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Carroll DM, Tessier KM, Cummings KM, O'Connor RJ, Reisinger S, Shields PG, Stepanov IS, Luo X, Hatsukami DK, Rees VW. Risk perceptions and continued smoking as a function of cigarette filter ventilation level among US youth and young adults who smoke. Tob Control 2023; 32:473-479. [PMID: 34857645 PMCID: PMC9160200 DOI: 10.1136/tobaccocontrol-2021-056833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 11/11/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND While evidence demonstrates that the industry's marketing of cigarettes with higher filter ventilation (FV) misleads adults about their health risks, there is no research on the relationships between FV, risk perceptions and smoking trajectories among youth (ages 12-17) and young adults (ages 18-24). METHODS Data on FV levels of major US cigarette brands/sub-brands were merged with the Population Assessment of Tobacco and Health Study to examine whether FV level in cigarettes used by wave 1 youth/young adults (n=1970) predicted continued smoking at waves 2-4, and whether those relationships were mediated by perceived risk of their cigarette brand. FV was modelled based on tertiles (0.2%-11.8%, low; 11.9%-23.2%, moderate; 23.3%-61.1%, high) to predict daily smoking, past 30-day smoking and change in number of days smoking at successive waves. RESULTS The odds of perceiving one's brand as less harmful than other cigarette brands was 2.21 times higher in the high versus low FV group (p=0.0146). Relationships between FV and smoking outcomes at successive waves were non-significant (all p>0.05). CONCLUSION Youth and young adults who use higher FV cigarettes perceived their brand as less harmful compared with other brands. However, level of FV was not associated with continued smoking.
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Affiliation(s)
- Dana Mowls Carroll
- Division of Environmental Health Sciences, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | | | - K Michael Cummings
- Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Sarah Reisinger
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Peter G Shields
- James Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Irina S Stepanov
- Division of Environmental Health Sciences, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Xianghua Luo
- School of Public Health, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Dorothy K Hatsukami
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Vaughan W Rees
- Department of Social and Behavioral Sciences, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
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Hatsukami DK, Carroll DM. Tobacco harm reduction: Past history, current controversies and a proposed approach for the future. Prev Med 2020; 140:106099. [PMID: 32335031 PMCID: PMC7581601 DOI: 10.1016/j.ypmed.2020.106099] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/15/2020] [Accepted: 04/18/2020] [Indexed: 01/29/2023]
Abstract
Tobacco harm reduction remains a controversial topic in tobacco control. Tobacco harm reduction involves providing tobacco users who are unwilling or unable to quit using nicotine products with less harmful nicotine-containing products for continued use. The skepticism towards harm reduction is based in part on the experience with low-yield tar/nicotine cigarettes, which were presumed to be associated with lower health risks than higher yield cigarettes and marketed as such by cigarette manufacturers. Only later did the field learn that these cigarettes were a deceptive way for cigarette manufacturers to allay the health concerns over cigarette smoking. Since this experience, there has been a proliferation of tobacco products that might potentially serve as a means to reduce tobacco harm. Some members of the tobacco control community believe that these products have great potential to reduce mortality and morbidity among smokers who completely switch to them. Others believe that we will be addicting another generation to tobacco products. This paper reviews the past history, the current tobacco landscape and controversies, and an approach that might rapidly reduce the yearly half-million deaths associated with cigarette smoking in the U.S.
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Affiliation(s)
- Dorothy K Hatsukami
- Masonic Cancer Center and Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States.
