All cigarettes are not produced equal, and those in America do more damage than their foreign counterparts. American-blend cigarettes—as opposed to bright tobacco used overseas— have been found to have tripled the tobacco-specific nitrosamines than brands found in Australia, Canada, or the United Kingdom.

Tobacco-specific nitrosamines (TSNAs) are powerful carcinogens that are created during the curing and processing of tobacco. The Center for Disease Control recently completed research on TSNAs, with the results being published in the June issue of Cancer epidemiology biomarkers and prevention. Among the findings, based on analysis of cigarette butts and smokers from diverse countries, are that TSNAs differ from brand to brand, and from country to country and Americans are getting the short end of the cancer stick, so to speak.

By testing a range of day-old cigarette butts and the urine of smokers in Australia, Britain, Canada and the United States, they found an association between the amounts of TSNA that entered a smoker’s body and how much is broken down in the urine. They will be able to use this biomarker in the urine to help them recognize how much of the carcinogen exposure you are getting in your mouth and lungs, said Dr. Jim Pirkle, deputy manager for science at the CDC’s National Center for Environmental Health’s Division of Laboratory Sciences.

At the same time as this report may give the CDC ammunition to issue product standards it’s not likely to decrease the rate of smokers. For years campaigns have been waged on the dangers of smoking; from direct contact to secondhand smoke and yet U.S. smoking rates uphold their numbers, with hardly a descending trend among tobacco users.

More than 443,000 people die every year from cigarette smoke, a number that translates into the U.S. spending more than $96 billion in health care related to smoking-related diseases and the considerable deaths.