Comparison of measured and FTC-predicted nicotine uptake in smokers

Cigarette butts as a source of phenolic compounds for the environment

Cigarette butts (CBs) are small residues with mixed composition. Produced in large amounts, their accumulation in the environment has become alarming. It is possible to classify more than 7000 chemical components generated either in the burning process or when distilled from the tobacco. The aim of this work was to describe the rate of release of phenolic compounds from CBs, to determine the content of these compounds in freshly smoked CBs and to monitor the release of phenols from CBs into fresh natural waters. The kinetics of release of selected phenolic compounds (hydroquinone, resorcinol, pyrocatechol, phenol, guaiacol, o-cresol, m-cresol, p-cresol) into water was monitored for 48 h. More than 90% of the content was extracted within 10 h for all analytes. The phenolic content was determined in the CBs of five different brands. The total content of phenols determined for each sample of freshly smoked CB was 215-861 µg/CB. For all CBs analysed, phenol, pyrocatechol and hydroquinone were the most abundant analytes, accounting for up to 75% of the content of all phenols determined. Phenol was the most abundant analyte (64.6-267.8 µg/CB) in all analysed samples. The content of pyrocatechol, the second most abundant analyte, was 45.6-221.2 µg/CB and the third most abundant analyte was hydroquinone (41.71-157.5 µg/CB). Monitoring the release of phenols from CBs into fresh natural waters (river, stream, pond) under steady and slight moving conditions showed that the kinetics of release is not influenced by the type of water. On the contrary, the process of decomposition of the released compounds is influenced by the type of water. The maximum concentrations of individual phenols in CBs extracts were comparable to those determined via laboratory extraction, thus indicating that within 72 h, most of the phenolic compounds are released from CBs into natural water. This research provides missing information on the phenolic content in CBs and the rate of release into water. It thus complements previously published information on CBs as a source of environmental contamination.

Comprehensive metabolic study of nicotine in equine plasma and urine using liquid chromatography/high-resolution mass spectrometry for the identification of unique biomarkers for doping control

Nicotine is classified as a stimulant, and its use is banned in horse racing and equestrian sports by the International Federation of Horseracing Authorities and the Fédération Équestre Internationale, respectively. Because nicotine is a major alkaloid of tobacco leaves, there is a potential risk that doping control samples may be contaminated by tobacco cigarettes or smoke during sample collection. In order to differentiate the genuine doping and sample contamination with tobacco leaves, it is necessary to monitor unique metabolites as biomarkers for nicotine administration and intake. However, little is known about the metabolic fate of nicotine in horses. This is the first report of comprehensive metabolism study of nicotine in horses. Using liquid chromatography/electrospray ionization high-resolution mass spectrometry, we identified a total of 17 metabolites, including one novel horse-specific metabolite (i.e., 4-hydroxy-4-(3-pyridyl)-N-methylbutanamide), in post-administration urine samples after nasoesophageal administration of nicotine to three thoroughbred mares; eight of these compounds were confirmed based on reference standards. Among these metabolites, N-hydroxymethylnorcotinine was the major urinary metabolite in equine, but it could only be tentatively identified by mass spectral interpretation due to the lack of reference material. In addition, we developed simultaneous quantification methods for the eight target analytes in plasma and urine, and applied them to post-administration samples to establish elimination profiles of nicotine and its metabolites. The quantification results revealed that trans-3'-hydroxycotinine could be quantified for the longest period in both plasma (72 h post-administration) and urine (96 h post-administration). Therefore, this metabolite is the most appropriate monitoring target for nicotine exposure for the purpose of doping control due to its long detection times and the availability of its reference material. Further, we identified trans-3'-hydroxycotinine as a unique biomarker allowing differentiation between nicotine administration and sample contamination with tobacco leaves.

Cigarette Filter Ventilation and its Relationship to Increasing Rates of Lung Adenocarcinoma

The 2014 Surgeon General's Report on smoking and health concluded that changing cigarette designs have caused an increase in lung adenocarcinomas, implicating cigarette filter ventilation that lowers smoking machine tar yields. The Food and Drug Administration (FDA) now has the authority to regulate cigarette design if doing so would improve public health. To support a potential regulatory action, two weight-of-evidence reviews were applied for causally relating filter ventilation to lung adenocarcinoma. Published scientific literature (3284 citations) and internal tobacco company documents contributed to causation analysis evidence blocks and the identification of research gaps. Filter ventilation was adopted in the mid-1960s and was initially equated with making a cigarette safer. Since then, lung adenocarcinoma rates paradoxically increased relative to other lung cancer subtypes. Filter ventilation 1) alters tobacco combustion, increasing smoke toxicants; 2) allows for elasticity of use so that smokers inhale more smoke to maintain their nicotine intake; and 3) causes a false perception of lower health risk from "lighter" smoke. Seemingly not supportive of a causal relationship is that human exposure biomarker studies indicate no reduction in exposure, but these do not measure exposure in the lung or utilize known biomarkers of harm. Altered puffing and inhalation may make smoke available to lung cells prone to adenocarcinomas. The analysis strongly suggests that filter ventilation has contributed to the rise in lung adenocarcinomas among smokers. Thus, the FDA should consider regulating its use, up to and including a ban. Herein, we propose a research agenda to support such an effort.

