{
  "abstract": "Background Banning cigarette filter ventilation has been raised by some public health researchers and organisations because it has misled people who smoke to believe they are smoking a safer cigarette.Aim To examine the potential effects of banning ventilated filters on smoking behaviour and biomarkers of toxicant exposures.Trial design Randomised controlled trial with parallel semi-blind study design.Methods People who smoke (n=164) ventilated cigarettes daily were randomised to smoke ‘ventilated’ (≈27% ventilation) or ‘unventilated’ (≈0.11% ventilation) study cigarettes for 6 weeks. Non-inferiority testing was conducted on the changes in urinary 4-(methylnitrosamino)−1-(3-pyridyl)−1-butanol and its glucuronides (total NNAL) and cigarettes per day (CPD) between the two cigarette groups. Superiority testing was conducted for differences in smoking intensity (amount of nicotine in cigarette butts), other exposure biomarkers and subjective responses.Results The unventilated condition was generally non-inferior to the ventilated condition for change in total NNAL (3% greater for unventilated vs ventilated, less than the non-inferiority 15% margin but with wide variability with an upper bound of 95% CI of 16%, p=0.064) and in CPD (0.22 cigarettes greater for unventilated vs ventilated, lower than the non-inferiority margin of 2, p<0.001). There were no significant differences between the two groups in other biomarkers (p>0.05). Less intensity of smoking was observed with unventilated cigarettes (difference of changes=−0.04 mg nicotine, p=0.002), aligning with higher self-reported ratings of nicotine strength (p=0.005) and aversion (p=0.028).Conclusions Overall, banning filter ventilation is unlikely to lead to greater toxicant exposures but certain subgroups might experience greater exposures.",
  "authors": [
    {
      "affiliations": [
        "Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, Minnesota, USA",
        "Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA"
      ],
      "name": "Dorothy Hatsukami"
    },
    {
      "affiliations": [
        "Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA"
      ],
      "name": "Joni Jensen"
    },
    {
      "affiliations": [
        "The James Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA"
      ],
      "name": "Sarah Reisinger"
    },
    {
      "affiliations": [
        "Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA"
      ],
      "name": "Connor Demorest"
    },
    {
      "affiliations": [
        "Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA"
      ],
      "name": "Irina S Stepanov"
    },
    {
      "affiliations": [
        "Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA",
        "Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota, USA"
      ],
      "name": "Dana Mowls Carroll"
    },
    {
      "affiliations": [
        "Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA"
      ],
      "name": "Steven Carmella"
    },
    {
      "affiliations": [
        "Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA"
      ],
      "name": "Sharon E Murphy"
    },
    {
      "affiliations": [
        "Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA"
      ],
      "name": "Stephen S Hecht"
    },
    {
      "affiliations": [
        "Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA"
      ],
      "name": "Lori G Strayer"
    },
    {
      "affiliations": [
        "Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA"
      ],
      "name": "Xianghua Luo"
    },
    {
      "affiliations": [
        "The James Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA",
        "College of Medicine, The Ohio State University, Columbus, Ohio, USA"
      ],
      "name": "Peter G Shields"
    }
  ],
  "title": "Effects of unventilated versus ventilated filtered cigarettes on smoking behaviour and biomarkers of smoke exposure in a randomised clinical trial",
  "uid": "b202efad-a8e6-5c01-a6b2-3137959d4dae"
}