Professional Documents
Culture Documents
Emergency Response and Air ABSTRACT benzene, a known human carcinogen.8 Many of
Toxicants Branch, Division of Of the chemicals identified to date in mainstream the less volatile components, including the PAHs,
Laboratory Sciences, National
cigarette smoke with known toxicological properties, the metals and TSNAs, are associated with cigarette
Center for Environmental Health,
Centers for Disease Control and volatile organic compounds (VOCs) are considered the smoke particulate matter and contain potent
Prevention, Atlanta, Georgia, most hazardous group owing to their high abundance and carcinogens such as benzo[a]pyrene, cadmium,
USA toxicity. In this research we evaluate a recently introduced N’-nitrosonornicotine (NNN) and 4-(methylnitro-
line of cigarettes that contain charcoal in their filters. The samino)-1-(3-pyridyl)-1-butanone (NNK). Chronic
Correspondence to:
Gregory M Polzin, 4770 Buford amount of charcoal in these filters ranged from 45 mg to exposure to these and other compounds is what
Highway, NE, Atlanta, GA 180 mg and were either dispersed among the filter constitutes the inherent health risks associated
30341, USA; GPolzin@cdc.gov material or contained in a small cavity in the filter with smoking.
segment. Charcoal has long been used for removing VOCs But which chemical species are most responsible
Received 25 June 2007 from both water and air. Our findings indicate that these for smoking’s adverse health consequences is a
Accepted 1 December 2007
cigarettes reduce machine generated mainstream smoke matter of some debate. Much work has focused on
deliveries of a wide range of VOCs compared to a similar, the potent carcinogenic TSNAs.4 These compounds
non-charcoal filtered, cigarette. However, this reduction is merit concern because NNN contributes to cancers
dependent not only on the amount of charcoal present but of the upper aero-digestive tract, while NNK has
also on the volume of smoke being drawn through the been linked to adenocarcinoma much deeper in the
filter. While a brand with 45 mg charcoal reduces VOC lungs.9 Increased exposure to such smoke consti-
delivery under ISO smoking conditions, charcoal saturation tuents is associated with higher disease prevalence,
and breakthrough occur under more intense smoking prompting researchers to examine both the toxi-
conditions. Breakthrough is minimised for brands with the city of individual chemicals and their relative
most charcoal. Overall, the brands with the most charcoal abundance in smoke. Fowles and Dybing10 used
are effective at reducing VOC deliveries under even available toxicity indices in combination with
intense smoking conditions. standardised machine-smoked constituent levels
to rank chemicals in mainstream smoke by their
toxicity. They concluded that many toxic chemi-
Despite decades of public and private anti-smoking cals present in the volatile phase of cigarette smoke
campaigns, cigarette smoking remains the leading dominate the hazard risk indices. Such risk
cause of preventable deaths in the United States. calculations are, however, typically based on
Each year an estimated 440 000 people in the machine smoke yields—known to underestimate
United States1 and over five million throughout the deliveries of modern cigarettes—as a predictor for
world2 die from smoking-related illnesses. human exposure.11 Moreover, these relative rank-
Although nicotine is the primary source of tobacco ings could shift somewhat depending on the
dependence,3 many other chemical constituents in mainstream smoke concentrations of specific che-
mainstream cigarette smoke are causative agents micals from different machine smoking regimens10
for cancer, heart disease and birth defects.4 or from an individual’s smoking behaviour.
Mainstream cigarette smoke comprises more than Removal of the chemicals produced by the
4000 compounds,5 6 many of which are classes of combustion of the tobacco during cigarette smok-
toxic chemicals such as harmful gases, volatile ing has been addressed over the years by the
organic compounds (VOCs), polycyclic aromatic inclusion of an activated charcoal filter. Activated
hydrocarbons (PAHs), metals and metalloids and charcoal is formed from carbonaceous materials
tobacco-specific nitrosamines (TSNAs). The pre- and, having an extremely high surface area, allows
sence of these and other toxic chemicals has adsorption and entrapment of chemicals within
resulted in the International Agency for Research the porous structure of the carbon matrix.
