarette and relative perceptions of harm among smokers in China. METHODS Data are from 5209 smokers who were recruited using a stratified multistage sampling design and participated in Wave 3 of the International Tobacco Control (ITC) China Survey, a face-to-face survey of adult smokers and non-smokers in seven cities. RESULTS Smokers who agreed that their brand of cigarettes was smoother were significantly more likely to say that their brand of cigarettes was less harmful (p<0.001, OR=6.86, 95% CI 5.64 to 8.33). Mediational analyses using the bootstrapping procedure indicated that both the direct effect of 'light/low tar' cigarette smokers on the belief that their cigarettes are less harmful (b=0.24, bootstrapped bias corrected 95% CI 0.13 to 0.34, p<0.001) and the indirect effect via their belief that their cigarettes are smoother were significant (b=0.32, bootstrapped bias-corrected 95% CI 0.28 to 0.37, p<0.001), suggesting that the mediation was partial. CONCLUSIONS These results demonstrate the importance of implementing tobacco control policies that address the impact that cigarette design and marketing can have in capitalising on the smoker's natural associations between smoother sensations and lowered perceptions of harm.
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Affiliation(s)
- Tara Elton-Marshall
- Social and Epidemiological Research Department, Centre for Addiction and Mental Health, London, Ontario, Canada School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada Ontario Institute for Cancer Research, Toronto, Canada School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Hua-Hie Yong
- The Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Ron Borland
- The Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Steve Shaowei Xu
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Anne C K Quah
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Guoze Feng
- Office of Tobacco Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuan Jiang
- Office of Tobacco Control, Chinese Center for Disease Control and Prevention, Beijing, China
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88
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Henningfield JE. The tobacco endgame: it's all about behavior. Prev Med 2014; 68:11-6. [PMID: 25236479 DOI: 10.1016/j.ypmed.2014.09.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 09/01/2014] [Accepted: 09/08/2014] [Indexed: 11/20/2022]
Abstract
One of the ten great public health achievements in the 20th century was turning the tide on one of the greatest public health disasters of that century: the tobacco use and related disease epidemic. The premature death and disease caused by tobacco can be considered largely as a side-effect of tobacco use behavior and the disease of addiction. The spread of that disease was fostered by an industry that researched the behavioral and biological basis of tobacco use and addiction and applied its findings and knowledge to develop products and marketing approaches to increase the likelihood that people, especially young people, would try tobacco products and develop persistent use and addiction. Researchers outside of the tobacco industry also investigated the behavioral biology of tobacco use and their research has been critical in turning the tide of the tobacco and disease epidemic. The behavioral factors are considered vital to understand and address by United States Food and Drug Administration and Surgeon General, as well as the World Health Organization in their tobacco control efforts. This commentary discusses key behavioral factors in the rise and fall of the epidemic, as well as some of those increasingly discussed as potential contributors to the endgame.
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Affiliation(s)
- Jack E Henningfield
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, USA.
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89
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Walton KM, Abrams DB, Bailey WC, Clark D, Connolly GN, Djordjevic MV, Eissenberg TE, Fiore MC, Goniewicz ML, Haverkos L, Hecht SS, Henningfield JE, Hughes JR, Oncken CA, Postow L, Rose JE, Wanke KL, Yang L, Hatsukami DK. NIH electronic cigarette workshop: developing a research agenda. Nicotine Tob Res 2014; 17:259-69. [PMID: 25335949 DOI: 10.1093/ntr/ntu214] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Electronic cigarettes (e-cigarettes) represent an emerging public health issue. These devices deliver nicotine along with other constituents, including flavorants, via an inhalable aerosol. Their uptake is rapidly increasing in both adults and youths, primarily among current smokers. Public debate is increasing on how these devices should be regulated and used, yet only limited peer-reviewed research exists. To develop a informed policy for e-cigarettes, their effects on human behavior, physiology, and health need to be understood. PURPOSE This paper describes proceedings from a National Institutes of Health-sponsored workshop, which was held in November 2013, to identify research needs related to the effects of e-cigarettes. Discussion topics included e-cigarette risks and abuse potential; the potential role for e-cigarettes in harm reduction and smoking cessation; unintended consequences of e-cigarette use, such as becoming a gateway to conventional cigarettes; and dual use of both e-cigarettes and conventional cigarettes. RESULTS AND CONCLUSIONS The research needs identified by the workshop participants included the following: standards to measure the contents and emissions of e-cigarettes; biomarkers of exposure; physiological effects of e-cigarettes on tissues and organ systems, including pulmonary and cardiovascular; information on e-cigarette users, how the devices are used, and identification of the best tools to assess these measures; factors that drive use and influence patterns of use; and appropriate methods for evaluating a potential role for e-cigarettes in smoking or nicotine cessation. To understand fully the challenges and the opportunities that e-cigarettes represent, expertise will be needed in basic, behavioral, translational, and clinical sciences.
