Imitating Waterpipe Another Tobacco Industry Attempt to Create A

Addictive Behaviors 91 (2019) 244–252

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Addictive Behaviors

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Imitating waterpipe: Another tobacco industry attempt to create a cigarette T that seems safer ⁎ Isra Ahmada, , Lauren M. Dutrab a Santa Clara County Public Health Department, San Jose, CA 95126, 1400 Parkmoor Avenue Suite 120B, United States b RTI International, Center for Health Policy and Tobacco Research, 2150 Shattuck Avenue, Suite 800, Berkeley, CA 94704, United States

HIGHLIGHTS

• The tobacco industry documents prove the tobacco industry has attempted to replicate waterpipe technology • Industry continues to attempt to design cigarettes perceived as safer • The tobacco industry has a pattern of resurrecting products that have failed in the marketplace

ARTICLE INFO ABSTRACT

Keywords: Introduction: The use of waterpipe (also known as hookah) increased between 2011 and 2016 in the US and Hookah globally, especially among youth and young adults. The aim of this study is to examine the tobacco industry's e-hookah interest, involvement and role in proliferating waterpipe-like products and its technology. Electronic hookah Methods: We searched the University of California San Francisco Truth Tobacco Industry Documents beginning Waterpipe with the search terms “hookah’, ‘waterpipe’, ‘narghile’, ‘shisha’, ‘hooka’, ‘e-hookah’, ‘electronic hookah’, ‘water Tobacco filtration’, and ‘hubble-bubble’ and then expanded the search using snowball sampling. Over 1500 documents Tobacco industry were reviewed, and 39 were included in this analysis. Results: This review focuses on several companies' addition of water to the filter of one cigarette holder andto two cigarettes in an attempt to make these products seem safer. In 1954, the Aquafilter Corporation created and patented a filtered cigarette holder named Aquafilter, which the documents reveal was closely monitoredby multiple tobacco companies. In 1965, the American Tobacco Company developed the Waterford cigarette. In 1987, Japan Tobacco patented the Rivage cigarette. Waterford and Rivage were very similar products that contained crushable water capsules designed to “wet” the cigarettes' filter. Conclusion: Companies have been attempting to incorporate the water filtrating aspect of waterpipe into cigarette products. Ultimately, several tobacco companies adapted the technology from these devices to create cigarettes with crushable flavor capsules. Given the tobacco industry's history of resurrecting products, the industry may attempt to incorporate water filtration and other aspects of waterpipe into future products to attempt to make them appear safer.

1. Introduction malaria, and tuberculosis combined (Wipfli, Chu, Lancaster, & Valente, 2016). Since the first Surgeon General's Report on Smoking and Health in Recently, use of a tobacco product called the waterpipe, has in- 1964, the tobacco control community has made tremendous progress in creased (Amrock, Gordon, Zelikoff, & Weitzman, 2014; Bover reducing tobacco use. However, 480,000 Americans still die every year Manderski, Hrywna, & Delnevo, 2012; Cohn, Ehlke, Cobb, & Soule, due to tobacco related illnesses, and each day 2100 youth and young 2017; Doran, Godfrey, & Myers, 2015; Jordan & Delnevo, 2010; adults become daily cigarette smokers (U.S. Department of Health and Maziak, 2011; Rezk-Hanna, Macabasco-OʼConnell, & Woo, 2014; Sutfin, Human Services, 2014). Global tobacco use has become the leading Song, Reboussin, & Wolfson, 2014). A 2018 systematic review of global cause of preventable death in the world, killing more people than HIV, ever waterpipe use reported absolute increases in ever use among adults

⁎ Corresponding author. E-mail address: [email protected] (I. Ahmad). https://doi.org/10.1016/j.addbeh.2018.10.024 Received 22 April 2018; Received in revised form 2 October 2018; Accepted 17 October 2018 Available online 18 October 2018 0306-4603/ Published by Elsevier Ltd.