Using Monte Carlo simulation to assess variability and uncertainty of tobacco consumption in a city by sewage epidemiology

OBJECTIVE

To use Monte Carlo simulation to assess the uncertainty and variability of tobacco consumption through wastewater analysis in a city.

METHODS

A total of 11 wastewater treatment plants (WWTPs) (serving 2.2 million people; approximately 83% of urban population in Dalian) were selected and sampled. By detection and quantification of principal metabolites of nicotine, cotinine (COT) and trans-3'-hydroxycotinine (OH-COT), in raw wastewater, back calculation of tobacco use in the population of WWTPs can be realised.

RESULTS

COT and OH-COT were detected in the entire set of samples with an average concentration of 2.33 ± 0.30 and 2.76 ± 0.91 µg/L, respectively. The mass load of absorbed NIC during the sampling period ranged from 0.25 to 4.22 mg/day/capita with an average of 1.92 mg/day/capita. Using these data, we estimated that smokers in the sampling area consumed an average of 14.6 cigarettes per day for active smoker. Uncertainty and variability analysis by Monte Carlo simulation were used to refine this estimate: the procedure concluded that smokers in Dalian smoked between 10 and 27 cigarettes per day. This estimate showed good agreement with estimates from epidemiological research.

CONCLUSIONS

Sewage-based epidemiology may be a useful additional tool for the large-scale monitoring of patterns of tobacco use. Probabilistic methods can be used to strengthen the reliability of estimated use generated from wastewater analysis.

A High Throughput Method for Estimating Mouth-Level Intake of Mainstream Cigarette Smoke

INTRODUCTION

We developed a high throughput method for estimating smoker's mainstream smoke intake on a per-cigarette basis by analyzing discarded cigarette butts. This new method utilizes ultraviolet/visible (UV-Vis) spectrophotometric analysis of isopropanol-soluble smoke particulate matter extracted from discarded cigarette filters.

METHODS

When measured under a wide range of smoking conditions for a given brand variant, smoking machine delivery of nicotine, benzene, polycyclic aromatic hydrocarbons, and tobacco-specific nitrosamines can be related to the overall filter extract absorbance at 360 nm. Once this relationship has been established, UV-Vis analysis of a discarded cigarette filter butt gives a quantitative measure of a smoker's exposure to these analytes.

RESULTS

The measured mainstream smoke constituents correlated closely (correlation coefficients from 0.9303 to 0.9941) with the filter extract absorbance. These high correlations held over a wide range of smoking conditions for 2R4F research cigarettes as well as popular domestic cigarette brands sold in the United States.

CONCLUSIONS

This low cost, high throughput method is suitable for high volume analyses (hundreds of samples per day) because UV-Vis spectrophotometry, rather than mass spectrometry, is used for the cigarette filter butt analysis. This method provides a stable and noninvasive means for estimating mouth-level delivery of many mainstream smoke constituents. The ability to gauge the mouth-level intake of harmful chemicals and total mainstream smoke for cigarette smokers in a natural setting on a cigarette-by-cigarette basis can provide insights on factors contributing to morbidity and mortality from cigarette smoking, as well as insights on strategies related to smoking cessation.

Lack of effect of menthol level and type on smokers' estimated mouth level exposures to tar and nicotine and perceived sensory characteristics of cigarette smoke

Menthol can reduce sensory irritation and it has been hypothesised that this could result in smokers of mentholated cigarettes taking larger puffs and deeper post-puff inhalations thereby obtaining higher exposures to smoke constituents than smokers of non-mentholated cigarettes. The aim of our study was to use part-filter analysis methodology to assess the effects of cigarette menthol loading on regular and occasional smokers of mentholated cigarettes. We measured mouth level exposure to tar and nicotine and investigated the effects of mentholation on smokers' sensory perceptions such as cooling and irritation. Test cigarettes were produced containing no menthol and different loadings of synthetic and natural l-menthol at 1 and 4mg ISO tar yields. A target of 100 smokers of menthol cigarettes and 100 smokers who predominantly smoked non-menthol cigarettes from both 1 and 4mg ISO tar yield categories were recruited in Poland and Japan. Each subject was required to smoke the test cigarette types of their usual ISO tar yield. There were positive relationships between menthol loading and the perceived 'strength of menthol taste' and 'cooling' effect. However, we did not see marked menthol-induced reductions in perceived irritation or menthol-induced increases in mouth level exposure to tar and nicotine.

Variations in nicotine yields between single cigarettes

INTRODUCTION AND AIMS

It is beyond any doubt that nicotine yield in cigarettes as determined using standard ISO method bears almost no relation to smokers' actual intake. However, the ISO method is still in use in many countries where the government is responsible for controlling and monitoring cigarette quality. The aim of the study was to measure the nicotine yield in single cigarettes and to evaluate their statistical distribution among the same brand.

