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The Health and Environmental Impacts of Cigarette Filters

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The Health and Environmental Impacts of Cigarette Filters DOI: 10.1590/1413-81232021266.23692019 2395 Saúde sem filtro: os impactos dos filtros dos cigarros na saúde TEM e no meio ambiente AS LIV R E Health without filters: the health and environmental impacts of S F cigarette filters R EE THEME S André Luiz Oliveira da Silva (https://orcid.org/0000-0003-4768-959X) 1 Stefania Schimaneski Piras (https://orcid.org/0000-0003-0289-0126) 1 Stella Aguinaga Bialous (https://orcid.org/0000-0002-6471-5457) 2 Josino Costa Moreira (https://orcid.org/0000-0002-7457-2920) 3 Abstract Tobacco-related diseases kill eight mil- Resumo As doenças relacionadas ao tabaco lion people worldwide ever year and are responsi- matam oito milhões de pessoas anualmente no ble for thousands of cases of cancer, cardiovascu- mundo e, no Brasil, são responsáveis por milha- lar disease and other illnesses in Brazil. Cigarette res de casos de cânceres, doenças cardiovasculares filters are believed by many to reduce the health e outras enfermidades. Os filtros nos cigarros são risks of smoking. This article outlines the history percebidos como uma tecnologia que reduziria os of the technology of filters and discusses the im- danos à saúde. O objetivo deste artigo é descrever pacts of these cigarette design features and their a tecnologia dos filtros, seu histórico, seus impac- regulation. We conducted a literature review to tos e discutir formas de regulação. Foi feita uma assess the impacts of this technology. The results busca na literatura para avaliar os impactos desta show that filters were initially developed for aes- tecnologia. Os resultados mostram que os filtros fo- thetic purposes and later improved and marketed ram inicialmente desenvolvidos para fins estéticos, as a harm reduction technology. The most wide- e posteriomente aprimorados e promovidos como ly-used filters are those made of cellulose acetate uma tecnologia para redução de danos. O filtro de with or without activated carbon. Despite smok- cigarro mais utilizado é o de acetato de celulose, ers’ beliefs and advertising claims, filters have no combinado ou não com carvão ativado. Apesar das health benefits and filter tip ventilation can -in propagandas e da percepção dos fumantes, os fil- crease the health risks of smoking. Filters can also tros não trazem nenhum benefício à saúde, e sua 1 Agência Nacional de Vigilância Sanitária. Av. make cigarettes more appealing and cause signifi- associação com tecnologias como a perfuração nas Rio Branco 147 16º andar, cant environmental impacts. Cigarette filters have ponteiras podem trazer mais riscos à saúde. Os fil- Centro. 20081971 Rio de no health benefits and lull smokers into a false tros também podem tornar os cigarros mais atra- Janeiro RJ Brasil. [email protected] sense of security and should therefore be banned. tivos e causam impactos ao meio ambiente. Por 2 University of California Key words The tobacco industry; Control and proporcionarem uma falsa percepção de riscos e San Francisco, Helen Diller supervision of tobacco derived products nenhum benefício, os filtros deveriam ser uma tec- Family Comprehensive Cancer Center. San nologia proibida. Francisco, CA, USA. Palavras-chave Indústria do tabaco, Controle e 3 Centro de Estudos da fiscalização de produtos derivados do tabaco Saúde do Trabalhador e Ecologia Humana, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz. Rio de Janeiro RJ Brasil. 2396 et al. Silva ALO ALO Silva Introdução presentes na literatura, como por exemplo a forma de como os filtros são utilizados na propaganda As doenças relacionadas ao tabaco matam oito e as tecnologias utilizadas no mercado brasileiro. milhões de pessoas no mundo anualmente, ou seja, o consumo do tabaco e de seus derivados Seleção de dados, extração e síntese mata mais que Aids, cocaína, heroína, álcool, sui- cídios e acidentes de trânsito somados1. Foram buscadas publicações e documentos No Brasil, o tabagismo é responsável por relacionados ao design de cigarros, marketing cerca de 156 mil mortes anuais. Soma-se a isso, destes produtos, tecnologias associadas aos filtros 1.103.421 eventos médicos-ano. O tabaco ainda e novos tipos de filtros. é responsável por cerca de 157 mil infartos agu- A pesquisa foi refinada concentrando as bus- dos do miocárdio, 75 mil acidentes vasculares cas nas emissões tóxicas, na percepção e uso, cerebrais e 63 mil cânceres diagnosticados anu- impactos à saúde e ao ambiente, e na legislação almente 2. relevante para estes produtos. Assim, é natural que fumantes busquem for- Realizou-se uma busca utilizando uma com- mas de reduzir esses impactos e os filtros nos ci- binação das palavras-chave iniciais cigarro e filtro garros são percebidos como uma tecnologia que com palavras-chave relevantes para caracterís- seria capaz de reduzir os riscos decorrentes da ticas dos filtros: cápsulas, ventilação dos filtros, inalação da fumaça dos cigarros3-5. Atualmente, aditivos, design e todas palavras-chave relevantes alguns