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 ¼ 1,503). Adjusted relationships between filter ventilation and BOE or BOPH were nonsignificant except for VOC N-acetyl-S-(phenyl)-Lcysteine (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 ¼ 0.0103) and Q3 (4.48 vs. 3.36 pmol/mg; P ¼ 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 ¼ 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.
Bibliographical noteFunding Information:
This work was supported by NCI of the NIH under award number P01 CA217806 (to D.K. Hatsukami and P.G. Shields), R01 CA179246 (to I. Stepanov), and K07 CA197221 (to M.L. Berman). Research reported in this article was also supported by NIH, National Research Service Award T32 DA007097 (to D.M. Carroll) and National Institute on Minority Health and Health Disparities of the NIH under award number K01MD014795 (to D.M. Carroll). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
D.M. Carroll reports grants from NIH during the conduct of the study. I. Stepanov reports grants from NCI during the conduct of the study. R. O'Connor reports grants from NIH during the conduct of the study, as well as personal fees and nonfinancial support from World Health Organization and FDA outside the submitted work. K.M. Cummings reports grants from NIH during the conduct of the study, as well as payment as an expert witness on behalf of plaintiffs in litigation against cigarette companies. V.W. Rees reports grants from NCI during the conduct of the study, as well as personal fees from expert testimony in tobacco litigation outside the submitted work. W.K. Bickel reports grants from NIH during the conduct of the study.
© 2020 American Association for Cancer Research.
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