MATERIALS AND METHODS

Nicotine yields were measured according to the ISO method in single cigarettes of the twenty most popular Polish brands of cigarettes.

RESULTS

Relative standard deviation of nicotine yields in single cigarettes of the same brands varied from 16% to 34%. Relative differences between nicotine yields in a single cigarette of a particular brand and the mean value varied from -65% to +76%.

DISCUSSION AND CONCLUSIONS

The results indicate high variation in nicotine yields between cigarettes of the same brand. Such variation might affect compensatory smoking. This provides another reason why yields estimated using the standard ISO method are potentially misleading to smokers. Further studies are needed to better understand the implications of within-brand variability in yields for tobacco product regulation.

A survey of mouth level exposure to cigarette smoke in the United States

Smoke yields determined by a machine-based smoking method cannot adequately predict exposures experienced by human smokers. In this work, a filter analysis technique which addresses this fundamental limitation was used to measure mouth level exposures (MLE) to tar and nicotine in 1330 smokers of 26 brand-styles of US cigarettes covering a wide range of machine-generated yields. Despite the high degree of variability observed among individual smokers, MLEs were significantly correlated with machine-derived tar and nicotine yields (r=0.423 for nicotine MLE/cigarette; r=0.493 for tar MLE/cigarette; p<0.001 for both). Mean tar and nicotine MLE was higher for males than for females. Mean MLE across races was generally similar. Menthol cigarettes tended toward lower MLE than non-menthol cigarettes and King-Size cigarettes (≈ 83 mm) tended toward lower MLE than 100's cigarettes (≈ 100 mm), though those trends were not statistically significant. There were good agreements between MLEs measured in a group of 159 subjects smoking their usual cigarette brand-style on two separate occasions and between two independent groups of subjects smoking the same brand-styles. The results indicated that the filter analysis method used had sufficient precision to show similarity among groups.

UGT2B10 genotype influences nicotine glucuronidation, oxidation, and consumption

BACKGROUND

Tobacco exposure is routinely assessed by quantifying nicotine metabolites in plasma or urine. On average, 80% of nicotine undergoes C-oxidation to cotinine. However, interindividual variation in nicotine glucuronidation is substantial, and glucuronidation accounts for from 0% to 40% of total nicotine metabolism. We report here the effect of a polymorphism in a UDP-glucuronsyltransferase, UGT2B10, on nicotine metabolism and consumption.

METHODS

Nicotine, cotinine, their N-glucuronide conjugates, and total trans-3'-hydroxycotinine were quantified in the urine (n = 327) and plasma (n = 115) of smokers. Urinary nicotine N-oxide was quantified in 105 smokers. Nicotine equivalents, the sum of nicotine and all major metabolites, were calculated for each smoker. The relationship of the UGT2B10 Asp67Tyr allele to nicotine equivalents, N-glucuronidation, and C-oxidation was determined.

RESULTS

Individuals heterozygous for the Asp67Tyr allele excreted less nicotine or cotinine as their glucuronide conjugates than did wild-type, resulting in a 60% lower ratio of cotinine glucuronide to cotinine, a 50% lower ratio of nicotine glucuronide to nicotine, and increased cotinine and trans-3'-hydroxycotinine. Nicotine equivalents, a robust biomarker of nicotine intake, were lower among Asp67Tyr heterozygotes compared with individuals without this allele: 58.2 (95% confidence interval, 48.9-68.2) versus 69.2 nmol/mL (95% confidence interval, 64.3-74.5).

CONCLUSIONS

Individuals heterozygous for UGT2B10 Asp67Tyr consume less nicotine than do wild-type smokers. This striking observation suggests that variations in nicotine N-glucuronidation, as reported for nicotine C-oxidation, may influence smoking behavior.

IMPACT

UGT2B10 genotype influences nicotine metabolism and should be taken into account when characterizing the role of nicotine metabolism on smoking.

Comparison of the behavioral effects of cigarette smoke and pure nicotine in rats

Animal models of tobacco dependence typically rely on parenteral administration of pure nicotine. Models using cigarette smoke inhalation might more accurately simulate nicotine exposure in smokers. The primary goal of this study was to validate methods for administering cigarette smoke to rats using exposure conditions that were clinically relevant and also produced brain nicotine levels similar to those produced by behaviorally active doses of pure nicotine. A secondary goal was to begin examining the behavioral effects of smoke. Nose-only exposure (NOE) to smoke for 10-45min or whole-body exposure (WBE) to smoke for 1-4h produced serum nicotine concentrations similar to those in smokers (14-55ng/ml), without excessive carbon monoxide exposure. Daily nicotine (0.1mg/kg, s.c.) induced locomotor sensitization whereas 45-min NOE producing brain nicotine levels within the same range did not. Nicotine 0.125mg/kg s.c. reversed withdrawal from a chronic nicotine infusion as measured by elevations in intracranial self-stimulation thresholds whereas 4-h WBE producing similar brain nicotine levels did not. These data demonstrate the feasibility of delivering cigarette smoke to rats at clinically relevant doses, and provide preliminary evidence that the behavioral effects of nicotine delivered in smoke may differ from those of pure nicotine.