fabricantes sugerem que os filtros seriam e pertinentes: emissões, marketing, sabor, entre capazes de reduzir as emissões de alguns compo- outras, utilizando o método bola de neve. Não nentes tóxicos da fumaça, sem, contudo, corre- houve restrições quanto à data ou região geográ- lacioná-las com uma redução de riscos à saúde fica. Somente foram selecionados resultados em dos6. Alguns autores apontam ainda que a Indús- inglês e português. tria do Tabaco (IT) promoveu os filtros como uma tecnologia capaz de tornar os cigarros mais seguros e menos tóxicos para os fumantes, e que Resultados foi a principal tecnologia utilizada nos chamados cigarros “light”7. Entre os artigos científicos, 93 referências foram Por outro lado, estudos independentes apon- encontradas mencionando o termo filtro de ci- tam que os filtros não são capazes de reduzir garro (cigarette filter), destes, 14 retornaram com quaisquer riscos à saúde associados ao tabagismo o termo ventilação dos filtros de cigarros (ciga- (em algumas situações até mesmo aumentando rette filter ventilation), oito com o termo cápsulas seus riscos), seriam utilizados para estimular o nos filtros de cigarro (cigarette filter capsules), 14 consumo de cigarros, atrair novos fumantes e se- com o termo aditivos nos filtros de cigarros (ci- riam responsáveis por um significativo impacto garette filter aditives) e 18 com o termo design do ambiental8-12. filtro de cigarro (cigarette filter design). O objetivo deste trabalho é descrever a tec- nologia dos filtros, seu histórico, seu impacto e Histórico discutir sua regulação. Os filtros, nos cigarros, são utilizados desde 1860, basicamente para evitar que pedaços de ta- Métodos baco entrassem na boca do fumante, para manter os lábios úmidos e destinados ao público femi- Base de dados nino13-15. Em 1936 os filtros eram chamados de “ponteiras da beleza” (beauty tips), deixando cla- Entre abril de 2019 e maio de 2019 pesqui- ro para qual público se destina. O material origi- samos a literatura científica com base principal- nalmente utilizado era a cortiça, por isso muitos mente no banco de dados PUBMED. Incluímos filtros até hoje imitam esse padrão em sua apa- artigos relevantes citados em publicações obtidas rência14. através da pesquisa. Os sítios dos fabricantes de Nesse ínterim, foi patenteado um processo de cigarros, assim como sites de notícias e blogs tam- fazer um filtro de cigarro a partir de papel cre- bém foram pesquisados. pom e, em 1935, foi desenvolvida uma máquina Fontes não revisadas por pares foram incluídas que possibilitava fabricar cigarros com filtro16, o na pesquisa, pois podem fornecer dados ainda não que otimizou a fabricação destes tipos. 2397 Ciência & Saúde Coletiva, 26(6):2395-2401, 2021 26(6):2395-2401, Coletiva, & Saúde Ciência Contudo, o uso de filtros somente se popula- latos de alumínio, contendo tabaco cortados em rizou a partir da década de 1960, como resposta pequenos pedaços foram usados, ou pelo menos aos dados científicos que apontavam os danos sugeridos para serem usados8. causados pelo fumo. Diversas propagandas dos Os materiais que mais nos chamaram a aten- fabricantes de cigarro afirmavam que os com ção foram os filtros que continham asbestos, por filtro eram mais seguros, inclusive utilizando-se conta da alta toxidade deste composto e que che- da figura de médicos em suas peças publicitárias. garam a ser comercializados25 e uma patente de Diversos filtros de cigarro foram desenvolvidos um filtro para cigarro, que não se tem notícia de nessa época, aproveitando-se de um aumento da ter sido comercializado, feito com uma espécie preocupação publica com os malefícios do taba- de queijo ralado misturado ou não com carvão co, tendo sido utilizados inclusive filtros utilizan- ativado26. do asbesto (amianto). Em 1980 mais de 90% do Atualmente, os filtros mais utilizados são os mercado de cigarros já era constituído de cigar- de acetato de celulose tratados com triacetina e ros com filtro8,13. os de acetato de celulose combinados com carvão Como resposta às preocupações com a saú- ativado 6,8. de, a IT priorizou estratégias bem-sucedidas de Os filtros de fibras de acetato de celulose têm marketing focadas nos cigarros com filtro, como sua eficiência na redução do material particulado exemplo desse sucesso, o cigarro com filtro da influenciada por diversos fatores: tamanho, cir- marca Marlboro no início da década de 1920 era cunferência, número de filamentos de fibra e o uma marca voltada para o público feminino e foi uso de aditivos nas fibras. Os filtros combinados retirada do mercado durante a 2ª guerra mundial. de acetato de celulose e carvão ativado se valem Em meados de 1950 essa marca foi reintroduzida da premissa de que o carvão ativado é capaz de no mercado e reposicionada pela empresa para remover seletivamente componentes tóxicos da se tornar uma marca para o público masculino, fumaça do tabaco8,27. com filtro, simbolizada pelo famoso vaqueiro das Artigos científicos e documentos revelaram propagandas, se tornando uma das marcas mais que a IT havia desenvolvido cigarros para serem vendidas no mundo17.
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