on Cancer (IARC) classifying cigarette smoke as a Activated charcoal has a wide variety of uses,
group 1 carcinogen.2 ranging from the treatment of orally ingested
Exposure to certain toxic chemicals and chemical poisons,12 removal of contaminants from water13
classes in tobacco smoke has been linked to adverse and removal of chemicals from industrial gas
health outcomes in both people and laboratory streams.14 In mainstream smoke deliveries, char-
animals. For example, cigarette smoke includes coal-filtered cigarettes have been shown to sig-
large quantities of gaseous species such as carbon nificantly reduce many volatile components.15–20
monoxide (CO)—a cardiovascular toxin7—and Filtered cigarettes containing activated charcoal
many other highly volatile compounds including have been commercially available in the United
States since the RJ Reynolds Tobacco Company’s 1954 Cigarettes for testing
introduction of its Tareyton brand. Charcoal-filtered cigarettes Charcoal-filtered and traditional cigarettes were obtained from
held a US market share as high as 6% in the 1960s. A steady the test markets. Brands A and C were purchased in Atlanta,
decline over the years has, however, resulted in charcoal filters GA. Brands B, D and E were obtained in Bismarck, ND, Tampa,
capturing less than 1% of today’s US cigarette market. While Florida, and Salt Lake City, Utah, respectively. All cigarettes
charcoal-filtered cigarettes are today less common in the United were stored in their original packaging at 270uC until needed.
States, smokers in several countries, including Japan, Korea, For at least 24 hours before smoking, the cigarettes were
Venezuela and Hungary, predominantly favour charcoal-filtered conditioned in an environmental chamber (Parameter
cigarettes; in these markets, shares approach 90%.21 22 Generation Control, Inc, Black Mountain, North Carolina,
Yet the question of whether charcoal filters actually reduce USA) maintained as specified in ISO 3402:1999 at a temperature
exposure to harmful chemicals in cigarette smoke remains open. of 22uC, with 60% relative humidity.
Indeed, there is a lack of conclusive data that charcoal filtration
reduces risk of smoking-related diseases.23 24 Still, several
researchers have speculated that such reductions would be
Smoking conditions
prudent as a means of reducing exposure to many toxic After conditioning the cigarette, filter ventilation levels were
chemicals in smoke.25 26 Because so many factors contribute to measured using a QTM-5 filter ventilation and pressure-drop
cancer and heart disease (for example, smoking, diet, environ- apparatus (Cerulean, Milton Keynes, UK). Cigarettes were
ment and genetics) none of these studies have conclusively smoked using three different smoking regimens; the ISO
demonstrated that charcoal-filtered cigarettes reduce the inci- 3308:2000 regimen (35 ml puff of 2-second duration every
dence of smoking-related illness. Although no definitive 60 seconds), the Massachusetts regimen (45 ml puff of 2-second
population data have shown a clear decrease in cancer rates, duration every 30 seconds with the filter ventilation holes 50%
researchers have demonstrated that smokers of charcoal-filtered obstructed) and the Health Canada Intense regimen (55-ml puff
cigarettes do demonstrate significant reductions in many of 2-second duration every 30 seconds with the filter ventilation
exposure biomarkers27 although their exposure to nicotine and holes 100% obstructed) on an automated linear 16-port ASM
CO was not reduced. Nevertheless, given that charcoal-filtered 500 smoking machine (Cerulean, Milton Keynes, UK) to a butt
cigarettes have shown promising reductions in associated length of either filter +8 mm or filter paper overwrap +3 mm,
exposure biomarkers linked to exposure to VOCs in mainstream whichever was greater.