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Affiliation(s)
- Kevin M Walton
- Division of Pharmacotherapies and Medical Consequences of Drug Abuse, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD;
| | - David B Abrams
- Schroeder Institute at Legacy, Washington, DC, and Department of Health, Behavior and Society, Johns Hopkins School of Public Health, Baltimore, MD
| | - William C Bailey
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - David Clark
- Behavioral and Social Sciences Research Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD
| | - Gregory N Connolly
- Schools of Law and Bouve Health Sciences , Northeastern University, Boston, MA
| | - Mirjana V Djordjevic
- Tobacco Control Research Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | | | - Michael C Fiore
- Center for Tobacco Research and Intervention, University of Wisconsin, Madison, WI
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY
| | - Lynne Haverkos
- Child Development and Behavior Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Stephen S Hecht
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN
| | - Jack E Henningfield
- Pinney Associates, Bethesda, MD, and Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD
| | - John R Hughes
- Department of Psychological Science, University of Vermont College of Medicine, Burlington, VT
| | - Cheryl A Oncken
- Department of Medicine, University of Connecticut Health Center, Farmington, CT
| | - Lisa Postow
- Airway Biology and Disease Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Jed E Rose
- Center for Smoking Cessation, Duke University Medical Center, Durham, NC
| | - Kay L Wanke
- Office of Disease Prevention, National Institutes of Health, Bethesda, MD
| | - Lucie Yang
- Division of Nonprescription Clinical Evaluation, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD
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Hammond D, O'Connor RJ. Reduced nicotine cigarettes: smoking behavior and biomarkers of exposure among smokers not intending to quit. Cancer Epidemiol Biomarkers Prev 2014; 23:2032-40. [PMID: 25150282 DOI: 10.1158/1055-9965.epi-13-0957] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The U.S. FDA has the authority to limit the nicotine content of cigarettes; however, there are concerns that reduced nicotine cigarettes will be smoked more intensely and, therefore, will increase exposure to toxic chemicals in smoke. This study examined changes in consumer behavior and exposure in response to cigarettes with substantially reduced nicotine content. METHODS Seventy-two adult smokers completed an unblinded trial of reduced nicotine cigarettes. Participants completed a 7-day baseline period during which they smoked their usual cigarette brand, followed by consecutive 7-day periods smoking cigarettes with progressively lower nicotine levels (0.6, 0.3, and 0.05 mg emission Quest cigarettes). Nicotine dependence and withdrawal, smoking behavior, and biomarkers of exposure were assessed for each 7-day period. RESULTS Significant reductions in nicotine intake were observed between usual brand smoking (∼1.2 mg nicotine) and the 0.3 and 0.05 mg nicotine emission cigarettes, but not the 0.6 mg cigarette. The findings provide little evidence of compensatory smoking of Quest cigarettes, with no increases in exhaled breath carbon monoxide levels, smoking intensity, or levels of 1-hydroxypyrene across study periods. No significant differences were observed for smoking urges or measures of nicotine dependence. CONCLUSIONS The study adds to the evidence that cigarettes with markedly reduced nicotine content are not associated with increased smoking intensity or exposure to smoke toxicants. IMPACT The findings add to the evidence base on reduced nicotine content cigarettes and have the potential to inform FDA policy on nicotine levels.