Downloaded for Anonymous User (n/a) at Santa Clara Valley Medical Center - JCon from ClinicalKey.com by Elsevier on April 04, 2019. For personal use only. No other uses without permission. Copyright ©2019. Elsevier Inc. All rights reserved. I. Ahmad, L.M. Dutra Addictive Behaviors 91 (2019) 244–252 in the US (2011–2014), youth in the U.S. states of Florida and New discussion of the history of waterpipe, the tobacco industry's knowledge Jersey (2007–2012), youth in Canada (2006–2012), and youth in of and interest in waterpipe, and attempts to market products that in- Jordan (2008–2011) in the 2000's (Jawad et al., 2018). Similarly, past corporated waterpipe technology. We found three products that at- 30-day waterpipe use increased significantly among youth in Jordan tempted to incorporate the water filtration technology of the waterpipe (2008 to 2011), Lebanon (2001−2011), Canada (2006–2012), and the for the purpose of creating cigarettes and cigarette accessories that U.S. (2011–2015; among high school students) over similar time per- could be marketed as safer: a filtered cigarette holder marketed bya iods. The largest increase in past-30-day use documented by this ana- non-industry-affiliated company (1954), and two cigarettes developed lysis was 2.9% per year in Jordan between 2008 and 2012 (Jawad et al., by tobacco companies (1965, 1987). 2018). Although some of these trends have reversed directions in recent years, in many countries, ever and past-30-day use has increased overall 2. Methods in the 2000's. In the U.S., current waterpipe use increased significantly (but not linearly) from 1.0% to 2.0% among U.S. middle school students A qualitative analysis of relevant documents was conducted using and from 4.1% to 4.8% among U.S. high school students between 2011 the Truth (formerly Legacy) Tobacco Industry Documents online ar- and 2016 (Jamal, Gentzke, Hu, et al., 2017). Studies from 2016 and chive (https://www.industrydocumentslibrary.ucsf.edu/tobacco/) be- 2017 have also reported that US adolescents and young adults per- tween September of 2016 and April of 2017. Ahmad identified the first ceived waterpipe as less harmful than traditional combustible cigarettes set of relevant documents using traditional snowball sampling techni- (Creamer, Loukas, Li, et al., 2016; Hair, Rath, Pitzer, et al., 2017). ques (Anderson, McCandless, Klausner, Taketa, & Yerger, 2011; Waterpipe, a centuries old tradition tracing back to ancient Persia Malone, 2000), beginning the search with the terms ‘hookah’, ‘water- and India, is used to heat and inhale smoke from loose tobacco leaves pipe’, ‘narghile’, ‘shisha’, ‘hooka’, ‘e-hookah’, ‘electronic hookah’, (Centers for Disease Control & Prevention, n.d.). A typical waterpipe ‘water filtration’, and ‘hubble-bubble’. The searches revealed project consists of a head, a metal body, a water bowl (or base to ‘cool’ the names that we then used to search the documents further, including smoke), a flexible hose (usually made of rubber) with a detachable ‘Project W’ (the American Tobacco Company (ATCo), 1965; a tobacco mouthpiece (Centers for Disease Control & Prevention, n.d.; Maziak, company established in 1890 that sold its operations to Brown & Wil- Taleb, Bahelah, et al., 2015). When the device is in use, the tobacco is liamson in 1994), ‘Waterford Cigarettes’ (ATCo, 1965), ‘Project 5000’, covered with perforated aluminum foil, and charcoal is placed on top of ‘Triple Aqua Filter’ (project of British American Tobacco (BAT), the covered head. Flavored and unflavored tobacco can be used ina ~1965), ‘Aquafilter Pacific Corporation’ (manufactured Aquafilter Ci- waterpipe, but Maassel (or mo'assel), or flavored tobacco (as opposed to garettes), ‘Rivage Cigarettes’ (Japan Tobacco, Inc. (JT)). These searches ‘ahami or unflavored), is most popular. Maassel is made of tobacco revealed several key individuals' names that we used to search the mixed with flavors, molasses, glycerin, and other ingredients (Shihadeh documents further, including Robert Barney Walker (Vice President of et al., 2015). Advertising and Sales, ATCo), E. F. Mooney (General Sales Manager, When the charcoal is lit, it heats air that passes through the alu- ATCo), and Frank Resnik (ATCo). Ahmad reviewed documents with minum foil and flows across the tobacco, becoming