Holes in Cigarette Filters Linked To Increase in Lung Adenocarcinomas

MedicalResearch.com Interview with:
Peter G. Shields, M.D.
Deputy Director, Comprehensive Cancer Center
James Cancer Hospital
Professor, College of Medicine
Julius F. Stone Chair in Cancer Research
The Ohio State University Columbus, OH

MedicalResearch.com: What do we know about the health effects of cigarette filters? 
Response:  The issue is that the design of the filters makes a cigarette even more dangerous, which can be regulated by the FDA. The issue is not about having a filter, but how they are made. And now we are changing the dialogue to the design of virtually all cigarettes. The holes on the filter are likely one reason the cigarettes of today are more dangerous.

MedicalResearch.com: In general terms, what did you find?

Response: The design of cigarette filters that have ventilation holes, we believe, can make cigarettes even more dangerous, because those holes can change how the tobacco burns, allows smokers to inhale more smoke and to think that the smoke is safer because it is smoother. 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. The holes have no health benefit whatsoever. 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.

MedicalResearch.com: What’s the link to adenocarcinoma of the lung rates?

Response: Available studies show that due to the holes, the smoke is changed, smokers take in bigger puffs, more smoke goes to the lungs, smoke can go deeper into the lungs where adenocarcinomas more commonly develop.

Lung adenocarcinoma, like other lung cancers, is a fatal disease for most patients, and we believe this is increased due to the holes in the filters. It is pretty clear that the only plausible explanation is changes in cigarette designs over the last 40+ years, because the evidence shows that more modern cigarettes are more risky for lung cancer. There are reasons in addition to the holes that also can contribute to the increasing risk, but one does not preclude the other, it does not matter if one is more important than the other, and actually multiple cigarette designs could be regulated to address all the possible reasons.

MedicalResearch.com: What else would you like to add?

Response: It is important to note that we are not saying to remove filters, only to change their designs by removing the holes on the filters. The tobacco companies do not need to wait for regulation. They did not wait when they introduced the holes into the filters.

An important message is that we are not suggesting that smokers switch to less ventilated cigarettes, because they are all very dangerous.


Cigarette Filter Ventilation and its Relationship to Increasing Rates of Lung Adenocarcinoma.
Song MA, Benowitz NL, Berman M, Brasky TM, Cummings KM, Hatsukami DK, Marian C, O’Connor R, Rees VW, Woroszylo C, Shields PG.
J Natl Cancer Inst. 2017 Dec 1;109(12). doi: 10.1093/jnci/djx075.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on May 22, 2017 by Marie Benz MD FAAD