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CIGARETTE LIGHTING AND LUNG CANCER: A NEW PERSPECTIVE CARLJ. MARIENFELD, MD., M.P.H.* The repeated and unsolicited gifts of book matches which have been received over the years from hotels, motels, and all manner of business establishments seeking to advertise their wares have led to a reexamination of the entire question of the relationship between smoking and health. The tentative conclusion has been reached that perhaps the increasing number of lung cancer victims might have been better served not to have accepted the gifts dedicated by these advertisers "to their matchless friends." This review has revealed what appears to be an unrecognized "blind spot" caused by the focus of recent research exclusively upon tobacco itself rather than upon the totality of the smoking habit. The act of smoking entails the use not only of tobacco, but also of other materials that enable smoking to take place. These materials must, of course, include some means of igniting the tobacco. Counting the number of cigarettes smoked daily also serves pari passu to enumerate the number of times a paraffined match or a cigarette lighter is burned within a few centimeters of the nasal airway. The original report of the advisory committee to the surgeon general of the Public Health Service published in 1964 selected as the title of its report "Smoking and Health" [I]. Similar titles have been applied to subsequent reports from the Clearing House on Smoking and Health. It is significant to note that the word "smoking" relating to the total activity involved in such tobacco usage is the term chosen and not solely "tobacco." The original title, or intent—despite some minimal attention to certain socioeconomic or psychologic factors—has been almost universally reduced to the microstudy of the possible carcinogenic components of tobacco leaf rather than of the total cigarette-smoking habit. ?Professor, Department of Community Health and Medical Practice and director of the Environmental Health Surveillance Center, University of Missouri, R.R. 4, Columbia, Missouri 65201. I am indebted to Dr. Corazón Hastings and Tom Clevenger of the University of Missouri Environmental Trace Substances Laboratory for the chemical analyses of the soot and match heads. 44 I Carl J. Marienfeld · Cigarette Lighting Great strides in research have resulted from this usual scientific process of breaking such a problem into its constituent parts. Unfortunately, however, the part or parts sometimes overwhelm the whole of the original problem being addressed. It is important, upon occasion, to ask again the original and more holistic question. A reexamination of the component activities involved in the smoking habit, a renewed observation of individuals while they smoke, and a few simple experiments have persuaded the author that we may have overlooked a very important, if not a most important, part of the cigarettesmoking habit. The increase in the death rates for respiratory cancer associated with cigarette smoking in particular may be due, in part at least, to the lighting of the cigarette, rather than only to the tobacco the cigarette contains. I. The Evidencefor Unburned Carbon Produced during Lighting of the Cigarette One can, by a very simple soot-condensation experiment such as that illustrated in figure 1, demonstrate that there is a considerable amount of unburned carbon soot created for inhalation by the burning of the paper book-type wax-impregnated match and by the burning petroleum products which are used in the cigarette lighter. Some difference is apparent between the soot produced by the book match, which is wax impregnated, and the wooden strike-anywhere kitchen match, which may or may not be soft wax-impregnated. The soot deposits pictured Fig. 1.—Soot deposit on porcelain surface derived from single burning matches and a 1second burning of cigarette lighter. Perspectives in Biology and Medicine · Autumn 1974 | 45 are collected on the cold surface of a porcelain burette stand held 5 cm above the incinerating portions of the matches or the cigarette lighter. The amount of soot shown in figure 1 is derived in each instance from a single burning match and from a cigarette lighter which was burned for 1 second. Figures 2 and 3 show the amount of soot deposited by the burning ofone complete book of 20...

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