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Table 4.7 Comparison of experimental cigarettes (yield/cigarette) a,b (from National Cancer Institute 1977c) Smoke components Unit of Non-filter Cellulose acetate Cellulose acetate Cellulose acetate measurement cigarette filter cigarette filter w/perforation filter w/perforation and highly porous paper Carbon monoxide ml 16.2 19.2 8.62 6.66 Hydrogen cyanide µg 368 296 201 109 Nitrogen oxides—NO x µg 406 438 364 224 Formaldehyde µg 36.0 20.9 31.7 21.4 Acetaldehyde µg 1040 1290 608 550 Acrolein µg 105 104 58.6 48.6 Tar mg 27.0 14.7 19.2 19.5 Nicotine mg 1.8 0.94 1.31 1.5 Phenol µg 161 61.7 122 129 Benz(a)anthracene µg 40.6 [1.40] 35.3 [2.25] 38.5 [1.88] 40.1 [1.91] Benzo(a)pyrene ng 29.9 [1.09] 19.6 [1.25] 29.2 [1.13] 23.9 [1.14] a The composition of the cigarette tobacco is identical in all four experimental cigarettes. b Numbers in square brackets = µg/dry tar.
68 THE CHANGING CIGARETTE: CHEMICAL STUDIES AND BIOASSAYS with tars obtained by the standardized machine-smoking method, with a 35-ml puff, taken once a minute over 2 s; (2) that more than 60 per cent of today’s smokers in the United States and in many developed countries smoke cigarettes with nicotine yields of only 1.2 mg or less (according to FTC standards of smoking); and (3) that most of these smokers compensate for the low nicotine delivery. Compensation and greater smoke intake is governed by the smokers’ acquired need for nicotine and, in essence, negates the intended benefits of reducing smoke yields by technical means (Russell 1976, 1980; Schultz and Seehofer 1978; Moody 1980; Herning et al. 1981; Benowitz et al. 1983; Gritz et al. 1983; Nil et al. 1986; Benowitz and Henningfield 1994; Djordjevic et al. 1995, 2000). Paper porosity Since about 1960, higher cigarette paper porosity and treatment of paper with citrate has significantly contributed to the reduction of smoke yields of several smoke components. During and in between puff drawing, porous paper enhances the outward diffusion through the paper of hydrogen, NO, CO, CO2 ,methane, ethane, and ethylene. On the other hand, it accelerates the diffusion of O2 and N2 into the tobacco column; this, in turn, causes more rapid smoldering during puff intervals (Hoffmann and Hoffmann 1997; Owens 1998). Porous cigarette paper causes a significant decrease of smoke yields of CO, hydrogen cyanide, nitrogen oxides, volatile aldehydes, yet it hardly changes the yields of tar, nicotine, benz(a)anthracene (BaA), and BaP. Importantly, the significant reduction of nitrogen oxides in the smoke of these cigarettes reduces the formation and, thus, significantly lowers the yields of volatile and tobaccospecific N-nitrosamines (TSNAs) (Brunnemann et al. 1994; Owens 1998). Cigarette construction Smoke yields of cigarettes are also dependent on physical parameters, such as length and circumference of the cigarette, and the width of the cut (number of cuts per inch) of the tobacco filler. Extending the cigarette length from 50 mm to 130 mm produces an increase in the level of oxygen in the mainstream smoke, while the absolute levels of hydrogen, carbon monoxide, methane, ethane, and ethylene decrease. The major reason for this lies in the diffusion of oxygen through the paper into the smoke stream (Terrell and Schmeltz 1970). This phenomenon is also reflected in an increased CO delivery with ascending number of puffs, because the available surface area of the paper diminishes as the cigarette is smoked. With increasing length of the cigarette, the overall yields of tar, nicotine, PAH, and other particulate components increase (DeBardeleben et al. 1978). A circumference of cigarettes smaller than the regular 24.8–25.5 mm, e.g. 23 mm or less, translates into less tobacco being burned but a greater volume of oxygen available during combustion. Thus, the smoke yields of tar, nicotine, and other particulate components are lowered (DeBardeleben et al. 1978; Lewis 1992; Brunnemann et al. 1994; Hoffmann and Hoffmann 1997). Cigarettes with a small
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Tobacco and Public Health: Science
