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Ansari SM, Hession PS, David M, Blanc N, de La Bourdonnaye G, Pouly S, Haziza C. Impact of switching from cigarette smoking to tobacco heating system use on biomarkers of potential harm in a randomized trial. Biomarkers 2024; 29:298-314. [PMID: 38804903 DOI: 10.1080/1354750x.2024.2358318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/24/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Smoking cessation reduces the risk of developing smoking-related diseases. Although smoking prevalence has declined, many continue smoking cigarettes. Switching completely to smoke-free alternatives like the Tobacco Heating System (THS) 2.2-a heated tobacco product for which there is evidence demonstrating significantly reduced formation and exposure to harmful chemicals compared to cigarettes-has the potential to reduce the harm caused by continuing to smoke cigarettes. METHODS We conducted a 6-month clinical study (NCT02396381) with a 6-month extension (NCT02649556), initially randomizing 984 adult smokers to continue smoking or switch to THS (non-mentholated), of which 672 continued into the extension study. Endpoints were evaluated at baseline and at 3, 6, and 12 months. We longitudinally assessed biomarkers of potential harm (BoPHs) known to be reversible upon smoking cessation as indicators of pathways involved in the pathogenesis of cardiovascular or respiratory diseases and carcinogenicity. The need to cough and safety profile were also assessed. Impact on eight key BoPHs was used as a proxy to evaluate harm reduction potential. RESULTS At 12 months, comparison of BoPH levels between the predominant THS use and cigarette smoking groups showed a positive effect in favor of switching, partially or in full, to THS. CONCLUSION These results provide additional evidence of the harm reduction potential of THS for smokers who would otherwise continue smoking, but they need to be verified in long-term confirmatory studies. CLINICAL TRIAL REGISTRATION Clinicaltrials.gov Identifier: NCT0264955. Date of registration: January 7, 2016 https://clinicaltrials.gov/ct2/show/NCT02649556.
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Affiliation(s)
| | - Paul S Hession
- PMI R&D, Philip Morris Products S.A, Neuchâtel, Switzerland
| | - Morgane David
- PMI R&D, Philip Morris Products S.A, Neuchâtel, Switzerland
| | - Nicolas Blanc
- PMI R&D, Philip Morris Products S.A, Neuchâtel, Switzerland
| | | | - Sandrine Pouly
- PMI R&D, Philip Morris Products S.A, Neuchâtel, Switzerland
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Gallart-Mateu D, Dualde P, Coscollà C, Soriano JM, de la Guardia M. The chemical memory of smoking tobacco. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2024; 16:3311-3317. [PMID: 38766840 DOI: 10.1039/d4ay00444b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
The concentration in urine of N-acetyl-hydroxy-propyl-cisteine (3HPMA), an acrolein metabolite, has been employed as a marker of the risk of illness of smokers and the relative concentration of creatinine has been evaluated to verify the effect of moving from the practice of burning tobacco to nicotine vaping. From the results concerning the urine samples of 38 subjects, collected from 2021 to 2023 and analyzed by LC-MS/MS, corresponding to 5 active smokers, 13 previously heavy smokers who replaced traditional tobacco by vaping, and 20 non-smokers, a dramatic reduction was found in 3HPMA/creatinine in urine. 3HPMA varied from values of 2150-3100 μg gcreatinine-1 to levels of 225-625 μg gcreatinine-1 found for non-smokers, with the time decay described by the equation y = 0.3661x2 - 94.359x + 6246.4 (R2: 0.757), providing a time of approximately 10 years for tobacco memory after the cessation of the consumption of burned tobacco.
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Affiliation(s)
- D Gallart-Mateu
- Department of Analytical Chemistry, University of Valencia, Research Building, 50 Dr Moliner Street, 16100-Burjassot, Valencia, Spain.
| | - P Dualde
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Av. Catalunya, 21, Valencia, 46020, Spain
| | - C Coscollà
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Av. Catalunya, 21, Valencia, 46020, Spain
| | - J M Soriano
- GISP Grup d'Investigació en Salut Pública, Universitat Politècnica de Catalunya, Spain
| | - M de la Guardia
- Department of Analytical Chemistry, University of Valencia, Research Building, 50 Dr Moliner Street, 16100-Burjassot, Valencia, Spain.
