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Ding ZM, Neslund EM, Sun D, Tan X. Methoxsalen inhibits the acquisition of nicotine self-administration: attenuation by cotinine replacement in male rats. Nicotine Tob Res 2024:ntae063. [PMID: 38513068 DOI: 10.1093/ntr/ntae063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Indexed: 03/23/2024]
Abstract
INTRODUCTION Cigarette smoking remains the leading preventable cause of disease and death. Nicotine is the primary reinforcing ingredient in cigarettes sustaining addiction. Cotinine is the major metabolite of nicotine that produces a myriad of neurobehavioral effects. Previous studies showed that cotinine supported self-administration in rats and rats with a history of cotinine self-administration exhibited relapse-like drug-seeking behavior, suggesting that cotinine may also be reinforcing. To date, whether cotinine may contribute to nicotine reinforcement remains unknown. Nicotine metabolism is mainly catalyzed by hepatic CYP2B1/2 enzymes in rats and methoxsalen is a potent CYP2B1/2 inhibitor. METHODS The study examined nicotine metabolism, self-administration, and locomotor activity. The hypothesis is that methoxsalen inhibits nicotine self-administration and cotinine replacement attenuates the inhibitory effects of methoxsalen in male rats. RESULTS Methoxsalen decreased plasma cotinine levels following a subcutaneous nicotine injection. Repeated daily methoxsalen treatments reduced the acquisition of nicotine self-administration, leading to fewer nicotine infusions, lower nicotine intake, and lower plasma cotinine levels. However, methoxsalen did not alter the maintenance of nicotine self-administration despite a significant reduction of plasma cotinine levels. Cotinine replacement by mixing cotinine with nicotine for self-administration dose-dependently increased plasma cotinine levels and enhanced the acquisition of self-administration. Neither basal nor nicotine-induced locomotor activity was altered by methoxsalen. CONCLUSIONS These results indicate that methoxsalen inhibition of cotinine formation impaired the acquisition of nicotine self-administration, and cotinine replacement attenuated the inhibitory effects of methoxsalen on the acquisition of self-administration, suggesting that cotinine may contribute to the initial development of nicotine reinforcement. IMPLICATIONS Smoking cessation medications targeting nicotine's effects are only moderately effective, making it imperative to better understand the mechanisms of nicotine misuse. Methoxsalen inhibited nicotine metabolism to cotinine and impaired the acquisition of nicotine self-administration. Cotinine replacement restored plasma cotinine and attenuated the methoxsalen inhibition of nicotine self-administration in rats. These results suggest that (1) the inhibition of nicotine metabolism may be a viable strategy in reducing the development of nicotine reinforcement, (2) methoxsalen may be translationally valuable, and (3) cotinine may be a potential pharmacological target for therapeutic development given its important role in the initial development of nicotine reinforcement.
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Affiliation(s)
- Zheng-Ming Ding
- Department of Anesthesiology & Perioperative Medicine, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA 17033, USA
- Department of Pharmacology, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA 17033, USA
| | - Elizabeth M Neslund
- Department of Anesthesiology & Perioperative Medicine, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA 17033, USA
| | - Dongxiao Sun
- Department of Pharmacology, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA 17033, USA
- Penn State Mass Spectrometry Core Facility, Penn State University College of Medicine, Hershey, PA 17033, USA
| | - Xiaoying Tan
- Department of Anesthesiology & Perioperative Medicine, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA 17033, USA
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Dai HD, Nollen N, Rennard S, Guenzel N, Pham H, Khan AS. Racial and ethnic disparities in biomarkers of exposure and potential harm among U.S. adult exclusive e-cigarette users: 2013-2019. Drug Alcohol Depend 2023; 252:110984. [PMID: 37804563 PMCID: PMC10615775 DOI: 10.1016/j.drugalcdep.2023.110984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/21/2023] [Accepted: 09/24/2023] [Indexed: 10/09/2023]
Abstract
OBJECTIVE Provide evidence on racial and ethnic differences in biomarkers of exposure from rising e-cigarette use among U.S. adults. METHODS Data were drawn from Waves 1-5 of the Population Assessment of Tobacco and Health study (September 2013-November 2019). Differences in biomarkers of exposure and potential harm (BOE/BoPH) across non-Hispanic (NH)-Whites, NH Blacks, Hispanic/Latinos, and NH others were examined using generalized estimation equations. RESULTS Among exclusive e-cigarette users, mean concentrations of BOEs/BoPHs were not significantly different across NH Blacks (n=97), NH others (n=122), and NH Whites (n=1062), after adjustment by wave, age, sex, education, exposure to the secondhand smoke, and the number of recent puffs. Compared to NH Whites, Hispanics (n=151) had lower concentrations of nicotine equivalents (0.5[0.2-1.7] vs. 15.5 [12.5-19.1] nmol/mg creatinine, p<.0001), cotinine (33.4[9.7-114.7] vs. 1008.3 [808.3-1257.9] ng/mg creatinine, p<.0001), and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) (2.6[1.5-4.4] vs. 5.7 [4.9-6.6] pg/mg creatinine, p=.004), but similar concentrations of BOEs for heavy metals, polycyclic aromatic hydrocarbons, volatile organic compounds, and oxidative stress. Differences between Hispanics and NH Whites are expected, given different e-cigarette use profiles. Specifically, Hispanics were less likely to be daily vapers (49.4[35.1-63.8]% vs 81.3[77.7-84.5]%, p<.0001) and nicotine e-cigarette users (72.7 [64.0-79.9]% vs. 89.2 [86.4-91.5]%, p=.0002] and reported a lower number of recent puffs (mean[standard error]=16.7[3.6] vs. 28.6[2.0], p=.02] than their NH-White counterparts. Hispanic vapers were also less likely than NH Whites to have previously smoked cigarettes (49.7 [37.2-62.3]% vs. 88.5 [84.7-91.5]%, p<.0001]). CONCLUSIONS Hispanic vapers exhibited lower exposure to nicotine metabolites and carcinogens than their non-Hispanic White counterparts. The harm reduction potential from e-cigarette use are likely to be realized across diverse racial and ethnic groups.