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Tobacco and Public Health: Science
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Preface Tobacco: The public health
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PREFACE vii The cigarette companies
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dramatically. Once more, I am not s
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it impairs quality of life for year
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documents and through litigation by
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PREFACE xv it will not succeed. Now
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Stratton, K., Shetty, P., Wallace,
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Contents Preface v C. Everett Koop
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27 Tobacco and pancreas cancer 479
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Contributors Amanda Amos Reader in
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Stephen S. Hecht University of Minn
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Cecily S. Ray Project Assistant Epi
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Abbreviations AAA Abdominal aortic
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Introduction The publication of thi
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Part 1 Tobacco: History
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Introduction Chapter 1 Evolution of
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RICHARD DOLL 5 However, little atte
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RICHARD DOLL 7 lung’ (Doll and Hi
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Table 1.1 Principal diseases caused
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Table 1.4 Manufactured cigarette co
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in 1995 was approaching the maximum
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References Adler, I. (1912). Primar
Page 50 and 51: Introduction Chapter 2 The great st
Page 52 and 53: MICHAEL J. THUN AND JANE HENLEY 19
Page 54 and 55: it seems likely that some of this v
Page 56 and 57: steady increase in lung cancer occu
Page 58 and 59: cigarette smoking in deaths from co
Page 60 and 61: the effects of smoking and smoking
Page 64 and 65: Lung cancer death rate (per 100,000
Page 68 and 69: Lickint, F. (1929). Zeitschrift fur
Page 70 and 71: Chapter 3 Dealing with health fears
Page 72 and 73: LYNN T. KOZLOWSKI AND RICHARD J. O
Page 78 and 79: Table 3.3 Selected cigarette advert
Page 84 and 85: Part 2 Tobacco: Composition
Page 86 and 87: Introduction Chapter 4 The changing
Page 88 and 89: ILSE HOFFMANN AND DIETRICH HOFFMANN
Page 94 and 95: Table 4.4 (continued) Carcinogens i
Page 96 and 97: Table 4.5 Standard conditions for m
Page 114 and 115: the lung in rats treated with NNK (
Page 116 and 117: serve as the scientific basis in su
Page 124 and 125: Senkus, M. (ed.) (1976). Leaf compo
Page 126 and 127: Introduction Chapter 5 Tobacco smok
Page 128 and 129: STEPHEN S. HECHT 95 Established pul
Page 130 and 131: STEPHEN S. HECHT 97 magnitude lower
Page 132 and 133: STEPHEN S. HECHT 99 generally great
Page 134 and 135: Table 5.1 1-Hydroxypyrene in the ur
Page 136 and 137: Table 5.2 NNAL and its glucuronides
Page 138 and 139: STEPHEN S. HECHT 105 Table 5.2 (con
Page 140 and 141: Table 5.3 Representative DNA adduct
Page 142 and 143: G No (Wang et al. 2001a) N 2 CHCH 2
Page 144 and 145: STEPHEN S. HECHT 111 N-Nitrosopyrro
Page 146 and 147: (Kozack et al. 2000; Seo et al. 200
Page 148 and 149: the DNA adducts resulting from toba
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Culp, S. J., Gaylor, D. W., Sheldon
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STEPHEN S. HECHT 119 International
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STEPHEN S. HECHT 121 Melchior, W. B
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STEPHEN S. HECHT 123 Rivenso, A., H
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Wang, M., McIntee, E. J., Cheng, G.
