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 In a review of research on changes in lung cancer rates, and changes
in the types of lung cancer that are most common, the study authors
argue that tiny ventilation holes in virtually all cigarettes sold
today are creating a new health risk.
"The design of cigarette filters that have ventilation can make the
cigarettes even more dangerous, because those holes can change how
the tobacco burns, allow smokers to inhale more smoke and to think
that the smoke is safer because it is smoother,” senior author Dr.
Peter D. Shields from The Ohio State University’s Wexner Medical
Center in Columbus told Reuters Health by email.
“This applies to all cigarettes, because almost all the cigarettes
on the market have the holes, not just the ones that used to be
called lights and ultra-lights,” he noted.
Although rates of lung cancer in the population have fallen with
declines in smoking overall, rates of lung cancer among smokers have
risen significantly, the researchers point out. And the type of lung
cancer associated with smoking has also shifted since the 1950s.
Rates of adenocarcinoma of the lung, the lung cancer most associated
with smoking, have more than quadrupled in men and increased
eight-fold in women along with changes in the design and composition
of cigarettes since the 1950s, the researchers write.
Shields and his team review the evidence linking cigarette filter
ventilation to these increased rates of lung cancer in a report
online May 22nd in the Journal of the National Cancer Institute.
Filter ventilation reduces the amount of tar in the cigarette smoke
when tested on smoking machines, but the increased ventilation and
slower tobacco burn result in more puffs per cigarette and more
toxic cancer-causing chemicals being inhaled by smokers, they write.
“The use of the ventilation holes yields lower tar only on a
machine,” Shields said. “Machines have nothing to do with actual
exposures in humans. The holes let them actually inhale more smoke
with more cancer-causing agents.”
Because of the claims of lower tar content, though, smokers develop
the false belief that a lower tar cigarette is a healthier
cigarette, Shields' team writes.
Increased filter ventilation also results in smaller particle size,
allowing more smoke to reach vulnerable parts of the lung.
Moreover, even though machine-measured tar and nicotine levels have
decreased over time, there has been no appreciable change in daily
nicotine intake among smokers over the past 25 years, they write.
“The evidence shows that more modern cigarettes are more risky for
lung cancer,” Shields said. “There are reasons in addition to the
holes that also can contribute to the increasing risk, but one does
not preclude the other.”
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Cigarette designs could and should be regulated to address all the
possible reasons, Shields said.
“The holes have no health benefits; they serve no health purpose,”
he explained. “They do not lower tar delivery to people. So, if they
have the potential harm, the FDA can act, even if the science is not
perfect. The FDA can require cigarette manufacturers to make filters
without the holes. This is easy and they are doing it for some
brands already.”
Having filters may indeed be safer, Shields clarified. “This study
is about the holes on the filters. We are not saying to remove
filters, only to change their designs by removing the holes on the
filters.”
“The FDA now has the authority to require the elimination of filter
ventilation, as ventilation does not serve any public health purpose
and instead provides a false promise of reduced risk,” the study
team concludes.
“This single action for banning filter ventilation by the FDA is
scientifically justified, and within its mandate to improve the
public health,” they write.
There is some precedent for the ban Shields and colleagues propose,
Jonathan M. Samet and Lilit Aladadyan, both from the Tobacco Center
of Regulatory Science at the Keck School of Medicine of USC and the
USC Institute for Global Health in Los Angeles, write in an
accompanying editorial.
The evidence gathered by Shields’ team seems strong enough to
support FDA action, and “given a lack of evidence for countervailing
harms, ending filter ventilation could be a ‘no regrets’ action that
would benefit public health,” they write.
SOURCE: http://bit.ly/2rJhNyy and http://bit.ly/2rJKjA9
J Natl Cancer Inst 2017.
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