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Affiliation(s)
- David Hammond
- School of Public Health and Health Systems, University of Waterloo, Ontario, Canada.
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York
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91
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Cornelius ME, Cummings KM, Fong GT, Hyland A, Driezen P, Chaloupka FJ, Hammond D, O'Connor RJ, Bansal-Travers M. The prevalence of brand switching among adult smokers in the USA, 2006-2011: findings from the ITC US surveys. Tob Control 2014; 24:609-15. [PMID: 25260750 DOI: 10.1136/tobaccocontrol-2014-051765] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 08/28/2014] [Indexed: 11/04/2022]
Abstract
BACKGROUND Recent studies have suggested that about 1 in 5 smokers report switching brands per year. However, these studies only report switching between brands. The current study estimated the rates of switching both within and between brand families and examining factors associated with brand and brand style switching. METHODS Data for this analysis are from the International Tobacco Control 2006-2011 US adult smoker cohort survey waves 5-8 (N=3248). A switch between brands was defined as reporting two different cigarette brand names for two successive waves, while switching within brand was defined as reporting the same brand name, but a different brand style. Repeated measures regression was used to determine factors associated with both switch types. RESULTS A total of 1475 participants reported at least two successive waves of data with complete information on brand name and style. Overall switching increased from 44.9% in 2007-2008 to 58.4% in 2010-2011. Switching between brand names increased from 16% to 29%, while switches within the same brand name to a different style ranged from 29% to 33%. Between-brand switching was associated with younger age, lower income, non-white racial group and use of a discount brand, whereas, within-brand switching was associated with younger age and the use of a premium brand cigarette. CONCLUSIONS Nearly half of smokers in the USA switched their cigarette brand or brand style within a year. Switching between brands may be more price motivated, while switching within brands may be motivated by price and other brand characteristics such as product length.
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Affiliation(s)
- Monica E Cornelius
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA
| | - K Michael Cummings
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Pete Driezen
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Frank J Chaloupka
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois, USA
| | - David Hammond
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
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92
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Higashi T, Mai Y, Noya Y, Horinouchi T, Terada K, Hoshi A, Nepal P, Harada T, Horiguchi M, Hatate C, Kuge Y, Miwa S. A simple and rapid method for standard preparation of gas phase extract of cigarette smoke. PLoS One 2014; 9:e107856. [PMID: 25229830 PMCID: PMC4168273 DOI: 10.1371/journal.pone.0107856] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 08/15/2014] [Indexed: 12/19/2022] Open
Abstract
Cigarette smoke consists of tar and gas phase: the latter is toxicologically important because it can pass through lung alveolar epithelium to enter the circulation. Here we attempt to establish a standard method for preparation of gas phase extract of cigarette smoke (CSE). CSE was prepared by continuously sucking cigarette smoke through a Cambridge filter to remove tar, followed by bubbling it into phosphate-buffered saline (PBS). An increase in dry weight of the filter was defined as tar weight. Characteristically, concentrations of CSEs were represented as virtual tar concentrations, assuming that tar on the filter was dissolved in PBS. CSEs prepared from smaller numbers of cigarettes (original tar concentrations ≤ 15 mg/ml) showed similar concentration-response curves for cytotoxicity versus virtual tar concentrations, but with CSEs from larger numbers (tar ≥ 20 mg/ml), the curves were shifted rightward. Accordingly, the cytotoxic activity was detected in PBS of the second reservoir downstream of the first one with larger numbers of cigarettes. CSEs prepared from various cigarette brands showed comparable concentration-response curves for cytotoxicity. Two types of CSEs prepared by continuous and puff smoking protocols were similar regarding concentration-response curves for cytotoxicity, pharmacology of their cytotoxicity, and concentrations of cytotoxic compounds. These data show that concentrations of CSEs expressed by virtual tar concentrations can be a reference value to normalize their cytotoxicity, irrespective of numbers of combusted cigarettes, cigarette brands and smoking protocols, if original tar concentrations are ≤15 mg/ml.