cigarette smoke, there is great interest in exploring this
technology for emission reductions.28 Nicotine determination
We noted that one major US cigarette manufacturer recently Mainstream smoke nicotine deliveries were determined from
began test marketing four different dual-component cigarette extraction of the CFP in 2-propanol. Nicotine levels in the
filters with activated charcoal in one of the components and extracts were analysed and quantified using gas chromatogra-
cellulose acetate in the other. The manufacturer markets these phy with flame ionisation detection as previously reported.29
prototype products under its flagship brand name and many
design features are comparable to its popular, similarly named,
cellulose-acetate filtered, ‘‘ultralight’’ cigarette. All of these VOC determination
prototypes have filter ventilation levels, ‘‘tar’’ and nicotine The vapour-phase portion of mainstream cigarette smoke was
deliveries that are comparable to the non-charcoal-filtered collected in individual 1-litre PVF bags attached directly ASM
ultralight variety. The prototype brands make no external 500 puffing engines’ exhaust ports as previously described.30 To
package reference to charcoal-containing filters, nor do they reduce background and sample carryover, 30 blank puffs per
make any claims regarding delivery reductions or health port were taken before attaching the PVF bags. Before smoking,
benefits. Thus to examine the effectiveness of charcoal filtration an internal standard solution was added to each 1-litre PVF bag
for reducing vapour phase VOC levels in mainstream cigarette using a gas-tight syringe. After smoking, portions of the smoke
smoke, we measured the four prototypes’ key physical design samples were transferred from the PVF bags via cannula to
properties and mainstream smoke deliveries. The similarity in evacuated 20-ml headspace vials (Microliter Corporation,
these designs gave a basis by which to evaluate how changes in Atlanta, Georgia, USA). The headspace vials were subsequently
charcoal filter designs may impact the delivery of vapour phase loaded on a Combi-Pal auto sampler (Leap Technologies,
VOCs. Carrboro, North Carolina, USA) equipped with a 75-mm
Carboxen-PDMS SPME fibre for sample preconcentration and
transferred to the heated inlet of a 6890 gas chromatograph
METHODS coupled to a 5973 mass spectrometer (Agilent Technologies,
Materials Palo Alto, California, USA). The smoke samples were incubated
We purchased all target compounds from Aldrich Chemical Co at 30uC for 2 minutes then sampled with the SPME fibre for
(Milwaukee, Wisconsin, USA). Methanol was purchased from 30 seconds. Analytes desorbed from the fibre at 260uC in the
Tedia Company Inc (Fairfield, Ohio, USA). The ultra-high GC’s heated sample inlet were cryo-focused on an Agilent DB-
purity gas helium was obtained from AirGas, Inc (Atlanta, 624 capillary column (30.0 m 6 320 mm 6 1.80 mm) head.
Georgia, USA). Glass fibre filters, 44 mm diameter, commonly Constant helium flow was maintained at an average linear
referred to as Cambridge filter pads (CFP) were purchased from velocity of 46 cm/s. The GC oven programme started at 220uC,
Whatman (Maidstone, UK). Tedlar brand PVF gas sampling held for 2 minutes and ramped to 200uC at 8uC/min, for a total
bags, carboxen-polydimethylsiloxane (Carboxen-PDMS) solid- run time of 29.50 minutes. The GC transfer line was
phase microextraction (SPME) fibres and Mininert septum caps maintained at a temperature of 255uC and the MS source and
were purchased from Supelco (Bellefonte, Pennsylvania, USA). quadrupole temperatures were 230uC and 150uC, respectively.
All chemicals and solvents were used without further purifica- Data were acquired in full-scan mode over a detection range
tion. spanning 30–200 mass-to-charge units.
Brand A 27 45 0.58 0
Brand B 27 45 0.59 45
Brand C 27 44 0.56 45
Brand D 33 43 0.50 120
Brand E 33 46 0.54 180
Table 2 Mainstream smoke constituent deliveries for brands in this study measured under ISO (35 ml puff,
2-second duration, 60 seconds between puffs), Massachusetts (45 ml puff, 2-second duration, 30 seconds
between puffs, ventilation holes 50% obstructed), or Health Canada (55 ml puff, 2-second duration,
30 seconds between puffs, ventilation holes 100% obstructed) regimens
Analyte (units) Brand ISO Massachusetts Health Canada
the levels in the vapour phase of mainstream smoke remain US charcoal-filtered cigarettes and popular Japanese filtered
significantly different between brand A and brands B-E at all cigarettes. Brand E’s charcoal cavity design has appeared in
smoking regimens. other commercial cigarette brands and is available from several
manufacturers.
With the similarities among all five brands, it was not
DISCUSSION surprising that the ISO machine- smoked deliveries of tar,
The non-charcoal-filtered brand A served as a reference for nicotine and carbon monoxide (TNCO) differed only slightly.
comparison to brands B–E because, excluding filter construc- Differences in TNCO values were small compared to the
tion, A has similar physical properties (for example, length, dramatic differences observed for the vapour phase VOCs.
diameter and filter ventilation). Visual comparison of brand A Statistical analysis (general linear model) established a correla-
and B packs or individual intact cigarettes showed no tion between carbon monoxide (p,0.003) and nicotine
differences. Brand C cigarettes contained a similar charcoal (p,0.02) to tobacco filler weight. Tar, however, correlated
filter to brand B (fig 1) and were visually similar to brand A and poorly (p,0.3) with tobacco weight. The average tar and CO
B cigarettes. The filters of brands D and E had distinct design deliveries were slightly lower in the smoke of cigarettes with
differences. Brand D had a longer charcoal-containing segment longer filters and higher charcoal content (brands D and E).