smoke. Next, the adjacent Bates numbers, which yielded additional relevant documents. smoke passes through the water in the base as bubbles, cools, and is Ahmad compiled the resulting important documents and findings and inhaled by the user through the hose Maziak, Taleb, Bahelah, et al., organized them into thematic groups based on dates, products, and 2015. Unlike cigarette smoking, the tobacco does not combust during manufacturing companies. Dutra then reviewed these documents and waterpipe smoking, and the smoke generated by this several hundreds findings and located additional relevant and related documents using of degrees cooler than cigarette smoke Shihadeh et al., 2015. The adjacent Bates numbers and updating previous searches using the ori- passage of the tobacco smoke through water, and, relatedly, the cooling ginal set of search terms (the database is updated continuously as of the smoke, has led to the inaccurate belief that the water filters out documents are released). Ahmad and Dutra both excluded documents many of the toxins in the smoke (Cornacchione, Wagoner, Wiseman, that were not in English, were unreadable (blurry, redacted informa- et al., 2016). tion, etc.), or were authored by public health agencies. In total, the In fact, the smoke contains just as many toxins, if not more, than authors reviewed over 1500 documents and included 39 in this analysis cigarette smoke (NCI, 2010; Shihadeh et al., 2015). Waterpipe smoke (Plantation Tobacco et al., n.d.; Elias & Ling, n.d.; Miller, n.d.; American delivers the highly addictive substance nicotine (Aljarrah, Ababneh, & Tobacco, 1965; American Tobacco Company, 1965; Anderson et al., Al-, 2009; Schubert, Müller, Schmidt, Luch, & Schulz, 2015; Shihadeh, 2011; Aquafilter, Medical Economics, 1955; Aquafilter Pacific 2003). Additionally, waterpipe smoke may contain higher concentra- Corporation, 1961; ATCO. The American Tobacco Company, 1967; tions of heavy metals than cigarettes and exposes users to carbon ATCO. The American Tobacco Company, 1968; Badgett, 1965; Barton, monoxide, nicotine and carcinogens (Aljarrah et al., 2009; Schubert 1966; British-American Tobacco Company Limited, Ivinson, MG, 1962; et al., 2015; Shihadeh, 2003; St. Helen et al., 2014). One waterpipe Cogbill & ATCO, 1965; Cohen & American Tobacco Company, 1965; smoking session (approximately 200 puffs), overall, lasts much longer Dutra et al., 2017; Green, 1968; Heimann, 1965; Heimann & ATCO, than smoking one traditional combustible cigarette (approximately 20 1965; International Service Corporation, 1967; Jones & ATCO, 1965; puffs) (Centers for Disease Control & Prevention, n.d.). Thus, waterpipe Leake, 1977; Malone, 2000; Mooney, 1962; Morris, 1965; PMI et al., smokers may inhale more toxins than cigarette smokers (American 1988; PMUSA, USA, & Smith, 1988; Resnik, 1965; SFM, 1988; Lung Association, n.d.; Dunbar, Shadel, Tucker, & Edelen, 2016; Unknown, 1955; Unknown, 1965a; Unknown, 1965b; Unknown, 1966; Harrell, Naqvi, Plunk, Ji, & Martins, 2016). Unknown, 1967; Unknown, 1968; Unknown, 1985; Unknown, 1988a; During the same time period that waterpipe increased in popularity Unknown, 1988b; Watson, 1966). in the US, industry involvement in novel tobacco products, such as Between March and April 2017, Ahmad and Dutra also searched electronic cigarettes and heat-not-burn tobacco products, has increased Google Patents (http://patents.google.com) with product names and (Elias & Ling, n.d.; Dutra, Grana, & Glantz, 2017). Reviews of formerly patent identification numbers found in the industry documents tostudy confidential tobacco industry documents have revealed a long history the technical specifications of patented products discussed inthe of interest and development of these devices, as well as resurrection of documents. formerly unsuccessful products as the regulatory and social landscape has changed over time (Elias & Ling, n.d.; Dutra et al., 2017). Given the 3. Results lack of clarity regarding whether the tobacco industry similarly played a role in the recent rise in popularity of the waterpipe, we searched We identified one cigarette holder and two cigarettes that usedand/ formerly confidential tobacco industry documents for industry or were specifically advertised as inspired by or incorporating technical