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Cordery S, Thompson K, Stevenson M, Simms L, Chapman F, Grandolfo E, Malt L, Weaver S, Fearon IM, Nahde T. The Product Science of Electrically Heated Tobacco Products: An Updated Narrative Review of the Scientific Literature. Cureus 2024; 16:e61223. [PMID: 38939262 PMCID: PMC11209752 DOI: 10.7759/cureus.61223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2024] [Indexed: 06/29/2024] Open
Abstract
Heated tobacco products represent a novel category of tobacco products in which a tobacco consumable is heated to a temperature that releases nicotine from the tobacco leaf but not to a temperature sufficient to cause combustion. Heated tobacco products may therefore have the potential to be a less harmful alternative for adult smokers who would otherwise continue to smoke cigarettes, as their use should result in exposure to substantially fewer and lower levels of toxicants. This update represents a two-year extension to our previous narrative review, which covered peer-reviewed journal articles published up to August 31, 2021. The scientific evidence published between 2021 and 2023 continues to indicate that aerosols produced from heated tobacco products contain fewer and substantially lower levels of harmful and potentially harmful constituents and that these observed reductions consistently translate to reduced biological effects in both in vitro and in vivo toxicological studies. Biomarker and clinical data from studies in which product use is controlled within a clinical setting continue to suggest changes in levels of biomarkers of exposure, biomarkers of potential harm, and clinical endpoints indicating the potential for reduced harm with switching to exclusive use of heated tobacco products in adult smokers. Overall, the available peer-reviewed scientific evidence continues to indicate that heated tobacco products offer promise as a potentially less harmful alternative to cigarettes, and as such, the conclusions of our original narrative review remain valid.
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Affiliation(s)
- Sarah Cordery
- Group Science and Regulatory Affairs, Imperial Brands Plc., Bristol, GBR
| | - Keith Thompson
- Independent Scientific Consultant, Elucid8 Holdings Ltd., Coleraine, GBR
| | - Matthew Stevenson
- Group Science and Regulatory Affairs, Imperial Brands Plc., Bristol, GBR
| | - Liam Simms
- Group Science and Regulatory Affairs, Imperial Brands Plc., Bristol, GBR
| | - Fiona Chapman
- Group Science and Regulatory Affairs, Imperial Brands Plc., Bristol, GBR
| | - Erika Grandolfo
- Group Science and Regulatory Affairs, Imperial Brands Plc., Bristol, GBR
| | - Layla Malt
- Group Science and Regulatory Affairs, Imperial Brands Plc., Bristol, GBR
| | - Sarah Weaver
- Group Science and Regulatory Affairs, Imperial Brands Plc., Bristol, GBR
| | - Ian M Fearon
- Scientific Research, whatIF? Consulting Ltd., Harwell, GBR
| | - Thomas Nahde
- Group Science and Regulatory Affairs, Imperial Brands Reemtsma, Hamburg, DEU
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Polosa R, Pluym N, Scherer M, Belsey J, Russell C, Caponnetto P, Weglarz J, Campagna D. Protocol for the "magnitude of cigarette substitution after initiation of e-cigarettes and its impact on biomarkers of exposure and potential harm in dual users" (MAGNIFICAT) study. Front Public Health 2024; 12:1348389. [PMID: 38584934 PMCID: PMC10996441 DOI: 10.3389/fpubh.2024.1348389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 03/08/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction Many smokers who use e-cigarettes (ECs) to quit continue smoking alongside vaping. The impact on health among individuals who simultaneously smoke conventional cigarettes (CCs) and use ECs remains unclear. The varying patterns of dual use present differing levels of overall toxin exposure and relative risks concerning smoking-related diseases. Understanding these complexities is vital to assessing the implications for human health. Objective Herein we describe a protocol designed to analyze the impact of different level of substituting CCs with ECs on exposure to toxicants. We'll use biomarkers to measure this exposure and assess harm reduction in dual users through clinical endpoints, harm-related biomarkers, and behavioral correlations. We expect to observe progressive changes with varying patterns of dual use. Methods and analyses For this