Machine-smoking studies of cigarette filter color to estimate tar yield by visual assessment and through the use of a colorimeter

This paper explores using the intensity of the stain on the end of the filter ("filter color") as a vehicle for estimating cigarette tar yield, both by instrument reading of the filter color and by visual comparison to a template. The correlation of machine-measured tar yield to filter color measured with a colorimeter was reasonably strong and was relatively unaffected by different puff volumes or different tobacco moistures. However, the correlation of filter color to machine-measured nicotine yield was affected by the moisture content of the cigarette. Filter color, as measured by a colorimeter, was generally comparable to filter extraction of either nicotine or solanesol in its correlation to machine-smoked tar yields. It was found that the color of the tar stain changes over time. Panelists could generally correctly order the filters from machine-smoked cigarettes by tar yield using the intensity of the tar stain. However, there was considerable variation in the panelist-to-panelist tar yield estimates. The wide person-to-person variation in tar yield estimates, and other factors discussed in the text could severely limit the usefulness and practicality of this approach for visually estimating the tar yield of machine-smoked cigarettes.

Methods used in internal industry clinical trials to assess tobacco risk reduction

OBJECTIVE

Methods to assess reduced exposure products should include those that aid in determining likely patterns of human use and exposure. Tobacco industry clinical trial methods may provide insight into strategies to assess potential reduced exposure products (PREP) for public health purposes. Internal tobacco industry documents detailing human clinical research with PREPs were examined to document major research strategies used and identify potentially fruitful methods not currently used in the mainstream arena.

METHODS

Primary data were obtained from records of research conducted internally by tobacco companies and affiliated researchers, and included manuscript drafts, presentations, protocols, and instruments relating to internal clinical trials of human tobacco use and exposure.

RESULTS

Tobacco industry clinical research has focused on reduced exposure products, most notably Premier, Accord, and Eclipse. The most widely used strategy observed is switching studies, and details of study designs and protocols favored by the industry are described. Key measures include biomarkers of exposure (e.g., cotinine, CO, and specific carcinogens) and acute health effects such as physical health and fitness.

CONCLUSIONS

Tobacco industry clinical research has used relatively standard switching study methods, but with a broad set of measures. Clinical switching studies have been conducted by the industry primarily to support existing claims or to develop new claims. Knowledge of prior industry activity can guide and inform future public health research efforts. Although industry clinical trial methods are comparable with current mainstream methods, limited information about the validity of outcome measures used limits their viability for immediate adoption in mainstream science.

Estimating tar and nicotine exposure: human smoking versus machine generated smoke yields

OBJECTIVE

Determine human smoked (HS) cigarette yields of tar and nicotine for smokers using their own brand in their everyday environment.

METHOD

A robust, filter analysis method was used to estimate the tar and nicotine yields for 784 subjects. Seventeen brands were chosen to represent a wide range of styles: 85 and 100 mm lengths; menthol and non-menthol; 17, 23, and 25 mm circumference; with tar yields [Federal Trade Commission (FTC) method] ranging from 1 to 18 mg. Tar bands chosen corresponded to yields of 1-3 mg, 4-6 mg, 7-12 mg, and 13+ mg.

RESULTS

A significant difference (p<0.0001) in HS yields of tar and nicotine between tar bands was found. Machine-smoked yields were reasonable predictors of the HS yields for groups of subjects, but the relationship was neither exact nor linear. Neither the FTC, the Massachusetts (MA) nor the Canadian Intensive (CI) machine-smoking methods accurately reflect the HS yields across all brands. The FTC method was closest for the 7-12 mg and 13+ mg products and the MA method was closest for the 1-3mg products. The HS yields for the 4-6 mg products were approximately midway between the FTC and the MA yields. HS nicotine yields corresponded well with published urinary and plasma nicotine biomarker studies.

The relationship between smoking machine derived tar yields and biomarkers of exposure in adult cigarette smokers in the US

Comprehensive data on human exposure to smoke constituents from different machine-measured tar yield cigarettes is limited.

METHODS

This study used a stratified, cross-sectional, multi-center design to estimate biomarkers of exposure (BOE) from nicotine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), pyrene, CO, acrolein, and 1,3-butadiene and their relationship to tar yield categories of cigarette in adult smokers in the U.S. 3625 adults smokers were enrolled into four tar categories < or =2.9 mg (T1), 3.0-6.9 mg (T2), 7.0-12.9 mg (T3), and > or =13.0mg (T4). Biomarkers were measured in blood (carboxyhemoglobin, 4-aminobiphenyl-hemoglobin (4-ABP-Hb)-adducts, serum cotinine) and 24h urine (nicotine and five metabolites, calculated as nicotine equivalents (NE), NNAL, 1-OH-pyrene, 3-HPMA, MHBMA and DHBMA). Data were analyzed using analysis of covariance (ANCOVA).