and brand E contained a pocket or cavity containing charcoal Their longer filter lengths displaced several millimetres of
granules. The filters of cigarette brands B, C and D were visually tobacco rod length, resulting in an average of 1.3 fewer puffs
similar and resembled the charcoal-on-tow style filters in other per cigarette (,15% less smoke volume) under all smoking
Figure 2 Total volatile organic compounds (VOC) deliveries for all five
brands under ISO (35 ml puff, 2-second duration, 60 seconds between
puffs), Massachusetts (45 ml puff, 2-second duration, 30 seconds
between puffs, ventilation holes 50% obstructed), or Health Canada
(55 ml puff, 2-second duration, 30 seconds between puffs, ventilation
holes 100% obstructed) regimens. Results are reported as the average of
three observations.
misleading data, suggesting to smokers that using these VOCs in both air and water. Yet in all of these commercial and
products may reduce their exposure to VOCs no matter how domestic applications, because charcoal actively absorbs VOCs
these cigarettes are smoked. Because brands A–E are all high- over time it becomes saturated, thus necessitating filter
ventilation cigarettes, smokers are likely to smoke these more replacement or regeneration. One concern arising from use of
intensely to obtain the nicotine they crave and overcome any an active filtration agent such as charcoal in cigarette filters is a
benefit that could occur from reduced delivery of volatiles.10 11 reduction in efficiency from the absorption of volatile chemical
Such observations underscore the need for testing tobacco species such as those associated with pack aroma over time.
products under a broad range of usage patterns to understand Ceschini examined this phenomenon in detail and found that
fully if particular cigarette design change can achieve mean- after an initial loss (,20–30%) in the capacity of activated
ingful reductions for smokers under a range of smoking charcoal during the first two weeks, the filters’ effectiveness
conditions. remained consistent up to 6 months.33 Consistent with
A more appropriate means for comparing brands is to Ceschini’s findings, in our own work, over a 12-week period
normalise vapour phase mainstream smoke VOC deliveries between initial receipt and the completed analysis of these
with nicotine. After adjusting for nicotine delivery or when cigarette packs, we noticed no change in the efficiency of the
smoked under a more intense regimen, the majority of standard charcoal filters.
US domestic king-sized filtered cigarettes, regardless of filter In accordance with statements by the US Surgeon General,34
ventilation, deliver comparable levels of these VOCs.30 This is toxic compounds in cigarette smoke should be removed or their
important because, as smokers require sufficient dosages to levels should be reduced to the lowest possible values. We do
satisfy their nicotine cravings, users of highly ventilated brands not know whether a reduction in mainstream smoke VOC
usually compensate by taking larger or more frequent puffs or levels would influence the adverse health effects associated with
by blocking vent holes, resulting in higher inhalation of toxic smoking. If sufficient charcoal is used, charcoal filters have the
mainstream smoke constituents.32 Comparing nicotine-normal- potential to reduce VOC levels in mainstream smoke under
ised VOC levels from the charcoal-filtered brands B–E to the some machine smoking conditions, but little or no reduction
non-charcoal-filtered brand A indicated that when smoked was seen for other, less volatile harmful constituents. Charcoal-
under ISO conditions, the nicotine-normalised VOC levels from filtered cigarettes with reduced mainstream smoke VOC
harmful compounds such as acrolein and benzene were reduced deliveries cannot be considered ‘‘safer’’ and there is a significant
by charcoal filtration (fig 3). Under more intense smoking risk of the public making such conclusions as happened
regimens, brands B and C, which contained less charcoal, had previously with ‘‘light’’ cigarettes.32 Although a cigarette filter
nicotine-normalised VOC deliveries similar to those of the non- with sufficient charcoal achieves reduced VOC levels in main-
charcoal brand (A). Brands D and E, however, with higher stream smoke, there would not be a corresponding reduction in
charcoal levels, maintained significant reductions. Such beha- sidestream cigarette smoke. Therefore, the VOC exposure from
viour demonstrates that enough charcoal needs to be present in sidestream smoke for the active or any passive smokers would
the cigarette filters to prevent breakthrough and to maintain not be reduced.