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Table 1 Overview of waterpipe-like tobacco products.

Product Characteristics Year (estimated) Company Market

Auqafilter Water-holding plastic cigarette filter 1954 Aquafilter Corporation U.S.A Waterford Cigarette Breakable water capsule in filter of cigarette 1965 The American Tobacco Company U.S.A Rivage Cigarette Breakable water capsule in filter of cigarette 1987 Japan Tobacco Japan, U.A.E aspects of a waterpipe: the ‘Aquafilter’ filtered cigarette holder developed by the Aquafilter Corporation, ‘Waterford Cigarettes’ by ATCo and ‘Rivage Cigarettes’ by JT (Table 1). Aquafilter, although not developed by a major tobacco corporation, was the first waterpipe-inspired product, and the documents reveal that the product was closely monitored by several tobacco companies. These products were marketed as improving the safety of cigarettes or providing safer alternatives to traditional cigarettes.

3.1. Aquafilter

The first waterpipe-inspired cigarette product discussed inthe documents is the Aquafilter, a filtered cigarette holder developed bythe Aquafilter Corporation in the 1950's that contained water and was marketed as a reduced nicotine waterpipe-inspired product. Although not designed by a tobacco company, British American Tobacco (BAT), Lorillard, and ATCo closely monitored the device. A 1959 patent titled “Holders and Filters for Tobacco Smoking” [Fig. 1](Merwin & Seeleg, 1954), authored by the inventor Merwin Gerard, describes the device's components as: …a filter material consisting of a mixture of water-absorbent fibers and non-water-absorbent fibers substantially saturated with water is effective in reducing the nicotine passing to the smokers mouth well below the safe value of 0.65 mg per cigarette. An exceedingly large percentage of the nicotine in the smoke is removed upon its contact with the water absorbed and present in the filter. (Merwin & Seeleg, 1954) An Aquafilter ad in the September 1955 issue of Medical Economics magazine (Lorillard Collection) (Aquafilter, Medical Economics, 1955; Unknown, 1955) claimed that the “Aquafilter is the only filter which uses water to wash and cool cigarette smoke…adapting the Oriental ‘hookah’ to modern smoking” (Aquafilter, Medical Economics, 1955) and that “Aquafilter and only Aquafilter … removes up to 92% ofni- cotine; 74% of tars from any cigarette plain or filter tip, keeps oral mucus cool and moist, and thus enhances the taste of tobacco, protects both fingers and teeth from messy, unsightly tobacco stain.” (Aquafilter, Medical Economics, 1955) Similarly, an April 1961 Aquafilter advertisement titled “Is There A Fig. 1. Diagram of Aquafilter from 1959 U.S. Patent (Merwin & Seeleg, 1954). Safe Way To Smoke?” (ATCo collection) highlighted water as the key to Aquafilter's (supposed) reduced harm and once again compared the device to a waterpipe: tarry stains on your fingers…a dangerous substance that would otherwise have coated your lungs Water (suspended in AQUAFILTER in a cartridge of patented fibers) is Aquafilter Pacific Corporation, 1961. the most effective filtering agent for tobacco smoke known to science. Yemenite immigrants to Israel, who smoke the “hookah” or water-pipe, In an untitled April 1962 internal ATCo memo, E. F. Mooney have not suffered a single case of lung cancer, while the disease has (General Sales Manager) summarized Aquafilter's advertising strategy struck heavily among other immigrant groups. Water removes only the for Mr. Robert Barney Walker (Vice President of Advertising and Sales): sharp, harsh nicotine, and the deadly and irritating tar. The Boston Globe and Boston Herald will both run ads the first 3 weeks (Aquafilter, Medical Economics, 1955) of June showing that the Aqua Filter removes certain percentages of ni- The advertisement also stated that “AQUAFILTER has been accepted cotine and tar from a number of brands of cigarettes […] this has been for advertising in many of the world's leading medical journals (proof established through a private organization […] […] the amount of ni- that medical boards have accepted independent research findings on cotine and tar that was removed by the Aquafilter would be shown”. AQUAFILTER)” (Kaye, n.d.) and advised readers to: Mooney, 1962 Smoke 20 cigarettes with an AQUAFILTER. Then break open the plastic In April of 1962, BAT's Research & Development division conducted holder and remove the filtering cartridge from the holder. Squeeze the an internal laboratory study on Aquafilter (titled “The Aquafilter: cartridge between your fingers. You'll be amazed at the thick, brown Laboratory Report Number L 55-F" (British-American Tobacco