RESULTS

Tar was a significant factor for most biomarkers in the ANCOVA models. The largest least square mean differences between tar categories was 35% for NE per day, 28% for NE per cigarette, 36% for serum cotinine, 42% for NNAL per day, 29% for NNAL per cigarette, 26% for 1-OHP, 24% for COHb, 14% for 3-HPMA and 40% for 4-ABP-Hb. Variability in BOE ranged from 41% to 154% CV.

CONCLUSIONS

There was a statistically significant effect of machine-measured tar yield on most BOE, which were generally lower with lower tar yield.

A study to estimate and correlate cigarette smoke exposure in smokers in Germany as determined by filter analysis and biomarkers of exposure

A clinical study, conducted in Germany, compared two methods of estimating exposure to cigarette smoke. Estimates of mouth level exposure (MLE) to nicotine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), pyrene and acrolein were obtained by chemical analysis of spent cigarette filters for nicotine content. Estimates of smoke constituent uptake were achieved by analysis of corresponding urinary biomarkers: for nicotine; total nicotine equivalents (nicotine, cotinine, trans-3'-hydroxycotinine plus their glucuronide conjugates), for NNK; (4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) plus glucuronide, for pyrene; 1-hydroxy pyrene (1-OHP) plus glucuronide and for acrolein; 3-hydroxylpropyl-mercapturic acid (3-HPMA) plus the nicotine metabolite cotinine in plasma and saliva. Two hundred healthy volunteer subjects were recruited; 50 smokers of each of 1-2 mg, 4-6 mg and 9-10 mg ISO tar yield cigarettes and 50 non-smokers (NS). Smokers underwent two periods of home smoking, each followed by residence in a clinic. Smoking was permitted ad libitum, and spent cigarette filters, cigarette consumption data, 24h urine, as well as plasma and saliva samples were collected. Significant correlations (p<0.001) were found between MLE and the relevant biomarker for each smoke constituent. The Pearson correlation coefficients (r) were 0.83 (nicotine), 0.76 (NNK), 0.82 (acrolein) and 0.63 (pyrene). Mean MLE estimates for nicotine, NNK and pyrene showed a dose response in line with ISO tar yield smoked, with 10 mg > 4 mg >1 mg, and for acrolein 10 mg> 4 mg > *1mg (where * indicates not significant at 95% confidence level). The mean exposure estimates from biomarkers for nicotine, NNK and acrolein also showed a dose response in line with ISO tar yield with 10 mg > 4 mg > 1 mg > NS, and for pyrene 10 mg > *4 mg> 1 mg> NS. This study shows that estimates of exposure obtained by filter analysis and biomarkers of exposure correlate significantly over a wide range of smoke exposures and that filter analysis may provide a simple and effective alternative to biomarkers for estimating smokers' exposure.

Changes in nicotine intake and cigarette use over time in two nationally representative cross-sectional samples of smokers

Population surveys have observed decreases in cigarette use over time among smokers. These decreases have probably been influenced by tobacco control measures implemented over the past several decades, but few data exist on whether smokers have also reduced their nicotine intake. The authors examined data from two cross-sectional National Health and Nutrition Examination Surveys (NHANES), conducted in 1988-1994 and 1999-2002. Laboratory, examination, and interview data from current smokers not reporting nicotine intake from other sources were examined. From NHANES III (1988-1994) to NHANES 1999-2002, the average number of cigarettes smoked per day (CPD) fell by nearly 15% (three cigarettes), while the mean serum cotinine level fell by 13% (30 ng/ml). Finer breakdowns of CPD data in each time period suggested that most of the change occurred in the lower (<10 CPD) and higher (>or=20 CPD) smoking categories. These data suggest that CPD may represent a proxy for exposure to nicotine and perhaps other tobacco smoke constituents on the population level, since the decline in serum cotinine levels observed among smokers closely paralleled the decline in self-reported CPD between 1988-1994 and 1999-2002. In addition, these data are inconsistent with the hypothesis that the remaining population of smokers is becoming more dependent on nicotine over time.

Biomarkers of exposure and potential harm in adult smokers of 3-7 mg tar yield (Federal Trade Commission) cigarettes and in adult non-smokers

The paper reports levels of 24-h urine nicotine and five of its major metabolites (expressed as nicotine-equivalents) and blood carboxyhaemoglobin as biomarkers of exposure to particulate- and gas-phase cigarette smoke, respectively, from an exploratory pilot study of adult smokers of 3.0-6.9 mg tar delivery (Federal Trade Commission (FTC) method) cigarettes. On multiple occasions over 6 weeks, blood high-sensitivity C-reactive protein (hs-CRP), fibrinogen, HDL- and LDL-cholesterol, and 24-h urine 8-epi-prostaglandin F2alpha (8-epi-PGF2alpha) and 11-dehydro-thromboxane B2 (11-dehydro-TxB2) were also evaluated as biomarkers of potential harm. All the biomarkers examined, except for LDL-cholesterol, discriminated with high sensitivity and specificity between adult smokers and non-smokers overall. Except for HDL-cholesterol, all biomarker medians were greater in adult smokers than in non-smokers: urine nicotine-equivalents 64.514 versus < 0.034 nmol mg-1 creatinine (p<0.001), carboxyhaemoglobin 4.0 versus 0.4% saturation (p<0.001), hs-CRP 0.27 versus 0.12 mg dl-1 (p=0.05), fibrinogen 292 versus 248 mg dl-1 (p<0.001), HDL-cholesterol 46 versus 53 mg dl-1 (p=0.003), LDL-cholesterol 119 versus 109 mg dl-1 (p=0.18), urine 8-epi-PGF2alpha 1935 versus 1034 pg mg-1 creatinine (p<0.001) and urine 11-dehydro-TxB2 973 versus 710 pg mg-1 creatinine (p<0.001). All the biomarkers of exposure and most of the biomarkers of potential harm showed no time of sampling (by visit week) effect.

