title: High particulate matter emission from additive-free Natural American Spirit cigarettes.
abstract: BACKGROUND
  Involuntary exposure to health-threatening environmental tobacco smoke (Combined Mainstream and Side-stream Smoke, CMSS) is a worldwide problem, causing premature death of thousands of people. CMSS consists of particulate matter (PM), one of the main sources of indoor air pollution. PM constitutes a considerable health risk for passive smokers. It is important to inform the public about brand-specific differences in CMSS-associated PM, especially in the case of brands without additives, which are therefore promoted as natural and less health-threatening.
  
  
  METHODS
  Mean concentrations and the area under the curve of PM10, PM2.5and PM1generated by Natural American Spirit cigarettes without additives and the 3R4F standard research cigarette (University of Kentucky, USA) were measured, analyzed and compared with each other. An automatic environmental tobacco smoke emitter was used to smoke 100 cigarettes, 20 of each brand, according to a standardized smoking protocol.
  
  
  RESULTS
  This study could show that CMSS-associated PM released from tobacco brands without additives, which are therefore promoted as natural and less harmful, are higher than expected.
  
  
  CONCLUSIONS
  It is highly improbable that Natural American Spirit tobacco products are a less harmful choice-at least not for passive smokers as this study could show. We conclude, the CMSS-associated PM level of every single customized brand should be measured because the origin of the tobacco and not the amount of CO, tar and nicotine (given as product information) seem to be responsible for the brand-specific PM release. This data is urgently needed to adequately inform the public about CMSS-associated PM exposure and the related health risk especially for passive smokers.
authors.affiliation: Center for Health Sciences, Institute of Occupational, Public and Environmental Medicine, Goethe University Frankfurt am Main, Frankfurt am Main, Germany.
authors.forename: Yvonne
authors.identifier: 0000-0003-1952-9169
authors.initials: Y
authors.lastname: Iffland
authors.affiliation: Center for Health Sciences, Institute of Occupational, Public and Environmental Medicine, Goethe University Frankfurt am Main, Frankfurt am Main, Germany.
authors.forename: Ruth
authors.initials: R
authors.lastname: Müller
authors.affiliation: Center for Health Sciences, Institute of Occupational, Public and Environmental Medicine, Goethe University Frankfurt am Main, Frankfurt am Main, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Groneberg
authors.affiliation: Center for Health Sciences, Institute of Occupational, Public and Environmental Medicine, Goethe University Frankfurt am Main, Frankfurt am Main, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Gerber
keywords: Cigarettes; Indoor air pollution; Particulate matter