| | - Dana M Carroll
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, United States
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Carroll DM, Stepanov I, O'Connor R, Luo X, Cummings KM, Rees VW, Bickel WK, Berman ML, Ashley DL, Bansal-Travers M, Shields PG, Hatsukami DK. Impact of Cigarette Filter Ventilation on U.S. Smokers' Perceptions and Biomarkers of Exposure and Potential Harm. Cancer Epidemiol Biomarkers Prev 2020; 30:38-44. [PMID: 33093163 DOI: 10.1158/1055-9965.epi-20-0852] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/24/2020] [Accepted: 10/14/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Relationships between cigarette filter ventilation levels, biomarkers of exposure (BOE) and potential harm (BOPH), and harm perceptions were examined. METHODS Filter ventilation levels in cigarette brands were merged with Wave 1 (2013-2014) Population Assessment of Tobacco Use and Health study. Data were restricted to smokers who reported a usual brand and not regular users of other tobacco products. BOEs included nicotine, tobacco-specific nitrosamines, volatile organic compounds (VOC), and polycyclic aromatic hydrocarbons. BOPHs measured inflammation and oxidative stress. Perceived harm was assessed as self-reported risk of one's usual brand compared with other brands. RESULTS Filter ventilation ranged from 0.2% to 61.1% (n = 1,503). Adjusted relationships between filter ventilation and BOE or BOPH were nonsignificant except for VOC N-acetyl-S-(phenyl)-L-cysteine (PHMA) and high-sensitivity C-reactive protein (hsCRP). In pairwise comparisons, PHMA was higher in quartile (Q) 4 (4.23 vs. 3.36 pmol/mg; P = 0.0103) and Q3 (4.48 vs. 3.36 pmol/mg; P = 0.0038) versus Q1 of filter ventilation and hsCRP comparisons were nonsignificant. Adjusted odds of perceiving one's own brand as less harmful was 26.87 (95% confidence interval: 4.31-167.66), 12.55 (3.01-52.32), and 19.18 (3.87-95.02) times higher in the Q2, Q3, and Q4 of filter ventilation compared with Q1 (P = 0.0037). CONCLUSIONS Filter ventilation was not associated with BOE or BOPH, yet smokers of higher ventilated cigarettes perceived their brand as less harmful than other brands compared with smokers of lower ventilated cigarettes. IMPACT Research to understand the impact of this misperception is needed, and remedial strategies, potentially including a ban on filter ventilation, are recommended.
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Affiliation(s)
- Dana M Carroll
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
| | - Irina Stepanov
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Richard O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Xianghua Luo
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - K Michael Cummings
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Vaughan W Rees
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Warren K Bickel
- Fralin Biomedical Research Institute of Virginia Tech, Roanoke, Virginia
| | - Micah L Berman
- College of Public Health and Moritz College of Law, The Ohio State University, Columbus, Ohio
| | - David L Ashley
- Department of Population Health Sciences, Georgia State University, Atlanta, Georgia
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Peter G Shields
- Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, Ohio
| | - Dorothy K Hatsukami
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota
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Abstract
Objectives Characterize physical design features of cigarette brands sold in the US according to the delivery method of menthol that may affect sensory perception among users. Methods Twelve cigarette brands, mentholated and non-mentholated, were purchased for analyses of the physical design characteristics, quantification of nicotine and menthol, and identification of flavor additives. Results Physical design characteristics did not differ significantly between the various cigarette brands. However, significant differences were seen in levels of menthol. Menthol levels were greatest in products that had dual delivery methods of menthol (6.7mg/cigarette; SE=0.27) followed by products mentholated in a filter capsule only (5.7mg/cigarette; SE=0.25), and those mentholated in the tobacco only (3.8mg/cigarette; SE=0.12); products that were not mentholated had the least (0.38mg/cigarette; SE=0.31). Finally, flavor additives with a mint flavor profile other than menthol were identified, such as pulegone and limonene, and differed between cigarette brands, which are likely contributing to the menthol flavor experience associated with use of these products. Conclusions The regulation of menthol delivery method, flavorings added to the capsule, and/or menthol concentration may be beneficial for the public health as these factors are likely creating unique sensory experiences.