Influence of smoking charcoal filter tipped cigarettes on various biomarkers of exposure

Charcoal (CC) filters of cigarettes are known to significantly reduce a series of volatile constituents in mainstream smoke, including reactive alpha,beta-unsaturated aldehydes such as acrolein and crotonaldehyde. We performed a randomized, crossover, 2-wk brand-switching study with 39 smokers. Twenty of the subjects smoked cellulose acetate (CA) filter tipped cigarettes during wk 1 of the study; the remaining 19 subjects smoked CC filter tipped cigarettes during wk 1. In wk 2, the subjects switched to the corresponding brand with the other filter type, with similar smoking machine-derived tar and nicotine yields. Daily cigarette consumption, carbon monoxide in exhaled breath, salivary cotinine, and urinary nicotine equivalents (molar sum of nicotine plus five major metabolites) did not change significantly when switching to the cigarettes with the other filter type. Urinary excretion rates of 3-hydroxy-1-methylpropylmercapturic acid (metabolite of crotonaldehyde), monohydroxybutenylmercapturic acid (metabolite of 1,3-butadiene), and S-phenylmercapturic acid (metabolite of benzene) were significantly lower when smoking CC compared to CA filter tipped cigarettes. The reduction in amount of 3-hydroxypropylmercapturic acid (metabolite of acrolein) was of borderline significance. Other mercapturic acids and thioethers (the latter is a summary parameter that indicates the exposure to electrophilic compounds) were not or were only slightly reduced upon smoking CC filter tipped cigarettes. We conclude that smoking CC filter tipped cigarettes does not change the uptake of carbon monoxide and nicotine when compared to CA filter tipped cigarettes with similar tar and nicotine yields, but significantly reduces the exposure to toxicologically relevant smoke constituents such as acrolein, crotonaldehyde, 1,3-butadiene, and benzene.

Do reductions in the tar and nicotine yields of cigarettes help to explain recent reductions in lung cancer rates in young men and women in the United States?

Between 1985 and 2000, lung cancer rates in U.S. men and women aged 35-54 yr have declined. To investigate whether these declines can adequately be explained by changes in smoking prevalence, consumption, and duration, or if changes in tar and nicotine yields also contributed, two model-fitting approaches were used. Both approaches used individual person National Health Interview Survey data on smoking prevalence, age of starting and time of quitting, and national estimates of consumption per smoker and yields. Both approaches compared observed rates (by sex and age) relative to 1985, with those predicted after successively including various smoking variables into the model, making varying allowance for compensation for reduced yield. Approach A was simpler, based on mean smoking statistics estimated separately for current and former smokers. Approach B used the multistage model and individual smoking histories to estimate risk. Both approaches showed observed declines in risk were (except for men aged 35-39 yr) clearly greater than predicted based only on prevalence, consumption, and duration. Including yield generally improved the fit. At younger ages, models assuming substantial compensation (consistent with evidence from studies relating nicotine yield and intake) fitted well, but at age 50-54 yr in both sexes and age 45-49 yr in women, the decline was better fitted by models assuming little compensation. The conclusions were not sensitive to the precise parameter values assumed in the modeling. Interpretation is not straightforward, but the findings suggest declines in yields have contributed to the recent declines in rates in young U.S. men and women.

Validation and application of a method for the determination of nicotine and five major metabolites in smokers' urine by solid-phase extraction and liquid chromatography-tandem mass spectrometry

An SPE-LC-MS/MS method was developed, validated and applied to the determination of nicotine and five major metabolites in human urine: cotinine, trans-3'-hydroxycotinine, nicotine-N-glucuronide, cotinine-N-glucuronide and trans-3'-hydroxycotinine-O-glucuronide. A 500 microL urine sample was pH-adjusted with phosphate buffer (1.5 mL) containing nicotine-methyl-d3, cotinine-methyl-d3 and trans-3'-hydroxycotinine-methyl-d3 internal standards. For the unconjugated metabolites, an aliquot (800 microL) of the buffered solution was applied to a 30 mg Oasis HLB-SPE column, rinsed with 2% NH4OH/H2O (3.0 mL) and H2O (3.0 mL) and eluted with methanol (500 microL). The eluate was analyzed isocratically (100% methanol) by LC-MS/MS on a diol column (50 x 2.1 mm). For the total metabolites, a beta-glucuronidase/buffer preparation (100 microL) was added to the remaining buffered solution and incubated at 37 degrees C (20 h). An aliquot (800 microL) of the enzymatically treated buffered solution was extracted and analyzed in the same manner. The conjugated metabolites were determined indirectly by subtraction. The quantitation range of the method (ng/mL) was 14-10,320 for nicotine, 15-9800 for cotinine and 32-19,220 for trans-3'-hydroxycotinine. The validated method was used to observe diurnal variations from a smoker's spot urine samples, elimination half-lives from a smoker's 24 h urine samples and metabolite distribution profiles in the spot and 24 h urine samples.