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Company Limited, Ivinson, MG, 1962)). BAT concluded that “these whenever the smoker is at leisure. Now for the first time, Waterford filters appear to show no novel features other than the wetting ofthe adapts this ancient device for the enjoyment of today's cigarette smokers. filter material, and the incorporation into a cigarette holder” (British- Tiny capsules in Waterford's filter are used to moisten the filter before American Tobacco Company Limited, Ivinson, MG, 1962). The report smoking, thus giving the same kind of taste improvement as the hookah. stated that, in contrast to advertising claims that the filter unit is A simple pinching action by the smoker crushes the capsules inside the tip “‘water-activated’” and removes “up to 90% of the nicotine and 91% of and moistens it the tars giving a ‘cleaner, fresher flavor [,]’ (British-American Tobacco Jones & ATCO, 1965 Company Limited, Ivinson, MG, 1962) that “The filtration efficiency is ATCo executives presented similar information to shareholders at much lower […] 34–44% depending upon the pressure-drop. Only a ATCo's 1965 Annual Shareholders meeting: very small amount of additional smoke is removed by the holder itself; less than 0.5% difference is observed between the filtration efficiency of Another “first” for the company is Waterford, introduced in September of the total holder, and that of the plug alone.” (British-American Tobacco last year. National distribution is expected early in 1966. In most Eastern Company Limited, Ivinson, MG, 1962) nations the hookah, or waterpipe, is thought to improve the tobacco taste, In 1974, Aquafilter Corporation filed a second patent based onthe now Waterford adapts this ancient device for the enjoyment of today's Aquafilter device that integrated a means of sealing the mouthpiece cigarette smokers into the manufacturing process (Goldstein, 1974). The goal was to re- Cohen & American Tobacco Company, 1965. duce manufacturing costs and improve shelf life. In 1976, Aquafilter The 1966 ATCO. The American Tobacco Company, 1967 and 1967 filed a third patent that added metal prongs to the design to prevent the ATCO. The American Tobacco Company, 1968 Annual Shareholder's cigarette from being dislodged from the holder. No further patents were Meeting reports did not mention Waterford Cigarettes. filed by Aquafilter. A September 1965 ATCo letter from Robert K. Heimann (Vice In August of 2017, a version of the disposable Aquafilter was still President of ATCo) to Dr. William R. Harlan (Managing Director of sold on Amazon.com Amazon, n.d. and Walgreen.com, the latter of Research and Development, ATCo) (Heimann & ATCO, 1965) noted the which included this description of the “Disposable Aqua filter Holders”: importance of comparing Waterford to a waterpipe: “It would be Cigarette smoke containing tar, nicotine plus other substances enter the helpful also if we could have a comparison between the percentage of Aquafilter. Aquafilter's exclusive wet filtration system removes asig- water in the particulate smoke of pipe tobacco smoked in the normal nificant portion of these substances (scientific research confirms thatwet way and pipe tobacco smoked through a hookah” (Heimann & ATCO, filtration is the most effective method to remove the tar and nicotine from 1965). cigarette smoke). Helps you inhale cleaner, cooler smoke. In contrast to advertising claims, a September 1965 memo (titled Walgreen's, n.d. “Analytical Data on the Waterford Cigarette”) from Frank Resnik (Chemist, Philip Morris (PM)) to Dr. Helmut Wakeham (PM Director of According to Walgreens.com, Aquafilter is patented by the Oakhurst Research and Development) compared the Waterford Cigarette to the Company, which “offers many “OLD” but “AGELESS” remedies and Marlboro cigarette and concluded, medicines, some originating as early as 1841…” (Oakhurst Company, n.d.). The only apparent feature of Waterford is that the filter delivers moisture to the smoke. This filter does not appear to modify the chemical com- 3.2. Project W: Waterford Cigarette ponents of the smoke which have been reported to be physiologically active, such as phenol, acrolein, oxides of nitrogen, hydrogen cyanide, ATCo advertised the first cigarette that, according to ATCo, im- acetaldehyde, etc.” plemented waterpipe technology: Waterford Cigarette. In January (Resnik, 1965) 1965, an untitled ATCo internal letter Heimann & ATCO, 1965 from Nicotine content in the smoke of Waterford (1.27 mg/cigarette), Robert K. Heimann (Vice President, Marketing and Public Relations) to Marlboro (1.16 mg/cigarette) and the P.M. Filter (1.22 mg/cigarette) Mr. John H. Hager (Coordinator of New Products Division) introduced were very similar. the project: (Resnik, 1965) I would now like to add a third [project]: a water filtered cigarette. The Resnik concluded that Waterford Cigarettes were an “advertising principle of water filtration is of course well known and has been offered gimmick” (Resnik, 1965) and would create competition for Marlboro in such clumsy apparatuses as the Oriental Narghile and the somewhat and other PM products. Similarly, another PM internal memo from less clumsy but still awkward Aquafilter of our own day. The problem October 1965 (titled “Water Delivery of Waterford Cigarettes”) from C. will be to incorporate the water filter in a cigarette that is ready to belit E. Badgett to Resnik concluded that “the Waterford filter does not and smoked. After a practical means of doing this is devised, there will contribute water to the smoke” and that “the unusually high water also be a problem of blending a suitable mixture to deliver taste through delivery from Waterford cigarettes can be attributed to unusually high water […] the initial problem is to devise a method or methods of water content in the filler, and not to the Waterford filter” (Badgett, achieving this type of filtration in a mass production product and Iwish 1965). you would address yourself to this. However, other documents claim greater water content in the (Heimann & ATCO, 1965) Waterford cigarette compared to other cigarette brands (Cogbill & In August 1965, ATCo authored an internal report titled “Historical ATCO, 1965; Unknown, 1965a; Unknown, 1965b; Watson, 1966). A Background on the Water Pipe” (author and recipient unknown) re- 1965 report from American Tobacco titled “Comparison of Waterford viewing the chronological history of the spread of the waterpipe in the and Competitive Brands of Cigarettes, Water Content of Smoke, Water Middle East, Asia and North Africa (American Tobacco, 1965). In Content of Tips and Moisture Content of Tobacco” (Author Unknown) September 1965, ATCo issued a press release Jones & ATCO, 1965 titled (Unknown, 1965b) concluded that, when “comparing the average per “Waterford Cigarettes Introduced by American Tobacco, World's First cent water in the smoke of Waterford (81.9%) with the highest average Water Tip Cigarette”: per cent water for any brand, namely, Lark (10.4%), [they] found that Waterford is higher by 81.7%” (Unknown, 1965a). Similarly, a Smoking through water dates back to about 1600, when the water pipe 1966 PM memo from Duane C. Watson (Research Scientist, PM) to first appeared in Persia and India. In most Eastern nations, water- Resnik (Watson, 1966) reported that the pinched Waterford Cigarette smoking is thought to improve tobacco taste and the hookah is preferred had 12.3 mg of water per cigarette compared to 9.2 mg of water per