reductions of VOCs in mainstream smoke. Preliminary results indicate that levels of other important
Brands D and E, with their higher charcoal content, were in but less volatile toxic constituents (for example, TSNAs,
fact superior at reducing vapour phase mainstream smoke PAHs) are not affected or are reduced to a lesser extent than
VOC deliveries. When these brands were test-marketed, no the VOCs examined here. Considerations involving the net
indication was revealed of which variant was available in each effects of all toxic smoke constituents are important when
location. The prototype brands were identically labelled and, drawing conclusions about the potential for reduced main-
presumably, consumers had no knowledge of whether a stream smoke deliveries and any resulting change in toxicity.
recently introduced brand contained high or low charcoal In fact, a recent article indicated that a charcoal filtered
amounts. Even a consumer knowingly smoking a charcoal- cigarette may have no less of a ‘‘harm index’’ when compared
filtered cigarette may not realise that their smoking behaviour in a nicotine normalised manner.20 Any efforts aimed at
can substantially reduce the efficiency of the filter. This study reducing risks must consider how people smoke—both in
also highlights the importance of consumers and public health terms of the toxicity levels delivered under such conditions
decision-makers knowing which of the various test market and in terms of whether any design changes actually produce a
cigarette configurations is selected to be sold nationally and reduced exposure or only a false sense of safety. To the best of
what compromises are made to produce a commercially our knowledge, currently no data show that selectively
acceptable product. For example, if the results for brand D reducing specific chemicals from smoke reduces a smoker’s
using the ISO method were used to promote a total VOC risk. Scherer et al27 found reduced body burden of mainstream
reduction for this product, but brand C was the one that was smoke volatiles among smokers of charcoal-filtered cigarettes.
actually marketed, this would be deceptive to both smokers Such findings are encouraging and they suggest possibilities
and to public health officials. may exist for reduced exposure through cigarette design
Activated charcoal filtration is a well accepted means for improvements. When it is technically feasible and relatively
removing VOC contamination from air and water. When easy to do so, manufacturers should be encouraged to remove
present in sufficient quantities it has great utility for reducing harmful chemicals from smoke. In the meantime, cessation
VOCs in mainstream cigarette smoke under the most intense remains the only proved means of reducing the risks associated
smoking conditions. The use of activated charcoal for filtration with cigarette smoking.
and purification of air streams encompasses a wide range of
Competing interests: None.
applications—from large industrial scrubbers to personal
respirator masks. Additionally, water treatment plants use Disclaimer: Use of trade names is for identification only and does not imply
endorsement by the Centers for Disease Control and Prevention or by the US
activated charcoal for filtration and charcoal filters are sold for Department of Health and Human Services. The findings and conclusions in this
home water purification. The effectiveness of these products report are those of the author(s) and do not necessarily represent the views of the
has routinely been demonstrated as an effective means to reduce Centers for Disease Control and Prevention.
REFERENCES 17. Cundiff RH. Analytical research; Markunas, PC; Unk. ‘‘the Spectrophotometric
1. Centers for Disease Control and Prevention. Annual smoking-attributable Determination of Hydrogen Cyanide in Cigarette Smoke.’’. 11 May 1964. Bates:
mortality, years of potential life lost and economic costs—United States, 1995–1999. 500963767–500963782.http://tobaccodocuments.org/rjr/500963767-3782.html
Morb Mort Wkly Rep 2002;51:300. Accessed 11/06.
2. International Agency for Research on Cancer. IARC monographs on the 18. British American Tobacco Company. 54 page document. No date. Bates:
evaluation of the carcinogenic risk of chemicals to humans. IARC: Lyon, France, 402368992–402369045.http://tobaccodocuments.org/guildford_misc/402368992-
2002;83. 9045.html Accessed 11/06.
3. US Department of Health and Human Services. The health consequences of 19. Xue L, Thomas CE, Koller KB. Mainstream smoke gas phase filtration performance of
smoking: nicotine addiction: a report of the Surgeon General; DHHS Publication No adsorption materials evaluated with a puff-by-puff multiplex GC-MS method. Beitr
(CDC) 88–8406; Center for Health Promotion and Education, Office on Smoking and Tabakforsch Int 2002;20:251–6.
Health: Rockville, MD, 1988. 20. Laugesen M, Fowles J. Marlboro UltraSmooth: a potentially reduced exposure
cigarette? Tob Control 2006;15:430–5.
4. Hoffmann D, Hoffmann I. The changing cigarette, 1950–1995. J Toxicol Environ
21. John AL. Japan. Always something new. Tob Int 1996 August:30–35.
Health 1997;50:307.