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Part 3 Nicotine and addiction
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Chapter 6 Pharmacology of nicotine
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JACK E. HENNINGFIELD AND NEAL L. BE
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Pickworth et al. 1995; Shiffman et
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American Caucasians and Hispanics (
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(US DHHS 2001). At doses delivered
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References JACK E. HENNINGFIELD AND
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Introduction Chapter 7 Behavioral p
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BRIDGETTE E. GARRETT ET AL. 151 How
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(Fischman and Foltin 1991). Another
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following repeated, infrequent and
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BRIDGETTE E. GARRETT ET AL. 157 oth
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BRIDGETTE E. GARRETT ET AL. 159 cli
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to tobacco product ingredients and
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BRIDGETTE E. GARRETT ET AL. 163 Gom
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BRIDGETTE E. GARRETT ET AL. 165 Ris
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Introduction Chapter 8 Cigarette sc
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JEFF FOWLES AND DENNIS SHUSTERMAN 1
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◆ The pressure drop of the filter
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Nitrosamines Nitrosamines are biolo
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Physical design features of cigaret
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Introduction Chapter 9 Nicotine dos
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world tobacco burden (World Health
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Table 9.2 The ranges of nicotine, n
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MIRJANA V. DJORDJEVIC 187 turing a
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Poland 19 1.4 n.a. n.a. 68−347 36
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MIRJANA V. DJORDJEVIC 191 cigarette
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MIRJANA V. DJORDJEVIC 193 Table 9.5
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MIRJANA V. DJORDJEVIC 195 MS wherea
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MIRJANA V. DJORDJEVIC 197 In recent
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MIRJANA V. DJORDJEVIC 199 Table 9.8
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MIRJANA V. DJORDJEVIC 201 Burns, D.
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International Agency for Research o
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Part 4 Tobacco use: Prevalence, tre
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Chapter 10 Tobacco in Great Britain
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Adult smoking PATTI WHITE 209 Since
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oys who were regular smokers report
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PATTI WHITE 213 cancer, and bringin
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Introduction Chapter 11 The epidemi
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since the late 1980s. In 2001, Phil
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YANG HONGHUAN 219 ◆ Among males,
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Table 11.1 Smoking among adolescent
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(57%) was higher than in males (45%
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20 cigarettes a day had double the
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Chapter 12 Patterns of smoking in R
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DAVID ZARIDZE 229 Ignatova et al. (
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DAVID ZARIDZE 231 Tyumen, respectiv
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References DAVID ZARIDZE 233 Alexee
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Chapter 13 Tobacco smoking in centr
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WITOLD ZATOŃSKI 237 The developmen
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especially post-Soviet countries, w
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No. of Cigarettes 3000 2500 2000 15
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WITOLD ZATOŃSKI 243 young men and
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DEATHS / 100,000 DEATHS / 100,000 7
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WITOLD ZATOŃSKI 247 According to d
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Unfortunately, available data on th
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Kaczmarczyk-Chalas, K., Gdulewicz,
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Chapter 14 The epidemic in India Pr
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aniseed, and musk, also available a
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PRAKASH C. GUPTA AND CECILY S. RAY
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Prevalence among youth PRAKASH C. G
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treatment and premature death were
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Although tobacco control legislatio
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PRAKASH C. GUPTA AND CECILY S. RAY
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Chapter 15 Tobacco in Africa: More
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In assessing tobacco use in Africa
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YUSSUF SALOOJEE 271 plug the gap th
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Table 15.2 Cigarette taxes as perce
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YUSSUF SALOOJEE 275 In recent years
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World Bank (2001). Economics of Tob
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Part 5 Tobacco and health. Global b
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Chapter 16 The future worldwide hea
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RICHARD PETO AND ALAN D LOPEZ 283 a
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UK male death rate at ages 35-69 ha
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Overview Chapter 17 Passive smoking
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evidence have proved to be effectiv
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JONATHAN M. SAMET 291 a thousand de
