{
  "abstract": "Background The cellulose acetate filter is a plastic attachment on nearly all commercial cigarettes sold worldwide. It is the main component of discarded cigarette butts, and the most prevalent waste item collected during urban and beach cleanups. This waste leaches toxic chemicals, including nicotine, metals and tobacco-specific nitrosamines and contributes to environmental microplastic pollution. There is growing international interest in reducing plastic waste from single-use, non-essential products such as cellulose acetate cigarette filters. Public health and environmental advocates recommend a ban on the sale of filtered cigarettes to reduce environmental pollution caused by discarded cigarette butts and to discourage cigarette smoking.Research question What potential health and behavioural implications might arise among people who smoke if filtered cigarettes are removed from the market.Methods We conducted a cross-over, randomised clinical trial of 29 people who smoke to evaluate changes in biomarkers for nicotine and tobacco-specific nitrosamine exposure when switching between filtered and unfiltered cigarette smoking.Results Although unfiltered smoking showed a higher trend in the geometric means of 4-[(methylnitrosamino])−1-[3-pyridyl]−1-butanol (NNAL) compared with filtered cigarettes, regression models for urinary cotinine and NNAL showed no significant differences when switching between filtered and unfiltered cigarettes.Conclusion This proof-of-principle study suggests there is no increased risk to people who smoke when switching to unfiltered cigarette smoking. Although larger studies might provide more evidence regarding unfiltered cigarette smoking, banning the sale of filtered cigarettes may be an important policy intervention to both reduce hazardous tobacco waste and discourage smoking.",
  "authors": [
    {
      "affiliations": [
        "San Diego State University School of Public Health, San Diego, California, USA",
        "University of California San Diego Herbert Wertheim School of Public Health and Human Longevity Science, La Jolla, California, USA"
      ],
      "name": "Giovanni Appolon"
    },
    {
      "affiliations": [
        "San Diego State University School of Public Health, San Diego, California, USA"
      ],
      "name": "Eyal Oren"
    },
    {
      "affiliations": [
        "Department of Psychology, California State University San Marcos, San Marcos, California, USA"
      ],
      "name": "Kim Pulvers"
    },
    {
      "affiliations": [
        "Department of Kinesiology, California State University San Marcos, San Marcos, California, USA"
      ],
      "name": "Devan Romero"
    },
    {
      "affiliations": [
        "San Diego State University School of Public Health, San Diego, California, USA"
      ],
      "name": "Eunha Hoh"
    },
    {
      "affiliations": [
        "San Diego State University School of Public Health, San Diego, California, USA",
        "San Diego State University Research Foundation, San Diego, California, USA"
      ],
      "name": "Nathan G Dodder"
    },
    {
      "affiliations": [
        "San Diego State University Research Foundation, San Diego, California, USA"
      ],
      "name": "Jade Wong"
    },
    {
      "affiliations": [
        "San Diego State University Research Foundation, San Diego, California, USA"
      ],
      "name": "Katelyn Nynas"
    },
    {
      "affiliations": [
        "San Diego State University School of Public Health, San Diego, California, USA"
      ],
      "name": "LaRee Tracey"
    },
    {
      "affiliations": [
        "San Diego State University School of Public Health, San Diego, California, USA"
      ],
      "name": "Hector Lemus"
    },
    {
      "affiliations": [
        "San Diego State University School of Public Health, San Diego, California, USA"
      ],
      "name": "Thomas E Novotny"
    }
  ],
  "title": "Nitrosamine and nicotine exposure after switching from filtered to unfiltered cigarette smoking: a cross-over clinical trial",
  "uid": "5921e666-22c9-5ed5-9ce6-8efdba17385b"
}