Mouth level smoke exposure using analysis of filters from smoked cigarettes: a study of eight countries.

The analysis of spent cigarette filters enables the estimation of the nicotine and tar (nicotine-free dry particulate matter) yields obtained by smokers in their everyday environment and has been shown to correlate well with biomarkers of exposure. Leading products across the range of ISO tar yields were selected from Australia, Brazil, Canada, Germany, Japan, New Zealand, South Africa and Switzerland. At least fifty demographically representative smokers were recruited per product. Subjects, ≥ 21 years of age and smoking ≥ 5 cigarettes per day, were asked to collect ≥ 15 filters from cigarettes they had smoked. The collected filters were analysed for nicotine and UV absorbance to enable the smokers' mouth level exposure to nicotine and tar to be estimated and a comparison of countries and tobacco blend styles to be made. Smoking history data were also collected. More than 80,000 filters were collected from 5703 smokers of 106 products from eight countries. Mean ± SD estimated nicotine exposures per cigarette and per day ranged from 0.93 ± 0.34 mg/cigarette (Brazil) to 1.77 ± 0.69 mg/cigarette (South Africa) and from 16.4 ± 11.1mg/day (Germany) to 31.5 ± 14.8 mg/day (South Africa), respectively. Male smokers obtained higher mean estimated tar and nicotine exposures than female smokers. These gender differences were statistically significant for six countries. Significant correlations were found between estimated nicotine exposure and ISO nicotine yield, and between estimated tar exposure and ISO tar yield (p<0.001).