Randomized Crossover Clinical Trial of Unfiltered Cigarettes

In the mid-1960s, the US Surgeon General judged cigarette filters to be ‘unproved in reducing harms to the average smoker.’ Recent epidemiological data shows that overall mortality as well as the incidence of lung cancer, heart disease, and chronic obstructive pulmonary disease increased over time suggesting that the wide scale adoption of filtered cigarettes increased rather than decreased the risks of smoking. In addition, the discarded plastic filters may be an important source of environmental pollution. Many smokers continue to believe that filtered cigarettes are safer than unfiltered cigarettes, despite evidence to the contrary. This innovative research project assesses the acceptability among committed smokers of switching to unfiltered cigarettes from filtered cigarettes and compares the doses of nicotine and carcinogens after such a switch from filtered to unfiltered cigarettes. The project will involve a cross-over clinical trial among smokers to determine changes in their puffing behavior, carcinogen exposures, nicotine exposure, and attitudes toward smoking unfiltered cigarettes if they were no longer able to buy filtered cigarettes. Such research may inform regulatory policy regarding the possibility of banning filters from the U.S. cigarette market because they encourage uptake of smoking and discourage cessation.