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Member Research & Reports

Member Research & Reports

SDSU: A Randomized Cross-Over Clinical Trial of Unfiltered Cigarettes

Dr. Eyal Oren, associate professor within the division of epidemiology and biostatistics at San Diego State University School of Public Health, and colleagues recently received funding from the Tobacco-Related Disease Research Program to conduct a 2-year study examining smoking behaviors and effects. Dr. Oren’s research interests place an emphasis on respiratory health where he focuses on the links between social, environmental, and spatial epidemiologic methods, as well as how these apply to both health differences and disparities.

Dr. Oren and his colleagues will be assessing the acceptability among committed smokers of switching to unfiltered cigarettes from filtered cigarettes and will then compare the doses of nicotine and carcinogens after such a switch from filtered to unfiltered cigarettes. The study design utilized for this research will be a cross-over clinical trial including current, committed smokers. This will include a baseline period, two weeks of smoking filtered or unfiltered cigarettes with assignments determined through randomization, followed by a three week washout period. Then, the crossover will occur for each participant smoking the opposite condition for two weeks. Changes in smokers’ puffing behavior, carcinogen exposures, nicotine exposures, and attitudes toward smoking unfiltered cigarettes if they were no longer able to buy filtered cigarettes will be examined.

A study such as this has the ability to inform regulatory policy regarding the possibility of banning filters from the US cigarette market because they encourage uptake of smoking and discourage cessation. The findings from this proof-of-concept study could, “inform the design of larger clinical trials on unfiltered cigarettes. These trials could then serve as a basis for regulatory change by the FDA or for consideration by state or local governments that may, under the 2009 Family Smoking Prevention and Tobacco Control Act (FSPTC), regulate the sales of specific tobacco products,” states Oren. There is current legislation being considered in California in regards to a cigarette filter ban due to the startling amount of cigarette butts that pollute the coastline and oceans. According to Dr. Oren, “evidence from this study could lead the FDA Advisory Committee to recommend a ban on the sale of filtered cigarettes because filters make it easier for young people to start smoking, discourage smokers from quitting, and contaminate the environment with toxic tobacco waste.” He believes that this study will have very clear impacts – both environmentally and socially. “This could remove the vast number of cigarette butts and filters that pollute the environment and create cleaner air as well as ensure healthier living and working spaces for all” states Dr. Oren.