Metabolism and Disposition Kinetics of Nicotine

Nicotine is of importance as the addictive chemical in tobacco, pharmacotherapy for smoking cessation, a potential medication for several diseases, and a useful probe drug for phenotyping cytochrome P450 2A6 (CYP2A6). We review current knowledge about the metabolism and disposition kinetics of nicotine, some other naturally occurring tobacco alkaloids, and nicotine analogs that are under development as potential therapeutic agents. The focus is on studies in humans, but animal data are mentioned when relevant to the interpretation of human data. The pathways of nicotine metabolism are described in detail. Absorption, distribution, metabolism, and excretion of nicotine and related compounds are reviewed. Enzymes involved in nicotine metabolism including cytochrome P450 enzymes, aldehyde oxidase, flavin-containing monooxygenase 3, amine N-methyltransferase, and UDP-glucuronosyltransferases are represented, as well as factors affecting metabolism, such as genetic variations in metabolic enzymes, effects of diet, age, gender, pregnancy, liver and kidney diseases, and racial and ethnic differences. Also effects of smoking and various inhibitors and inducers, including oral contraceptives, on nicotine metabolism are discussed. Due to the significance of the CYP2A6 enzyme in nicotine clearance, special emphasis is given to the effects and population distributions of CYP2A6 alleles and the regulation of CYP2A6 enzyme.

Nicotine metabolism, human drug metabolism polymorphisms, and smoking behaviour

Large interindividual differences occur in human nicotine disposition, and it has been proposed that genetic polymorphisms in nicotine metabolism may be a major determinant of an individual's smoking behaviour. Hepatic cytochrome P4502A6 (CYP2A6) catalyses the major route of nicotine metabolism: C-oxidation to cotinine, followed by hydroxylation to trans-3'-hydroxycotinine. Nicotine and cotinine both undergo N-oxidation and pyridine N-glucuronidation. Nicotine N-1-oxide formation is catalysed by hepatic flavin-containing monooxygenase form 3 (FMO3), but the enzyme(s) required for cotinine N-1'-oxide formation has not been identified. trans-3'-Hydroxycotinine is conjugated by O-glucuronidation. The uridine diphosphate-glucuronosyltransferase (UGT) enzyme(s) required for N- and O-glucuronidation have not been identified. CYP2A6 is highly polymorphic resulting in functional differences in nicotine C-oxidation both in vitro and in vivo; however, population studies fail to consistently and conclusively demonstrate any associations between variant CYP2A6 alleles encoding for either reduced or enhanced enzyme activity with self-reported smoking behaviour. The functional consequences of FMO3 and UGT polymorphisms on nicotine disposition have not been investigated, but are unlikely to significantly affect smoking behaviour. Therefore, current evidence does not support the hypothesis that genetic polymorphisms associated with nicotine metabolism are a major determinant of an individual's smoking behaviour and exposure to tobacco smoke.

Simultaneous determination of nicotine and eight nicotine metabolites in urine of smokers using liquid chromatography-tandem mass spectrometry

A method based on liquid chromatography tandem mass spectrometry (LC-MSMS) applying atmospheric pressure chemical ionisation (APCI) in the positive ion mode was developed for the direct determination of nicotine, cotinine, trans-3'-hydroxycotinine, their corresponding glucuronide conjugates as well as cotinine-N-oxide, norcotinine, and nicotine-N'-oxide in the urine of smokers. The assay involves filtration of crude urine, fast liquid chromatography on a reversed-phase column and mass-specific detection using MSMS transitions. Deuterium-labeled nicotine, cotinine, and trans-3'-hydroxycotinine were used as internal standards. Glucuronides used as reference material were either chemically (cotinine-N-glucuronide) or enzymatically synthesized (nicotine-N-glucuronide and trans-3'-hydroxycotinine-O-glucuronide). Precision for the major nicotine analytes at levels observable in urine of smokers was better than 10%. Accuracy expressed in recovery rates in urine matrix for nicotine, cotinine, trans-3'-hydroxycotinine, and cotinine-N-glucuronide ranged from 87 to 113%. Quantitative results for the three glucuronides in urine samples of 15 smokers were compared to an indirect method in which the aglycons were determined with gas chromatography and nitrogen-selective detection (GC-NPD) before and after enzymatic splitting of the conjugates. Good agreement was found for cotinine-N-glucuronide (coefficient of variation, CV: 9%) and trans-3'-hydroxycotinine-O-glucuronide (CV: 20%), whereas the accordance between both methods was moderate for nicotine-N-glucuronide (CV: 33%). The described LC-MSMS method allows the simultaneous determination of nicotine and eight of its major metabolites in urine of smokers with good precision and accuracy. Since the method requires a minimum of sample clean-up and a very short time for chromatography (3 min), it is suitable for determining the nicotine dose in large-scale human biomonitoring studies.