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Table 17.2 Occupational ETS exposur
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Table 17.3 Nicotine concentrations
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portable piezobalance to sample aer
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JONATHAN M. SAMET 299 Fetal effects
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JONATHAN M. SAMET 301 Investigation
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Table 17.4 Summary of pooled random
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JONATHAN M. SAMET 305 also reported
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and involuntary exposure to tobacco
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Glantz, S. A. and Parmley, W. W. (1
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JONATHAN M. SAMET 311 O’Connor, G
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JONATHAN M. SAMET 313 US Department
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Introduction Chapter 18 Adolescent
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JOHN P. PIERCE ET AL. 317 would be
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JOHN P. PIERCE ET AL. 319 Indeed, t
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JOHN P. PIERCE ET AL. 321 reached i
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subsequent consumption. Most studie
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Burns, D., Garfinkel, L., and Samet
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JOHN P. PIERCE ET AL. 327 US Depart
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The epidemic Chapter 19 Tobacco and
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AMANDA AMOS AND JUDITH MACKAY 331 w
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AMANDA AMOS AND JUDITH MACKAY 333 T
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AMANDA AMOS AND JUDITH MACKAY 335 w
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AMANDA AMOS AND JUDITH MACKAY 337 p
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AMANDA AMOS AND JUDITH MACKAY 339 T
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AMANDA AMOS AND JUDITH MACKAY 341 o
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AMANDA AMOS AND JUDITH MACKAY 343 M
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such as Jewel and Madonna, who woul
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AMANDA AMOS AND JUDITH MACKAY 347 t
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particularly in developing countrie
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AMANDA AMOS AND JUDITH MACKAY 351 L
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Part 6 Tobacco and cancer
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Chapter 20 Cancer of the prostate F
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Table 20.1 Summary of results of ca
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Andersson et al. 1996 Sweden 256 ca
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Table 20.2 Summary of results of co
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cancer in younger or elderly men, w
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FABIO LEVI AND CARLO LA VECCHIA 365
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Summary Chapter 21 Laryngeal cancer
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12-year follow-up of the American C
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Hedberg et al. USA, 235, 81% P, 547
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cigarettes as compared to blond-tob
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of 3.78 and 11.47. An interpretatio
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Effect on survival In two studies f
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Cattaruzza, M. S., Maisonneuve, P.,
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USDHEW (1964). Laryngeal cancer. In
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Chapter 22 Smoking and cancer of th
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Table 22.1 Results from selected ca
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Asia Gao et al. 1994— Population
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EVA NEGRI 389 Ille-et-Vilaine, Fran
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Odds Ratio 2.5 2 1.5 1 0.5 0 0.30 2
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Garidou et al. 1996— Hospital ≤
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De Stefani, E., Barrios, E., and Fi
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Wynder, E. L. and Bross, I. J. (196
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Introduction Chapter 23 Tobacco use
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Table 23.1 Tobacco use and risk of
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Franceschi et al. Oral cavity, Oral
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Muscat et al. Oral cavity OR = 2.1
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Population-based case-control studi
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Lewin et al. Oral cavity, RR = 6.5
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TONGZHANG ZHENG ET AL. 411 the cont
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TONGZHANG ZHENG ET AL. 413 For smok
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TONGZHANG ZHENG ET AL. 415 per day
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TONGZHANG ZHENG ET AL. 417 than tha
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TONGZHANG ZHENG ET AL. 419 For exam
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TONGZHANG ZHENG ET AL. 421 decline
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Studies in India: Oral cancer is th
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carcinoma compared with other combi
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studies have demonstrated a positiv
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TONGZHANG ZHENG ET AL. 429 Garrote,
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TONGZHANG ZHENG ET AL. 431 Notani,
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Chapter 24 Smoking and stomach canc
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DAVID ZARIDZE 435 such as sex, age,
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DAVID ZARIDZE 437 (Kato et al. 1990
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DAVID ZARIDZE 439 respectively. The
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Gajalakshmi, C. K. and Shanta, V. (
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Pisani, P., Parkin, D. M., Bray, F.
