RT Journal Article SR Electronic T1 Blowing smoke: the history of tobacco-specific nitrosamines in Canadian tobacco JF Tobacco Control JO Tob Control FD BMJ Publishing Group Ltd SP 365 OP 370 DO 10.1136/tobaccocontrol-2015-052873 VO 26 IS 4 A1 Neil Collishaw YR 2017 UL http://tobaccocontrol.bmj.com/content/26/4/365.abstract AB Objective To demonstrate how changes in tobacco flue-curing practices in the 20th century increased levels of tobacco-specific nitrosamines (TSNAs) in tobacco smoke.Methods Previously undisclosed documents and testimony made public as a result of a class action trial against tobacco companies in Montreal, Canada, were reviewed for information on TSNAs and tobacco curing practices. These were combined with other pertinent documents to form the basis for a comprehensive historical review of TSNAs and tobacco curing practices.Results In the 1960s and 1970s, a change was made from indirect heating to direct heating for flue-curing tobacco that resulted in an increase in the TSNA-to-tar ratio in flue-cured tobacco. This occurred in both Canada and the USA. When this change was made, tobacco companies did not monitor for increased levels of TSNAs and did not study possible adverse effects on human health. As a result, smokers were unknowingly exposed to unnecessarily high levels of TSNAs for 30–40 years. In recent years, tobacco companies have changed curing practices back to indirect heating, thus returning the TSNA-to-tar ratios in tobacco smoke to their previously low levels.Conclusions In view of this information brought to light in this paper, any claims by tobacco companies that they were acting prudently by lowering TSNA levels are unwarranted. They fail to acknowledge that it was their actions that raised TSNA levels in the first place about half a century ago.