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Caruso RV, Fix BV, Thrasher JF, Cummings KM, Fong GT, Stephens WE, O'Connor RJ. Differences in cigarette design and metal content across five countries: results from the International Tobacco Control (ITC) Project. TOB REGUL SCI 2016; 2:166-175. [PMID: 32864393 PMCID: PMC7453336 DOI: 10.18001/trs.2.2.7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The current study examines physical cigarette design characteristics and tobacco metal content of cigarettes obtained from 5 countries to determine how these properties vary for cigarette brands, both within and across countries with different dominant manufacturers. METHODS Cigarette packs were collected from International Tobacco Control Policy Evaluation Survey (ITC) participants in the U.S., the U.K., Mauritius, Mexico, and Thailand. Cigarettes were assessed for physical and design properties (eg, ventilation, pressure drop, rod density, weight) by published methods, and for metal content (As, Cd, Ni, Pb) by X-ray fluorescence spectrometry. RESULTS Significant differences in cigarette design and toxic metal concentrations were observed between countries and between manufacturers within countries. Filter ventilation, which is strongly predictive of machine-measured tar and nicotine levels, varied most widely across countries. Ni and Cd were highest in Thailand (2.23ug/g and 1.64ug/g, respectively); As was highest in Mexico (0.29ug/g) and Pb was highest in the U.K. (0.43 ug/g). CONCLUSIONS Parties to the FCTC should consider the adoption of uniform product standards related to cigarette design, emissions, and tobacco content that would reduce population health risks.
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Affiliation(s)
- Rosalie V Caruso
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY
| | - Brian V Fix
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY
| | - James F Thrasher
- University of South Carolina, Department of Health Promotion, Education, and Behavior, Columbia, SC
| | - K Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
| | - W E Stephens
- Department of Earth and Environmental Sciences, St. Andrews University, Scotland, UK
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY
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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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O’Connor RJ, Schneller LM, Caruso RV, Stephens WE, Li Q, Yuan J, Fong GT. Toxic metal and nicotine content of cigarettes sold in China, 2009 and 2012. Tob Control 2015; 24 Suppl 4:iv55-9. [PMID: 25335903 PMCID: PMC4663972 DOI: 10.1136/tobaccocontrol-2014-051804] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 10/01/2014] [Indexed: 11/04/2022]
Abstract
BACKGROUND Metals of primary health concern can accumulate in the tobacco plant and contribute to smokers' exposures to carcinogens, a significant cause of the millions of smoking-related deaths in China each year. These exposures are due to the smoker's addiction to nicotine. OBJECTIVE This study sought to explore toxic heavy metal and nicotine concentrations in the tobacco of Chinese cigarette brands purchased in 2009 and 2012, as well as its regional variation. METHODS Cigarette packs for this study were purchased from seven Chinese cities in 2009 and 2012, and 91 pairs of cigarettes were matched based on UPC for comparison. Ten cigarette sticks were randomly selected from each pack and tested using polarised energy dispersive X-ray fluorescence (XRF) for arsenic (As), cadmium (Cd), chromium (Cr), nickel (Ni) and lead (Pb) concentrations. Nicotine analysis was conducted following Coresta's Recommended Method N°62. Data analysis was conducted using SPSS, encompassing descriptive statistics, correlations and generalised estimating equations to observe changes in brand varieties overtime. FINDINGS On average, from 2009 to 2012, As, Cd, Cr and Pb concentrations have decreased in Chinese tobacco. Of the seven cities where the cigarette brands were purchased, only four cities showed significant differences of the selected metals from 2009 to 2012. However, there was no significant change in the tobacco nicotine content from 2009 to 2012. CONCLUSIONS Tobacco in Chinese cigarettes purchased in seven geographically disbursed cities contains consistently high levels of metals, including carcinogens like Cd. One source may be the improper use of fertilisers. These numbers should be monitored more carefully and regulated by health officials.