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Introduction Chapter 25 Cigarette s
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attenuated in every study after con
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EDWARD GIOVANNUCCI 449 with a gener
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(Baron et al. 1994) of 352 colon ca
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(U.S. Dept. of Health Education and
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References EDWARD GIOVANNUCCI 455 A
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EDWARD GIOVANNUCCI 457 Kono, S., Ik
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Chapter 26 Smoking and cervical neo
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Tokuhata 1967* Williams 1977* Wigle
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Clarke 1985* Hellberg 1986* La Vecc
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ANNE SZAREWSKI AND JACK CUZICK 465
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case-control study nested in a scre
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five-fold risk of cervical cancer f
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(typically around two-fold), but be
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Introduction Chapter 27 Tobacco and
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Cigar, pipe, and chewing tobacco Wh
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Conclusion Overall, tobacco smoking
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Summary Chapter 28 Smoking and lung
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GRAHAM G. GILES AND PETER BOYLE 487
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quit for 20 years or more (Rogot an
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cancer and others where there is st
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Peto, R. (1986) Influence of dose a
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Chapter 29 Tobacco smoking and canc
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He further noted that case-control
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coefficients from the data in Table
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DIMITRIOS TRICHOPOULOS AND ARETI LA
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Epidemiology Chapter 30 Smoking and
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CRYSTAL N. HOLICK AND HARVEY A. RIS
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and at least the enteric variety of
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Chapter 31 Endometrial cancer Paul
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Table 31.1 Epidemiological studies
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studies (Terry et al. 1999, 2002a),
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Newcomer Population 740/2372 40-79
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PAUL D. TERRY ET AL. 531 levels, an
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Relative body weight Obesity is an
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Key et al. 1991 147 pre- and postme
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lood levels among current smokers,
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Table 31.7 Studies of cigarette smo
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of the association between cigarett
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Jensen, J., Christiansen, C., and R
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PAUL D. TERRY ET AL. 545 Weiderpass
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Part 7 Tobacco and heart disease
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citations of some of the best-known
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KONRAD JAMROZIK 553 because the dat
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KONRAD JAMROZIK 555 Fig. 32.2 Trend
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Table 32.3 Case-control studies of
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Table 32.5 Cohort studies of active
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Table 32.6 Effect of exclusion of p
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eadily addressed by cohort studies
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Specificity The entries in Table 32
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Table 32.8 Application of Bradford
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KONRAD JAMROZIK 569 arterial CVD re
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elationship goes beyond statistical
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Garland, C., Barrett-Connor, E., Su
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National Health and Medical Researc
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Part 8 Tobacco and respiratory dise
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Introduction Chapter 33 Chronic obs
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Many of the constituents in both th
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DAVID M. BURNS rate of growth in lu
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Death rates from COPD in smokers an
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Fraction of Excess Risk 1.20 1.00 0
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DAVID M. BURNS Higgins, M. W., Enri
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Part 9 Tobacco and other diseases
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Introduction Chapter 34 Smoking and
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ALLAN HACKSHAW 595 several mechanis
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Table 34.4 Studies that reported re
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Table 34.5 Cohort studies that repo
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than non-smokers; they have about h
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Table 34.8 Cohort studies that repo
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esults from cohort studies. There i
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ALLAN HACKSHAW 607 (DiFranza and Le
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Table 34.12 Cohort studies that rep
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Caries and tooth loss Because perio
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Table 34.16 Summary of disorders in
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References ALLAN HACKSHAW 615 Allar
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Johnsen, R., Forde, O. H., Straume,
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Seddon, J. M., Willett, W. C., Spei
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Part 10 Genetics, nicotine addictio
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Chapter 35 Genes, nicotine addictio
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Cotinine (ng/ml) 750 500 250 OXCHEC
