An analysis appearing in the Journal of the National Cancer Institute finds strong evidence that adding ventilation holes to cigarette filters has contributed to a rise in a type of lung cancer called adenocarcinoma among smokers. The authors say the FDA should consider regulating the use of filter ventilation, up to and including a ban.

Eric Jacobs, Ph.D., strategic director of pharmacoepidemiology says the new analysis is a welcome addition to existing information about the dangers of ventilated cigarette filters and should lead to further research to find out whether regulation is warranted.

“Rates of lung cancer in cigarette smokers were already high in the 1950s and 1960s, but have increased over time, driven by increases in adenocarcinoma, now the most common type of lung cancer. The new review in the Journal of the National Cancer Institute is therefore important because it systematically lays out and evaluates the scientific evidence that a specific change in cigarette design, the introduction of filter ventilation holes, may be responsible for the increased risk of adenocarcinoma of the lung in smokers.

Eric M. Jacobs. Ph.D.

“Ventilation holes, engineered into cigarette filters by the tobacco industry starting in the 1960s, are present in nearly all modern cigarettes and are tied to a long history of deception. These holes allow air to be drawn in, resulting in cigarettes that have lower tar levels when measured by smoke-testing machines and that have been misleadingly marketed as “light” or “low-tar.” In fact, it has long been known that real-life smokers inhale similar amounts of tar when smoking cigarettes with ventilation holes. This occurs because smokers, often unconsciously, compensate for the ventilation holes by changing their smoking behavior, for example by taking by taking bigger puffs, in order to obtain the level of nicotine to which they are addicted.

“Among other evidence, the review describes studies showing that ventilation holes cause smokers to take bigger puffs, potentially inhaling carcinogen-containing smoke deeper into the parts of the lungs where adenocarcinoma typically arises.

“Thorough evidence reviews, like this one, help establish the scientific basis the Food and Drug Administration (FDA) needs to make sound decisions about the regulation of ventilation holes and other design features of tobacco products.”