purpose, we planned to recruit a group of 250 smokers who will be asked to reduce their CC consumption by adopting ECs (intervention group). A separate group of 50 smokers will continue to smoke CC (reference group). Study groups will be followed up for 6 months during which biospecimens will be collected for biomarker analyses, and clinical endpoints will be assessed. The trial is structured to characterize subjects' usage patterns over time using robust biomarkers of exposure and a standardized mobile phone application to facilitate the precise categorization of dual users along the risk continuum based on their usage behaviors. Subject recruitment will start in February 2024 and enrolment is expected to be completed by August 2024. Results will be reported early in 2025. Study findings may provide valuable insights into health benefits or risks associated with varying patterns of dual use. Ethics and dissemination The study protocol and informed consent forms will be approved by the local Ethical Review Boards. Study results will be disseminated through articles published in reputable, peer-reviewed, open access, scientific journals, presentations at conferences, and the University website.
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Affiliation(s)
- Riccardo Polosa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), University Teaching Hospital "Policlinico-S.Marco", University of Catania, Catania, Italy
- Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), University of Catania, Catania, Italy
| | - Nikola Pluym
- ABF Analytisch-Biologisches Forschungslabor GmbH, Planegg, Germany
| | - Max Scherer
- ABF Analytisch-Biologisches Forschungslabor GmbH, Planegg, Germany
| | | | | | - Pasquale Caponnetto
- Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), University of Catania, Catania, Italy
- Department of Science of Education, Section of Psychology, University of Catania, Catania, Italy
| | - Jakub Weglarz
- ECLAT Srl, Spin-off of the University of Catania, Catania, Italy
| | - Davide Campagna
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- UOC MCAU, University Teaching Hospital "Policlinico-S.Marco", University of Catania, Catania, Italy
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Nishihara D, Yuki D, Suzuki T, Sakaguchi C, Nagata Y, Kakehi A. A Randomized Control Study in Healthy Adult Smokers to Assess Reduced Exposure to Selected Cigarette Smoke Constituents in Switching to the Novel Heated Tobacco Product DT3.0a. Clin Pharmacol Drug Dev 2024; 13:45-57. [PMID: 37680118 DOI: 10.1002/cpdd.1322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/06/2023] [Indexed: 09/09/2023]
Abstract
This was a randomized, controlled, open-label, confinement study to assess change in exposure to selected cigarette smoke constituents in healthy adult cigarette smokers who switched to using a novel heated tobacco product (direct heating tobacco system, platform 3, generation 3, version a [DT3.0a]). Sixty nonmenthol cigarette smokers were randomized into 1 of the 4 study groups in which subjects switched to a nonmenthol type of tobacco stick used with DT3.0a, switched to a nonmenthol tobacco stick used with an in-market heated tobacco product device (THS), continued to smoke nonmenthol cigarettes, or stopped smoking. Furthermore, 30 menthol cigarette smokers were randomized into 1 of the 2 study groups in which subjects switched to a menthol tobacco stick used with DT3.0a (mDT3.0a) or continued to smoke menthol cigarettes. Fifteen biomarkers of exposure to selected harmful and potentially harmful constituents (HPHCs) were measured during the 5-day exposure period, followed by assessment of nicotine pharmacokinetics with the assigned product. Results indicated that switching to DT3.0a, THS, and mDT3.0a showed significant exposure reductions in most of the selected HPHCs as compared to continuing smoking cigarettes, with reductions being similar in magnitude to reductions observed with smoking cessation. For DT3.0a and mDT3.0a, nicotine pharmacokinetic parameters were not remarkably different from those obtained for cigarettes and the THS except that a longer time to maximum concentration was obtained following use of the mDT3.0a. In conclusion, switching from smoking cigarettes to DT3.0a or THS use reduced exposure to most of the selected HPHCs, and no remarkable differences were observed for the measurements obtained from different flavors of DT3.0a stick.