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Affiliation(s)
- Richard J. O’Connor
- Department of Health Behavior, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA
| | - Liane M. Schneller
- Department of Health Behavior, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA
| | - Rosalie V. Caruso
- Department of Health Behavior, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA
| | - W. Edryd Stephens
- Department of Earth & Environmental Sciences, University of St Andrews, Irvine Building, North Street, St Andrews, Fife, KY16 9AL, UK
| | - Qiang Li
- Chinese Centers for Disease Control and Prevention, Beijing, China
- Department of Psychology, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Jiang Yuan
- Chinese Centers for Disease Control and Prevention, Beijing, China
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
- Ontario Institute for Cancer Research, Toronto, ON, M5G 0A3, Canada
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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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Agaku IT, Vardavas CI, Ayo-Yusuf OA, Alpert HR, Connolly GN. Gender and racial differences in smoking of long/ultra-long and king size cigarettes among U.S. adult smokers, NHANES 1999-2012. Drug Alcohol Depend 2014; 136:28-35. [PMID: 24417962 PMCID: PMC3935845 DOI: 10.1016/j.drugalcdep.2013.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 12/05/2013] [Accepted: 12/06/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cigarette rod length as a design feature may play a specific role in harm perception and tobacco use. Internal tobacco industry documents have shown targeting of females with long/ultra-long cigarettes. This study assessed trends and differences in smoking of long/ultra-long cigarettes among U.S. smokers aged ≥20 years during 1999 through 2012. METHODS Data were obtained from the 1999/2000 through 2011/2012 National Health and Nutrition Examination Survey. The proportion of current smokers who reported using long/ultra-long cigarettes during each survey year was calculated and compared using χ(2) statistics. Linear and quadratic trends during 1999 through 2012 were assessed using binary logistic regression (p<0.05). Multi-variable analyses were performed to assess current disparities in smoking of long/ultra-long cigarettes. RESULTS Despite overall declines in current smoking of long/ultra-long cigarettes during the 1999 through 2012 period (p<0.001 for both linear and quadratic trends), the proportion of smokers of long/ultra-long brands increased in recent years, with over a third (38.7%) of current smokers reporting smoking of long/ultra-long cigarettes during 2011/2012. Current smokers of long/ultra-long cigarettes were more likely to be female compared to males (aOR=3.09; 95%CI: 2.09-4.58), of black race compared to whites (aOR=2.07; 95%CI: 1.30-3.28), or aged 45-64, or ≥65 years (aOR=2.39 and 5.27, respectively), compared to 18-24 year olds. CONCLUSIONS Specific gender, age and race/ethnic characteristics of smokers of long/ultra-long cigarettes were noted, hence potentially contributing to the widening of health disparities. Cigarette rod length should be considered an important aspect of cigarette engineering/design in regulatory efforts to reduce the burden of tobacco-related disease.
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Affiliation(s)
- Israel T. Agaku
- Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, USA
| | - Constantine I. Vardavas
- Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, USA
| | - Olalekan A. Ayo-Yusuf
- Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, USA,Office of the Dean/Director, School of Oral Health Sciences, University of Limpopo, MEDUNSA campus, Pretoria, South Africa
| | - Hillel R. Alpert
- Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, USA
| | - Gregory N. Connolly
- Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, USA
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Toxic metal concentrations in cigarettes obtained from U.S. smokers in 2009: results from the International Tobacco Control (ITC) United States survey cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 11:202-17. [PMID: 24452255 PMCID: PMC3924441 DOI: 10.3390/ijerph110100202] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 11/28/2013] [Accepted: 12/02/2013] [Indexed: 11/18/2022]
Abstract
Smoking-related diseases can be attributed to the inhalation of many different toxins, including heavy metals, which have a host of detrimental health effects. The current study reports the levels of arsenic (As), cadmium (Cd), chromium (Cr), nickel (Ni), and lead (Pb) in cigarettes obtained from adult smokers participating in the 2009 wave of the ITC United States Survey (N = 320). The mean As, Cd, Cr, Ni, and Pb levels were 0.17, 0.86, 2.35, 2.21, and 0.44 µg/g, respectively. There were some differences in metal concentrations of cigarette brands produced by different manufacturers, suggesting differences in the source of tobaccos used by different companies. For Ni, there were significant pairwise differences between Philip Morris U.S. (PMUSA) and R.J. Reynolds (RJR) brands (PMUSA higher; p < 0.001), PMUSA and other manufacturer (OM) brands (PMUSA higher; p < 0.001), and RJR and OM brands (RJR higher; p = 0.006). For Cr, RJR brands had higher levels than did OM brands (p = 0.02). Levels of As, Cd, and Pb did not differ significantly across manufacturer groups (p > 0.10). Because of the variety of toxic heavy metals in cigarette tobacco, and their numerous negative health effects, metal content in cigarette tobacco should be reduced.
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