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Affiliation(s)
- Tsunehito Higashi
- Department of Cellular Pharmacology, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Yosuke Mai
- Department of Cellular Pharmacology, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Yoichi Noya
- Central Institute of Isotope Science, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Takahiro Horinouchi
- Department of Cellular Pharmacology, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Koji Terada
- Department of Cellular Pharmacology, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Akimasa Hoshi
- Department of Cellular Pharmacology, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Prabha Nepal
- Department of Cellular Pharmacology, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Takuya Harada
- Department of Cellular Pharmacology, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Mika Horiguchi
- Department of Cellular Pharmacology, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Chizuru Hatate
- Department of Cellular Pharmacology, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Yuji Kuge
- Central Institute of Isotope Science, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Soichi Miwa
- Department of Cellular Pharmacology, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
- * E-mail:
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93
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Novotny TE, Slaughter E. Tobacco Product Waste: An Environmental Approach to Reduce Tobacco Consumption. Curr Environ Health Rep 2014; 1:208-216. [PMID: 25152862 PMCID: PMC4129234 DOI: 10.1007/s40572-014-0016-x] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Cigarette butts and other tobacco product wastes (TPW) are the most common items picked up in urban and beach cleanups worldwide. TPW contains all the toxins, nicotine, and carcinogens found in tobacco products, along with the plastic nonbiodegradable filter attached to almost all cigarettes sold in the United States and in most countries worldwide. Toxicity studies suggest that compounds leached from cigarette butts in salt and fresh water are toxic to aquatic micro-organisms and test fish. Toxic chemicals have also been identified in roadside TPW. With as much as two-thirds of all smoked cigarettes (numbering in the trillions globally) being discarded into the environment each year, it is critical to consider the potential toxicity and remediation of these waste products. This article reviews reports on the toxicity of TPW and recommends several policy approaches to mitigation of this ubiquitous environmental blight.
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Affiliation(s)
- Thomas E Novotny
- Graduate School of Public Health, San Diego State University, 5500 Campanile Drive, Hardy Tower 119, San Diego, CA 92182 USA
| | - Elli Slaughter
- Graduate School of Public Health, San Diego State University, 5500 Campanile Drive, Hardy Tower 119, San Diego, CA 92182 USA
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Fagerström KO, Bridgman K. Tobacco harm reduction: the need for new products that can compete with cigarettes. Addict Behav 2014; 39:507-11. [PMID: 24290207 DOI: 10.1016/j.addbeh.2013.11.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 10/28/2013] [Accepted: 11/01/2013] [Indexed: 02/08/2023]
Abstract
Over the last 50 years, the concept of tobacco harm reduction has been well established. It is now understood that nicotine itself is not very harmful and nicotine replacement therapy products have been widely used as an aid to quit, reduce to quit or temporarily abstain from smoking for many years. The popularity of the unlicensed electronic cigarette has increased despite an unknown risk profile and sinus use in Sweden provides strong evidence in support of a harm reduction strategy. The regulatory environment around harm reduction has changed in the UK and is continuing to evolve across the globe. The need for more appealing, licensed nicotine products capable of competing with cigarettes sensorially, pharmacologically and behaviourally is considered by many to be the way forward. The significant positive impact on public health that could be gained from encouraging people to switch from cigarettes to licensed medicinal nicotine products cannot be ignored.