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Affiliation(s)
- Daisuke Nishihara
- Scientific and Regulatory Affairs, Japan Tobacco Inc., Minato-Ku, Tokyo, Japan
| | - Dai Yuki
- Scientific and Regulatory Affairs, Japan Tobacco Inc., Minato-Ku, Tokyo, Japan
| | - Takuya Suzuki
- Scientific and Regulatory Affairs, Japan Tobacco Inc., Minato-Ku, Tokyo, Japan
| | - Chikako Sakaguchi
- Scientific and Regulatory Affairs, Japan Tobacco Inc., Minato-Ku, Tokyo, Japan
| | - Yasufumi Nagata
- Scientific and Regulatory Affairs, Japan Tobacco Inc., Minato-Ku, Tokyo, Japan
| | - Aoi Kakehi
- Scientific and Regulatory Affairs, Japan Tobacco Inc., Minato-Ku, Tokyo, Japan
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Kanobe MN, Nelson PR, Brown BG, Chen P, Makena P, Caraway JW, Prasad GL, Round EK. Changes in Biomarkers of Exposure and Potential Harm in Smokers Switched to Vuse Vibe or Vuse Ciro Electronic Nicotine Delivery Systems. TOXICS 2023; 11:564. [PMID: 37505530 PMCID: PMC10384956 DOI: 10.3390/toxics11070564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/05/2023] [Accepted: 06/27/2023] [Indexed: 07/29/2023]
Abstract
Electronic nicotine delivery systems (ENDS) have the potential to provide nicotine to tobacco consumers while reducing exposure to combustion-related toxicants. Here, we report changes in biomarkers of exposure (BoE) and biomarkers of potential harm (BoPH) in smokers who completely switched to Vuse Vibe and Vuse Ciro ENDS products, or to smoking abstinence in a randomized, controlled clinical study. Thirteen BoE (12 urinary and one blood) that indicate exposure to harmful and potentially harmful toxicants (HPHCs) were evaluated at baseline on day 5. Urinary BoPH linked to oxidative stress, platelet activation, and inflammation were also assessed at baseline, and on day 5 and day 7. Nicotine exposure was lower in Vuse Vibe and Vuse Ciro groups compared to baseline values. Urinary non-nicotine BoE decreased significantly (52.3-96.7%) in the Vuse ENDS groups, and the reductions were similar in magnitude to those observed in the abstinence group. Blood carboxyhemoglobin decreased 52.8-55.0% in all study groups. Decreases (10-50%) in BoPH were observed in all study groups. Thus, smokers who switch exclusively to Vuse Vibe or Vuse Ciro products or completely abstain from smoking are exposed to substantially lower levels of HPHCs, and experience improvements in BoPH of oxidative stress and inflammation pathways.