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MICHAEL MURPHY ET AL. 627 of those
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MICHAEL MURPHY ET AL. risk associat
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Table 35.2 (continued) Gene map Chr
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MICHAEL MURPHY ET AL. pre-clinical
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Steps to carcinogenesis Exposure to
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DNA repair As previously alluded to
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MICHAEL MURPHY ET AL. Lichtenstein,
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Part 11 Tobacco and alcohol
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Table 36.1 Comparison of alcohol an
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Although gene therapy has rarely be
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20+ TABAC 5.1 10-19 0-9 3.4 12.3 0-
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Heavy drinking is known to cause ga
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Treatment issues and co-dependence
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ALBERT B. LOWENFELS AND PATRICK MAI
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Part 12 Tobacco control: Successes
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Introduction Chapter 37 Global toba
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NIGEL GRAY (sometimes at state leve
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NIGEL GRAY The first attempt to red
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per litre of smoke. Reduction of th
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Borland, R., Cappiello, M. and Owen
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Chapter 38 Lessons in tobacco contr
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entangling relationships with negot
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successful country advocates deeply
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Thus, when the opportunity arose, t
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Chapter 39 A brief history of legis
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Committee, mentioned above, little
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4. Tobacco and its related processi
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RUTH ROEMER 683 advertising and adv
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or shows, and distribution of free
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RUTH ROEMER 687 threat to the peopl
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RUTH ROEMER 689 The case was settle
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Another study by Harvard researcher
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At the end of 2003, 83 countries ha
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Chapter 40 Roles of tobacco litigat
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NGOs obtained sanctions against tob
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RICHARD A. DAYNARD 699 In a 1980s c
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RICHARD A. DAYNARD 701 Fourth, the
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even impossible. Such a statute pre
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RICHARD A. DAYNARD 705 Daynard, R.
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Introduction Chapter 41 Impact of s
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in this chapter, is evidence that s
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RON BORLAND AND CLAIRE DAVEY 711 Wh
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RON BORLAND AND CLAIRE DAVEY 713 On
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RON BORLAND AND CLAIRE DAVEY 715 ro
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you are subject, but this does not
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RON BORLAND AND CLAIRE DAVEY 719 to
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RON BORLAND AND CLAIRE DAVEY 721 fo
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RON BORLAND AND CLAIRE DAVEY 723 (E
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RON BORLAND AND CLAIRE DAVEY 725 th
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advanced. Although in countries lik
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RON BORLAND AND CLAIRE DAVEY 729 Da
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RON BORLAND AND CLAIRE DAVEY 731 Pr
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Introduction Chapter 42 Effective i
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PRABHAT JHA ET AL. 735 India (Gupta
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Average price or tax per pack (US$)
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PRABHAT JHA ET AL. 739 Bans on adve
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PRABHAT JHA ET AL. 741 Table 42.2 T
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PRABHAT JHA ET AL. 743 antismugglin
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Farrelly, M. C., Pechacek, T. F., a
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PRABHAT JHA ET AL. 747 Raw, M., Mc
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Part 13 Treatment of dependence
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Introduction Chapter 43 Treatment o
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Nocturnal sleep-disturbing nicotine
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MICHAEL KUNZE AND E. GROMAN 755 tob
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Fifteen different products were ide
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In summary, tobacco dependence amon
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medications for OTC sale in 1996, t
Page 796 and 797:
MICHAEL KUNZE AND E. GROMAN 763 US
Page 798 and 799:
Chapter 44 Regulation of the cigare
Page 800 and 801:
as these correlate quite well with
Page 802 and 803:
NIGEL GRAY 769 within three major g
Page 804 and 805:
of carcinogens and toxins in its wa
Page 806 and 807:
Index abdominal aortic aneurysm see
Page 808 and 809:
aromatic amines 58, 60, 98 DNA addu
Page 810 and 811:
central and eastern Europe (CEE) (C
Page 812 and 813:
coronary thrombosis 5 see also myoc
Page 814 and 815:
epinephrine 169 epoxide hydrolase g
Page 816 and 817:
health professionals advice on smok
Page 818 and 819:
laryngeal cancer (Continued) animal
Page 820 and 821:
Morris, Philip 207 see also Philip
Page 822 and 823:
nursing home residents 718 nutritio
Page 824 and 825:
Polish Central Statistical Office (
Page 826 and 827:
smoke, tobacco (including cigarette
Page 828 and 829:
Sweden female smoking rates 330-1 l
Page 830 and 831:
United Nations agencies 680-1 Unite
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Tobacco and Public Health - TCSC Indonesia

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