Tobacco smoking, harm reduction, and biomarkers

The only known way to reduce cancer risk in smokers is complete cessation, but many smokers are unable or unwilling to quit. Consequently, tobacco companies are now marketing products that purport to reduce carcinogen exposure, with the implication that such products provide a safer way to smoke. Moreover, researchers are exploring ways to reduce the amount of cigarette smoke carcinogens to which the smokers are exposed. Although these methods are, in theory beneficial, it is possible that the perceived availability of "safe" ways to smoke will cause some former smokers to resume smoking and some current smokers to delay quitting. Thus, the extent of exposure reduction and the impact on public health of these methods need to be considered carefully. However, risk reduction and its relation to exposure are not simple to estimate. The way people smoke and the way they respond to carcinogen exposure are both highly variable, as evidenced by the previous history of smokers who switched to light, or low-tar cigarettes. This can actually increase risk in some smokers. The evaluation of exposure reduction will therefore need to be multidisciplinary and include in vitro cell culture studies, animal studies, human clinical studies, and epidemiologic studies. Biomarkers will be critical for rapidly evaluating the effects of new strategies or products to reduce exposure to tobacco smoke carcinogens. No single biomarker will likely satisfy our assessment needs, and so a panel of biomarkers should be used that includes biomarkers of exposure, biologically effective dose, and potential harm. In addition, usefulness of new products will need to be tested in people of different susceptibilities (i.e., who vary in behavior, sex, age, genetics, and prior tobacco use). Even if the new products are shown to be effective at reducing lung carcinogens, they should not be used alone but rather be incorporated into a comprehensive tobacco control program.

Cigarette filter ventilation is a defective design because of misleading taste, bigger puffs, and blocked vents

OBJECTIVE

To review tobacco industry documents on filter ventilation in light of published studies and to explore the role of filter ventilation in the design of cigarettes that deliver higher smoke yields to smokers than would be expected from standard machine smoked tests (Federal Trade Commission (FTC), International Organization for Standardization (ISO)).

DATA SOURCES

Searched from November 1999 to November 2000 internet databases of industry documents (www.pmdocs.com, www.rjrtdocs.com, www.lorillarddocs.com, www.bw.aalatg.com, www.cdc.gov/tobacco/industrydocs, www.tobaccodocuments.org, www.tobaccopapers.org, www.hlth.gov.bc.ca/Guildford, www.cctc.ca/ncth/Guildford, www.cctc.ca/ncth/Guildford2) for documents related to filter ventilation. Documents found dated from 1955 through 1994.

STUDY SELECTION

Those documents judged to contain the most relevant information or data on filter ventilation related to cigarette taste and compensatory smoking, while also trying to avoid redundancy from various documents deriving from the same underlying data.

DATA SYNTHESIS

Filter ventilation is a crucial design feature creating three main problems for lower tar cigarettes as measured by official smoking machine testing. Firstly, it misleadingly makes cigarettes taste lighter and milder, and, therefore, they appear less dangerous to smokers. Secondly, it promotes compensation mainly by facilitating the taking of larger puffs. Thirdly, for very heavily ventilated cigarettes (that is, > 65% filter air dilution), behavioural blocking of vents with lips or fingers is an additional contributor to compensatory smoking. These three effects are found in industry research as well as published research.

CONCLUSIONS

Filter ventilation is a dangerous, defective technology that should be abandoned in less hazardous nicotine delivery systems. Health interested groups should test cigarettes in a way that reflects compensatory smoking. Lower tar (vented filter) cigarettes should be actively countermarketed.

Whose standard is it, anyway? How the tobacco industry determines the International Organization for Standardization (ISO) standards for tobacco and tobacco products

OBJECTIVE

To describe the extent of the tobacco industry involvement in establishing international standards for tobacco and tobacco products and the industry influence on the International Organization for Standardization (ISO).

METHODS

Analysis of tobacco industry documents made public as part of the settlement of the Minnesota Tobacco Trial and the Master Settlement Agreement. Search words included "ISO", "CORESTA", "Barclay", "compensation and machine smoking", "tar and nicotine deliveries", and the name of key players, in different combinations.

RESULTS

It is clear that the tobacco industry, through the Cooperation Centre for Scientific Research Relative to Tobacco (CORESTA), play a major role in determining the scientific evidence and suggesting the standards that are eventually adopted as international standards for tobacco and tobacco products in several areas, including the measurement of cigarette tar and nicotine yield.

CONCLUSIONS

ISO's tobacco and tobacco products standards are not adequate to guide tobacco products regulatory policies, and no health claims can be made based on ISO's tobacco products standards. There is an urgent need for tobacco control advocates and groups worldwide to be more involved with the work of the ISO, both directly and through their national standardisation organisations.