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Affiliation(s)
- Milly N Kanobe
- RAI Services Company, 401 N. Main Street, Winston-Salem, NC 27101, USA
| | - Paul R Nelson
- Former Employees of RAI Services Company, 105 Bowes Road, Winston Salem, NC 27106, USA
| | - Buddy G Brown
- Former Employees of RAI Services Company, 5714 Wonderous Lane, Durham, NC 27712, USA
| | - Peter Chen
- RAI Services Company, 401 N. Main Street, Winston-Salem, NC 27101, USA
| | - Patrudu Makena
- RAI Services Company, 401 N. Main Street, Winston-Salem, NC 27101, USA
| | - John W Caraway
- RAI Services Company, 401 N. Main Street, Winston-Salem, NC 27101, USA
| | - Gaddamanugu L Prasad
- Former Employees of RAI Services Company, 490 Friendship Place Ct, Lewisville, NC 27023, USA
- Prasad Scientific Consulting LLC, 490 Friendship Place Ct, Lewisville, NC 27023, USA
| | - Elaine K Round
- BAT (Investments) Limited, Globe House, 1 Water Street, London WC2R 3LA, UK
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McDermott S, Reichmann K, Mason E, Fearon IM, O'Connell G, Nahde T. An assessment of nicotine pharmacokinetics and subjective effects of the pulze heated tobacco system compared with cigarettes. Sci Rep 2023; 13:9037. [PMID: 37270650 DOI: 10.1038/s41598-023-36259-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/31/2023] [Indexed: 06/05/2023] Open
Abstract
Nicotine delivery and subjective effects are determinants of the ability of potentially less harmful tobacco products such as heated tobacco products (HTPs) to support adult smokers in switching away from cigarettes, and therefore to support tobacco harm reduction. This open-label, randomised, crossover, clinical study in 24 healthy adult smokers study assessed nicotine pharmacokinetics and subjective effects of the Pulze Heated Tobacco System (HTS; Pulze HTP device and three iD stick variants-Intense American Blend, Regular American Blend and Regular Menthol) compared with subjects' usual brand cigarettes (UBC). Cmax and AUCt were highest for UBC and significantly lower for each Pulze HTS variant. Cmax and AUCt were significantly higher for Intense American Blend compared with Regular American Blend, while AUCt was significantly higher for Intense American Blend compared with Regular Menthol. Median Tmax was lowest (i.e., nicotine delivery was fastest) for subjects' usual brand cigarettes and similar across the iD stick variants, although no between-product differences were statistically significant. All study products reduced urges to smoke; this effect was greatest for cigarettes although this was not statistically significant. Product evaluation scores for each Pulze HTS variant in the domains of 'satisfaction', 'psychological reward' and 'relief' were similar, and lower than those for UBC. These data demonstrate that the Pulze HTS effectively delivers nicotine and generates positive subjective effects, including satisfaction and reduced urge to smoke. This supports the conclusion that the Pulze HTS may be an acceptable alternative to cigarettes for adult smokers while having a lower abuse liability than cigarettes.
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Affiliation(s)
- Simon McDermott
- ICON PLC, South County Business Park, Leopardstown, Dublin 18, Ireland
| | | | - Elizabeth Mason
- Imperial Brands PLC, 121 Winterstoke Road, Bristol, BS3 2LL, UK
| | - Ian M Fearon
- whatIF? Consulting Ltd, The Crispin, Burr Street, Harwell, OX11 0DT, UK
| | - Grant O'Connell
- Imperial Brands PLC, 121 Winterstoke Road, Bristol, BS3 2LL, UK
| | - Thomas Nahde
- Reemtsma Cigarettenfabriken GmbH, Max-Born-Straße 4, 22761, Hamburg, Germany.
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Begić E, Aziri B, Omeragić E, Medjedović E, Iglica A, Stanetić B, Kovačević-Preradović T, Živanović Ž, Begić A, Janković S, Mlačo N, Mladenović Z, Badnjević A. Heat-not-burn tobacco products and cardiovascular risk reduction: A systematic review of randomized controlled trials. Technol Health Care 2023:THC220677. [PMID: 36641697 DOI: 10.3233/thc-220677] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Heat-not-burn (HNB) technology by the U.S. Food and Drug Administration has been classified as a modified risk tobacco product, which can be a better option for those populations who cannot give up the habit of smoking. The outlook on the effects of these products is quite controversial in the scientific world. OBJECTIVE To present the effect of HNB tobacco products on the cardiovascular system, with reference to the existence of possible benefits of the technology. METHODS The literature search was conducted in PubMed/Medline, the Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov databases, with reliance on a well-defined guiding research statement. Quality appraisal was performed using the CASP checklist for randomized controlled trials. RESULTS The search of three databases identified 167 records, and after selection process, 25 randomized controlled trials were eligible for our study's criteria. Twenty studies investigated the effects of HNB products on biomarkers of clinical relevance. Five studies evaluated other functional heart parameters rather than biomarkers. CONCLUSION With HNB tobacco products, significant reductions were found in biomarkers of exposure and biological effect related to pathways involved in cardiovascular disease, including inflammation, oxidative stress, lipid metabolism, platelet function, and endothelial dysfunction.