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3.3. Rivage Cigarettes

Twenty-two years after ATCo patented the Waterford cigarette, in 1987, Japan Tobacco (JT) patented Rivage (Tamaoki, n.d.) the second cigarette that attempted to mimic waterpipe technology Unknown, 1988. The patent, titled “Easily breakable plastic capsule and a water filter for a cigarette using the same,” describes a water filter foraci- garette made up of “a flexible casing in the form of a tube open atboth ends, one end of the casing serving as a socket for a cigarette and the other end serving as a mouthpiece; at least one filter member for the cigarette contained in the casing and capable of being impregnated with liquid; an easily breakable plastic capsule disposed in close vici- nity to the filter members in the casing; and guide means for guiding a flow of smoke from the cigarette into the casing… the cylindrical body having a packed chamber… being sealable after being packed with the liquid composed mainly of water… thin enough to be broken when the body is subjected to external force applied through the casing” Fig. 2. Patent technology originally designed for Waterford Cigarettes (Irby & (Tamaoki, n.d.). Sprinkle, n.d.). The documents reveal that, in 1988, several US tobacco companies,

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Fig. 3. Advertisement for Rivage Cigarettes (Unknown, 1988a). including ATCo, were monitoring Rivage [Fig. 3](Unknown, 1988). An internal PM International (PMI) letter dated February 1988 from Leslie Greher (PM Marketing Communications Manager) to Louis Suwarna Fig. 4. JTIC Patent filed in 1990 (Tamaoki, 1990). (General Manager of PM Asia Incorporated) stated: I'm enclosing a pack of the latest Japanese Monopoly launch in the the product. U.A.E. [United Arab Emirates]– Rivage. As you can see from the pack Unknown, 1988 and the news articles/ad, it is meant to be like a water pipe… Since it was In 1990, scientists from JT presented the technology behind Rivage somewhat reminiscent of an old U.S. brand, at the 44th Tobacco Chemists' Research Conference. The abstract of Waterford, I've sent a pack to Bob Eck and to R&D in Richmond so they their paper referenced the “hubble-bubble pipe” and stated that “stu- can check it against any patents we may have. dies on water cigarettes are continuing with the aims of improving the PMI et al., 1988 function and lowering production costs” (PM & Lunsford, 1990). Ulti- In June 1988, Angela Smith, a PMI Scientist, sent PM USA the re- mately, Rivage was unsuccessful (McAdam, Kevin, & John, n.d.). JTIC sults of focus group testing performed by PMI to determine “whether filed a second patent for Rivage in 1990 Tamaoki, 1990 that consisted the activated aquafilter of the Rivage cigarettes resulted in differences of a crushable plastic flavor capsule inside a smoking article (i.e., ci- in the subjective responses [to smoking].” (PMUSA et al., 1988) The garette) [Fig. 4](Tamaoki, 1990). That same year, Japan Tobacco re- findings reported, “with the exception of resistance to draw, theacti- ported they did not have plans for a new cigarette that incorporated the vated aquafilter did not appear to have any effect on subjective rat- flavor capsule in the filter (Japan Tobacco Incorporated & Doolittle, ings.” (PMUSA et al., 1988) A May 1988 ATCo note titled “Rivage Ci- 1990). garettes” stated the following: 4. Discussion Rivage Cigarettes manufactured by JTIC and sold in the Middle East, contains a “Triple Aqua Filter” capsule insert that releases liquid into the The first waterpipe-inspired product, a filtered cigarette holder that filter when pressure is applied to the capsuleSFM, 1988. This document contained water in the filter, was developed in 1954. Since at least displayed results of tests on the average quantity of water content of 5 1955, the tobacco industry has been monitoring the incorporation of Rivage cigarette capsules […]SFM, 1988228.1 mg of water in the filled waterpipe technology into cigarettes and cigarette accessories, and, capsules since at least 1965, resulting in the Waterford and Rivage cigarettes, SFM, 1988. which contained water-filled capsules that soaked the filter with water An ATCo newsletter dated 1988 and titled “JTIC's ‘water cigarette’ in an attempt to imitate the water filtration technology of the waterpipe flows to the Middle East” (1988) stated: (Unknown, 1955). The defining component of these products was water filtration, which the industry's documents and current literature have Japan Tobacco International Corp. (JTIC) has launched Rivage in the proven does not effectively filter the chemicals in tobacco smoke(PMI United Arab Emirates, a cigarette that employs the hubble bubble, or et al., 1988; Schubert et al., 2015; SFM, 1988; St. Helen et al., 2014; hookah smoking, principle…the Japanese company needed only a few Unknown, 1955). The growing scientific evidence of the harms of days to decide that the idea for the new cigarette was worth pursuing, But smoking and the declining social acceptability of cigarette smoking at researching appropriate technology and conforming to high industry the time likely motivated industry attempts to use water filtration to standards were time consuming. It took three-and-a-half years to develop create a “less harmful” cigarette (Health and Human Services, 1964).

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All of these products were marketed as safer methods of smoking ci- Funding garettes. Versions of Aquafilter are still available through chain retailers in- This research did not receive any specific grant from funding cluding Walgreens and Amazon.com; however, Aquafilter Corporation agencies in the public, commercial, or not-for-profit sectors. no longer manufactures this product (Amazon, n.d.; Walgreen's, n.d.; Oakhurst Company, n.d.). Waterford Cigarettes had a very short life in Conflict of interest the marketplace and were ultimately unsuccessful (Rodgman & Perfetti, 2008). We could not find any internal industry documents featuring None. Rivage cigarettes after 1990 (PM & Lunsford, 1990). However, the documents suggest that ATCo channeled the tech- Data sharing statement nology gained from Waterford's crushable water capsule into a cigarette that contained a flavor capsule (not just water). In 1967, ATCo devel- All source materials are available in the UCSF Truth Tobacco oped a cigarette called Tennyson that delivered menthol using the Industry Documents Library, available at http://industrydocuments. crushable capsules from Waterford (Neill & Edmonds, 1968). In 1969, library.ucsf.edu/tobacco or on other publicly available websites. ATCo released Brighton cigarettes, which featured the same crushable This work does not represent the opinions and views of RTI menthol capsule (Unknown, 1985). We were unable to find Tennyson International or the Santa Clara County Public Health Department and and Brighton marketed in the US in 2018. are solely those of the authors. In addition to ATCo, other tobacco companies have incorporated crushable menthol capsules into their cigarettes as evidenced by RJR References patents for mass marketing of cigarettes with crushable flavor capsules in 2003, which were applied to Camel Crush, a cigarette containing Aljarrah, K., Ababneh, Z. 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