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95
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Shen J, Li J, Qian X, Ren W, Fatehi P. A review on engineering of cellulosic cigarette paper to reduce carbon monoxide delivery of cigarettes. Carbohydr Polym 2014; 101:769-75. [DOI: 10.1016/j.carbpol.2013.09.101] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 09/13/2013] [Accepted: 09/18/2013] [Indexed: 10/26/2022]
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Afridi HI, Kazi TG, Talpur FN, Brabazon D, Naher S. Estimation of toxic elements in the samples of different cigarettes and their impact on human health of Irish hypertensive consumers. Clin Chim Acta 2013; 426:51-7. [PMID: 24012826 DOI: 10.1016/j.cca.2013.08.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Revised: 08/27/2013] [Accepted: 08/28/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cigarette smoking interferes with the metal homeostasis of the human body, which plays a crucial role for maintaining the health. A significant flux of heavy metals, among other toxins, reaches the lungs through smoking. In the present study, the relationship between toxic element (TE) exposure via cigarette smoking and hypertension incidence in population living in Dublin, Ireland is investigated. METHODS The different brands of cigarette (filler tobacco, filter and ash) consumed by the studied population were analyzed for cadmium (Cd), nickel (Ni), and lead (Pb). The concentrations of TEs in biological samples and different components of cigarette were measured by inductively coupled plasma atomic emission spectrophotometer after microwave-assisted acid digestion. The validity and accuracy of the methodology were checked using certified reference materials. RESULTS The filler tobacco of different branded cigarettes contains Cd, Ni and Pb concentrations in the ranges of 1.73-2.02, 0.715-1.52 and 0.378-1.16 μg/cigarette, respectively. The results of this study showed that the mean values of Cd, Ni and Pb were significantly higher in scalp hair and blood samples of hypertensive patients in relation to healthy controls, while the difference was significant in the case of smoker patients (p<0.001). The levels of all the three TEs were 2-3 folds higher in scalp hair and blood samples of non-hypertensive smoker subjects as compared to nonsmoker controls. CONCLUSION The high exposure of toxic metals as a result of cigarette smoking may be synergistic with risk factors associated with hypertension.
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Affiliation(s)
- Hassan Imran Afridi
- Mechanical & Manufacturing Engineering, Dublin City University, Dublin, Ireland; National Center of Excellence in Analytical Chemistry, University of Sindh, Jamshoro, Pakistan.
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O'Connor RJ, Caruso RV, Borland R, Cummings KM, Bansal-Travers M, Fix BV, King B, Hammond D, Fong GT. Relationship of cigarette-related perceptions to cigarette design features: findings from the 2009 ITC U.S. Survey. Nicotine Tob Res 2013; 15:1943-7. [PMID: 23943847 DOI: 10.1093/ntr/ntt075] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Many governments around the world have banned the use of misleading cigarette descriptors such as "light" and "mild" because the cigarettes so labeled were found not to reduce smokers' health risks. However, underlying cigarette design features, which are retained in many brands, likely contribute to ongoing belief that these cigarettes are less harmful by producing perceptions of lightness/smoothness through lighter taste and reduced harshness and irritation. METHODS Participants (N = 320) were recruited from the International Tobacco Control U.S. Survey conducted in 2009 and 2010, when they answered questions about smoking behavior, attitudes and beliefs about tobacco products, and key mediators and moderators of tobacco use behaviors. Participants also submitted an unopened pack of their usual brand of cigarettes for analysis using established methods. RESULTS Own-brand filter ventilation level (M 29%, range 0%-71%) was consistently associated with perceived lightness (p < .001) and smoothness (p = .005) of own brand. Those whose brand bore a light/mild label (55% of participants) were more likely to report their cigarettes were lighter [71.9% vs. 41.9%; χ(2)(2) = 38.1, p < .001] and smoother than other brands [75.5% vs. 68.7%; χ(2)(2) = 7.8, p = .020]. CONCLUSION Product design features, particularly filter ventilation, influence smokers' beliefs about product attributes such as lightness and smoothness, independent of package labels. Regulation of cigarette design features such as filter ventilation should be considered as a complement to removal of misleading terms in order to reduce smokers' misperceptions regarding product risks.