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Affiliation(s)
- Edin Begić
- Department of Pharmacology, Sarajevo Medical School, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina.,Department of Cardiology, General Hospital "Prim. Dr. Abdulah Nakaš", Sarajevo, Bosnia and Herzegovina
| | - Buena Aziri
- Department of Pharmacology, Sarajevo Medical School, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
| | - Elma Omeragić
- Faculty of Pharmacy, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Edin Medjedović
- Clinic of Gynecology and Obstetrics, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Amer Iglica
- Clinic for Heart, Blood vessels and Rheumatism, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Bojan Stanetić
- Department of Cardiology, University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina.,Department of Internal Medicine, Medical Faculty, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | - Tamara Kovačević-Preradović
- Department of Cardiology, University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina.,Department of Internal Medicine, Medical Faculty, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | - Željko Živanović
- Department of Cardiology, University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
| | - Amra Begić
- Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Slobodan Janković
- Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Nejra Mlačo
- Health Care Centre, Visoko, Bosnia and Herzegovina
| | - Zorica Mladenović
- Department of Cardiology, Military Medical Academy, University of Defense, Belgrade, Serbia
| | - Almir Badnjević
- International Burch University, Sarajevo, Bosnia and Herzegovina.,Genetics and Bioengineering Department, Faculty of Engineering and Natural Sciences, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
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Scherer G, Riedel K, Pluym N, Scherer M. Assessment of the Exposure to Aromatic Amines in Users of Various Tobacco/Nicotine Products. ACS OMEGA 2022; 7:41775-41782. [PMID: 36406517 PMCID: PMC9670903 DOI: 10.1021/acsomega.2c06130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
Aromatic amines such as ortho-toluidine (o-Tol), 2-aminonaphthalene (2-AN), and 4-aminobiphenyl (4-ABP) are human bladder carcinogens and occur at various workplaces, in ambient air, in food products, as well as in tobacco smoke. In a clinical study comprising a period of 74 h under confinement, we investigated the exposure to these three aromatic amines as well as to 3-aminobiphenyl (3-ABP) by measuring them in urine of habitual users of combustible cigarettes (CCs), electronic cigarettes (ECs), heated tobacco products (HTPs), oral tobacco (OT), and nicotine replacement therapy products (NRTs). Non-users (NU) of any tobacco/nicotine products served as (negative) control group. Smokers (CC) exhibited the highest levels for all four aromatic amines measured, significantly elevated compared to NU and non-CC users. Urinary levels in users of EC, HTP, NRT (mostly nicotine gum), and OT (mostly snus) were not significantly different from those in NU. Users of HTP showed slightly elevated urinary excretion levels of o-Tol, 3-ABP, and 4-ABP compared to some other non-CC groups. Dose markers such as daily consumption, urinary nicotine equivalents (Nequ), and plasma cotinine (CotP) were found to be consistently and significantly correlated with the excretion of aromatic amines for smokers (CC) only. Excretion levels of 3- and 4-ABP in smokers were significantly lower in the urine collected overnight compared to that collected during the day, which is just the opposite of what we observed for other biomarkers in this study. The possible reason for this observation is discussed. In conclusion, in contrast to smoking of CCs, the use of ECs, HTPs, nicotine gum, and oral tobacco was not observed to be associated with significant exposure to the aromatic amines o-Tol, 2-AN, 3-ABP, and 4-ABP. The observed slight increase in o-Tol, 3-ABP, and 4-ABP excretions in HTP users has to be verified in larger studies.
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