Abstract
Since the near universal adoption of filter-tipped cigarettes in the 1950-60s, followed by ventilated filters (i.e., “light” cigarettes) in the 1970s, tobacco companies have falsely promoted filtered cigarettes as less harmful for consumers than unfiltered cigarettes.1-4 Claims that filtered cigarettes were “lower risk” were based on early, limited, epidemiologic and machine-measured exposure studies which appeared to show reductions in lung cancer, all-cause mortality, as well as reduced nicotine, tar, and other toxicant yields in cigarette smoke.2-4 However, these early studies were flawed because they failed to consider cigarette design and compensatory smoking, which seriously limited machine testing as a valid method of measuring toxicant exposure to those who smoke.3,4 For decades, the tobacco industry knowingly deceived the public about filtered cigarette safety,1,2 in what has been described as the “deadliest fraud in human civilization”.2
In the years following the rise of filtered cigarette use, lung adenocarcinoma incidence and mortality rates increased relative to other lung cancer subtypes, including the previously most common squamous cell carcinoma.3,5 This shift to adenocarcinoma—a more aggressive type of lung cancer— reflects the widespread adoption of filtered cigarettes over the last 75 years, as well as changes in tobacco-specific nitrosamine and nicotine levels in filtered cigarettes. With filtered cigarette smoking, people also compensated for filtration with deeper inhalation and increased cigarette consumption.3-5 Additionally, cellulose acetate fibers from filters have been found to deposit in lungs of people who smoke.1