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Affiliation(s)
- Richard J O'Connor
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY
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98
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Gray N, Borland R. Research required for the effective implementation of the framework convention on tobacco control, articles 9 and 10. Nicotine Tob Res 2013; 15:777-88. [PMID: 23024247 PMCID: PMC3693498 DOI: 10.1093/ntr/nts175] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 06/24/2012] [Indexed: 01/13/2023]
Abstract
This paper is part of a series of articles intended to set out the research questions that are relevant to the successful implementation of the various provisions of the Framework Convention on Tobacco Control (FCTC). This paper focuses on issues affecting Articles 9 and 10 of the FCTC. This paper focuses on the research that is most important for most countries, rather than on what is desirable in countries with high levels of research capacity. Articles 9 and 10 of the FCTC address the regulation of contents and emissions of tobacco products and regulation of tobacco product disclosure. Such regulation will be essential if the long-term objective of reducing the danger of tobacco products is to be achieved. There are many components of tobacco and tobacco smoke that are excessively toxic and dangerous to the user. Many of these components are carcinogenic and addictive and can be removed or reduced substantially with current known technology. The fact that these components remain in tobacco and tobacco smoke at levels that are unnecessarily dangerous is precisely the reason why the successful implementation of Articles 9 and 10 of the FCTC is important to tobacco control. This paper discusses the scientific challenges involved in successfully implementing Articles 9 and 10 of the FCTC, which focuses on regulating carcinogens and toxins in tobacco and tobacco smoke, the abuse liability of tobacco products, and the additives and engineering features in tobacco products that make tobacco products appealing to future consumers. The research issues we focus on are those required to support the early stages of regulation. As regulation proceeds, new and more sophisticated research questions will undoubtedly emerge.
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Affiliation(s)
- Nigel Gray
- Cancer Council Victoria, Carlton, Victoria, Australia.
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Behm I, Sokol NA, Kennedy RD, Rees VW, Connolly GN. Population use, sales, and design: a multidimensional assessment of "light" cigarettes in the United States, 2009. Am J Public Health 2013; 103:e93-9. [PMID: 23327263 DOI: 10.2105/ajph.2012.300950] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We compared multiple measures of surveillance of "light" cigarette use, including population use, sales, and design features. Measures were obtained before the 2010 descriptors ban to establish a baseline for future evaluation of the effect of the ban. METHODS We examined light cigarette use, sales, and design using 3 data sets from 2009. We assessed population use using National Survey on Drug Use and Health data. Sales data were drawn from AC Nielsen. We gathered design features, including nicotine concentration, filter ventilation, and weight, from tobacco industry disclosures mandated by the Massachusetts Department of Public Health. RESULTS In 2009, 52.7% of smokers self-reported light cigarette use, which accounted for 56.0% of cigarettes sold in the United States. Self-reported light smokers were more likely to be female, White, older, and nondaily smokers. Of design features analyzed, only average filter ventilation differed significantly between light and "full-flavored" cigarettes. CONCLUSIONS Assessment of the impact of the descriptors ban and any future policies surrounding light cigarettes should use multiple surveillance strategies, including measures of population use, sales, and cigarette design.
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Affiliation(s)
- Ilan Behm
- Center for Global Tobacco Control, Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA, USA.
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Gage SH, Zammit S, Hickman M. Stronger evidence is needed before accepting that cannabis plays an important role in the aetiology of schizophrenia in the population. F1000 MEDICINE REPORTS 2013; 5:2. [PMID: 23361397 PMCID: PMC3544397 DOI: 10.3410/m5-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Schizophrenia is a debilitating but poorly understood condition with very few known modifiable risk factors. Cannabis use can acutely induce psychotic experiences, but its causal relationship to schizophrenia is less well understood. Longitudinal cohort studies suggest that the association between cannabis and psychotic outcomes is not due to chance or reverse causation. However, the association could be due to bias or residual confounding. Methods that can test alternative explanations in greater depth are required. This is especially important as ecological studies have found little association between the increase in cannabis use over recent decades and incidence of psychotic disorders; public health models suggest that cannabis use may need to be treated and prevented in many thousands of users in order to prevent one case of schizophrenia. We believe that, while such uncertainty exists, there is a scientific duty to continue to investigate the role of cannabis in the aetiology of schizophrenia and that the policy case for considering cannabis exposure as a critical target for preventing schizophrenia is yet to be made. However, due to other evidence of the harms of cannabis use, this should not affect the public health message that cannabis can be harmful and that cannabis dependence should be prevented.
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Affiliation(s)
- Suzanne H Gage
- School of Social and Community Medicine, University of Bristol, Canynge Hall 39 Whatley Road, Bristol, BS8 1TU ; MRC Centre for Causal Analyses in Translational Epidemiology Oakfield House 15-23 Oakfield Grove, Bristol, BS8 2BN
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