Ventilation holes in cigarettes contribute to lung cancer. Researchers call for ban.

According to a new study by the National Cancer Institute in the US, there is ‘very strong evidence’ that the tiny ventilation holes in cigarettes contribute to an increase in adenocarcinoma, the most common form of lung cancer. The ‘tampered cigarettes’, as lawyer Bénédicte Ficq calls cigarettes with invisible holes designed in the filters, do more than mislead smoking machines that test cigarettes for harmful substances.

(Orginal article from the Dutch Newspaper: De Volkskrant, May 29th 2017)

‘Those holes should be banned straight away,’ argues Ficq, who is preparing a case against the tobacco industry. Her case rests to a large extent on how cigarette manufacturers ‘tamper’ with the machine-measured tar yields. And she asserts that the new evidence from America only strengthens her case.

The eleven cancer researchers, who published their findings in the Journal of the National Cancer Institute, are also calling for a ban on cigarette filter ventilation by the Food and Drug Administration (FDA), the government agency that must approve medicines, food and stimulants before they are marketed. A FDA spokesperson says that the news is being ‘evaluated for future decisions by the FDA’.

‘Those tiny holes in all cigarette filters are designed by the tobacco industry to trick smoking machines,’ asserts Wanda de Kanter, a lung specialist at the Antoni van Leeuwenhoek Hospital and chairwoman of the Youth Smoking Prevention Foundation. ‘Smokers block these holes with their lips and fingers, so they inhale far more carcinogenic substances – tar and nicotine – than smoking machines register.’

In addition to the controversial way that holes influence test results, the eleven researchers point to a causal link between filter ventilation and the increase in this particular form of cancer.

Relationship very plausible
‘This is a very thorough study, carried out by a respected research group, published in an authoritative scientific journal,’ comments Onno van Schayck, epidemiologist and professor of preventative medicine at Maastricht University. The researchers have classified all published scientific literature and provide a weight-of-evidence review using causation criteria linking filter ventilation with an increase in lung cancer. ‘With their classification, they keep arriving at the same conclusion: that a link is very plausible. So the chance that these holes contribute to adenocarcinoma is a probability bordering on certainty.’

According to the researchers, when a smoker does not completely block the ventilation holes in the filter with his lips and fingers, he inhales more air, thereby increasing the burn time of the tobacco, lowering the temperature burn and ensuring less complete combustion. As a result, more carcinogenic substances are inhaled. Moreover, the researchers assert that the holes make the smoker inhale more deeply, increasing the penetration of carcinogenic substances into the lungs. According to lung specialist De Kanter, this explains why the number of people with lung cancer is increasing, even though the total number of smokers is declining.

Professor Van Schayck ‘fully agrees’ with the researchers’ call to ban cigarette filter ventilation. ‘This should be done swiftly.’ He ‘urgently recommends that this American article be read’ by the Dutch Food and Consumer Product Safety Authority (NVWA), which maintains that cigarette manufacturers do not break the law with their ventilation holes.’

‘We use legally prescribed methods to measure rates of harmful substances in cigarettes,’ says an NVWA spokesperson. ‘It’s up to the Ministry of Health to express a view on this article.’

The ministry has made it known that, within Europe, the Netherlands is an advocate of amending the measurement methods, ‘so we are aware that those perforations are of influence,’ commented a spokesperson. ‘Further, the National Institute for Public Health and the Environment (RIVM) is the government agency that advises us on this matter.’

Cigarettes with ventilation holes were originally marketed as less harmful, says Reinskje Talhout, a senior tobacco expert with the RIVM. ‘This study offers new evidence to support the position that we have held for some time, namely that they provide no benefit to smokers. It’s up to the Ministry of Health, Welfare and Sport to decide whether or not to amend policy based on that position.’