title: The association between cigarette rod length, slim design, and blood cadmium levels among U.S. smokers: NHANES 1999-2010.
abstract: BACKGROUND
  Previous research has shown that long or slim cigarette design can mitigate perception of harmfulness. Cadmium (Cd) is a toxicant in cigarettes and is associated with adverse outcomes. We assessed the relationship between cigarette rod length/circumference and blood Cd levels among U.S. smokers using data from the 1999-2010 National Health and Nutrition Examination Survey.
  
  
  METHODS
  The analyses were performed on 4486 current cigarette smokers aged ≥20years old. Cigarette rod length included regular (68-72mm), king (79-88mm), long (94-101mm), and ultra-long (110-121mm) cigarettes currently smoked. Overall and gender stratified multivariate linear regression analyses were performed, adjusting for other influential covariates.
  
  
  RESULTS
  Gender stratified analysis indicated that female smokers of long and ultra-long cigarette had 20% and 27% higher mean Cd levels compared to smokers of regular sized cigarettes respectively, despite the fact that all the ultra-long cigarettes were slim cigarettes. Furthermore, among females, slim cigarette users did not reduce blood cadmium levels compared to non-slim users.
  
  
  CONCLUSIONS
  Female smokers of long or ultra-long cigarettes had higher mean blood Cd levels compared to smokers of regular cigarettes independent of slim design. Further research into this association is warranted.
authors.affiliation: Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, 401 Park Drive, Landmark Center, 4th Floor West Wing, Boston, MA 02215, USA. Electronic address: yum892@mail.harvard.edu.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Matsunaga
authors.affiliation: Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, 401 Park Drive, Landmark Center, 4th Floor West Wing, Boston, MA 02215, USA. Electronic address: iagaku@post.harvard.edu.
authors.forename: Israel T
authors.initials: IT
authors.lastname: Agaku
authors.affiliation: Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, 401 Park Drive, Landmark Center, 4th Floor West Wing, Boston, MA 02215, USA. Electronic address: vardavas@hsph.harvard.edu.
authors.forename: Constantine I
authors.initials: CI
authors.lastname: Vardavas
mesh_terms: D000328:Adult; D002104:Cadmium / Q000097:blood*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects*; D062789:Tobacco Products / Q000009:adverse effects / Q000145:classification* / Q000706:statistics & numerical data; D014481:United States; D055815:Young Adult
chemical_list: D002104:Cadmium
keywords: Cadmium; Cigarette length; Cigarette smoking; Female; NHANES; Slims