22. Fisher B. Filtering new technology. Tob Reporter 2000;127:46–7.
5. Stedman RL. The chemical composition of tobacco and tobacco smoke. Chem Rev
23. Marugame T, Sobue T, Nakayama T, et al. Filter cigarette smoking and lung cancer
1968;68:153.
risk; a hospital-based case-control study in Japan. Br J Cancer 2004;90:646–51.
6. Roberts DL. Natural tobacco flavor. Recent Adv Tobacco Sci 1988;14:45.
24. Muscat JE, Takezaki T, Tajima K, et al. Charcoal cigarette filters and lung cancer risk
7. US Department of Health and Human Services. The health consequences of in Aichi Prefecture, Japan Cancer Sci 2005;96:283–7.
smoking: cardiovascular disease. A report of the Surgeon General, 1983. Rockville, 25. Djordjevic MV, Stellman SD, Zang E. Doses of nicotine and lung carcinogens
MD: Public Health Service, Office on Smoking and Health, 1983 (DHHS Publication No delivered to cigarette smokers, J Natl Cancer I 2000;92:106–11.
(PHS) 84–50204) 26. Stellman SD, Takezaki T, Wang L, et al. Smoking and lung cancer risk in American
8. National Toxicology Program. Report on carcinogens, 10th ed. Research Triangle and Japanese men: an international case-control study. Cancer Epidemiol Prev
Park, NC: US Department of Health and Human Services, Public Health Service, 2001;10:1193–9.
National Institutes for Health, 2002. 27. Scherer G, Urban M, Engl J, et al. Influence of smoking charcoal filter tipped
9. Hecht SS. Biochemistry, biology, and carcinogenicity of tobacco-specific N- cigarettes on various biomarkers of exposure, Inhal Toxicol 2006;18:821–9.
nitrosamines. Chem Res Toxicol 1998;11:559–603. 28. Laugesen M, Fowles J. Scope for regulation of cigarette smoke toxicity: the case for
10. Fowles J, Dybing E. Application of toxicological risk assessment principles to the including charcoal filters. N Z Med J 2005;118:U1402.
chemical constituents of cigarette smoke. Tob Control 2003;12:424. 29. Calafat AM, Polzin GM, Saylor J, et al. Determination of tar, nicotine, and carbon
11. Kozlowski LT, Rickert WS, Pope MA, et al. Estimating the yield to smokers of tar, monoxide yields in the mainstream smoke of selected international cigarettes, Tob
nicotine, and carbon-monoxide from the lowest yield ventilated filter-cigarettes. Control 2004;13:45–51.
Br J Addict 1982;77:159. 30. Polzin GM, Kosa-Maines RE, Ashely DL, et al. Analysis of volatile organic compounds
12. Bond GR. The role of activated charcoal and gastric emptying in gastrointestinal in mainstream cigarette smoke. Environ Sci Technol 2007;4:1297–302.
decontamination: a state-of-the-art review. Ann Emerg Med 2002;39:273–86. 31. Taylor JK. Quality assurance of chemical measurements. Boca Raton, FL: CRC Press,
13. Yu JJ, Chou SY. Contaminated site remedial investigation and feasibility removal of 1987.
chlorinated volatile organic compounds from groundwater by activated carbon fiber 32. Burns DM, Major JM, Shanks TG, et al. Risks associated with smoking cigarettes
adsorption. Chemosphere 2000;41:371–8. with low machine-measured yields of tar and nicotine; Smoking and Tobacco Control
14. Ruddy EN, Carroll LA. Select the best VOC control strategy. Chem Eng Prog Monograph 13; NIH Publication 02–5074. Bethesda, MD: US Department of Health
1993;89:28–35. and Human Services, National Institutes of Health, National Cancer Institute,
15. Steinik M, Smith M. The path to a safer cigarette. Advance Lights. Trionic filter. 2000:65–158.
Global Equity Research, JP Morgan, 28 July 2004. Packet insert. 33. Ceschini P. Decrease of the carbon retention capacity in cigarette filters. Beitr
16. Lorillard L, Ihrig AM. ‘‘The selective removal of aldehydes from cigarette smoke’’. 20 Tabakforsch Int 1972;6:220–2.
Feb 1980. Bates: 80007395-80007421.http://tobaccodocuments.org/lor/80007395- 34. Centers for Disease Control and Prevention. Reducing tobacco use: a report of
7421.html. Accessed Nov 2006. the surgeon general. Atlanta, GA: Office on Smoking and Health, 2000.