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Affiliation(s)
- Hongying Daisy Dai
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States.
| | - Nikki Nollen
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States
| | - Stephen Rennard
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, United States
| | - Nicolas Guenzel
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, United States
| | - Hanh Pham
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States; College of Osteopathic Medicine, Kansas City University, Kansas City, MO, United States
| | - Ali S Khan
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
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Edwards KC, Khan A, Sharma E, Wang L, Feng J, Blount BC, Sosnoff CS, Smith DM, Goniewicz ML, Pearson J, Villanti AC, Delnevo CD, Bover-Manderski MT, Hatsukami DK, Niaura R, Everard C, Kimmel HL, Duffy K, Rostron BL, Del Valle-Pinero AY, van Bemmel DM, Stanton CA, Hyland A. Validating Wave 1 (2014) Urinary Cotinine and TNE-2 Cut-points for Differentiating Wave 4 (2017) Cigarette Use from Non-use in the United States Using Data from the PATH Study. Cancer Epidemiol Biomarkers Prev 2023; 32:1233-1241. [PMID: 37342065 PMCID: PMC10527251 DOI: 10.1158/1055-9965.epi-22-1228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 04/21/2023] [Accepted: 06/16/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Sex and racial/ethnic identity-specific cut-points for validating tobacco use using Wave 1 (W1) of the Population Assessment of Tobacco and Health (PATH) Study were published in 2020. The current study establishes predictive validity of the W1 (2014) urinary cotinine and total nicotine equivalents-2 (TNE-2) cut-points on estimating Wave 4 (W4; 2017) tobacco use. METHODS For exclusive and polytobacco cigarette use, weighted prevalence estimates based on W4 self-report alone and with exceeding the W1 cut-point were calculated to identify the percentage missed without biochemical verification. Sensitivity and specificity of W1 cut-points on W4 self-reported tobacco use status were examined. ROC curves were used to determine the optimal W4 cut-points to distinguish past 30-day users from non-users, and evaluate whether the cut-points significantly differed from W1. RESULTS Agreement between W4 self-reported use and exceeding the W1 cut-points was high overall and when stratified by demographic subgroups (0.7%-4.4% of use was missed if relying on self-report alone). The predictive validity of using the W1 cut-points to classify exclusive cigarette and polytobacco cigarette use at W4 was high (>90% sensitivity and specificity, except among polytobacco Hispanic smokers). Cut-points derived using W4 data did not significantly differ from the W1-derived cut-points [e.g., W1 exclusive = 40.5 ng/mL cotinine (95% confidence interval, CI: 26.1-62.8), W4 exclusive = 29.9 ng/mL cotinine (95% CI: 13.5-66.4)], among most demographic subgroups. CONCLUSIONS The W1 cut-points remain valid for biochemical verification of self-reported tobacco use in W4. IMPACT Findings from can be used in clinical and epidemiologic studies to reduce misclassification of cigarette smoking status.
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Affiliation(s)
| | | | | | - Lanqing Wang
- Centers for Disease Control and Prevention, Atlanta, GA 30333
| | - June Feng
- Centers for Disease Control and Prevention, Atlanta, GA 30333
| | | | | | | | | | | | - Andrea C. Villanti
- Rutgers Biomedical and Health Sciences; Rutgers University, New Brunswick, NJ 08854
| | - Cristine D. Delnevo
- Rutgers Biomedical and Health Sciences; Rutgers University, New Brunswick, NJ 08854
| | | | | | | | - Colm Everard
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, Maryland 20852
- Kelly Government Solutions; Rockville, MD 20850
| | - Heather L. Kimmel
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, Maryland 20852
| | - Kara Duffy
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993
| | - Brian L. Rostron
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993
| | | | - Dana M. van Bemmel
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993
| | | | - Andrew Hyland
- Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263
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Ding ZM, Neslund EM, Sun D, Tan X. Methoxsalen inhibited the acquisition of nicotine self-administration: attenuation by cotinine replacement in rats. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.04.543614. [PMID: 37333320 PMCID: PMC10274622 DOI: 10.1101/2023.06.04.543614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Cigarette smoking remains the leading preventable cause of disease and death. Nicotine is the primary reinforcing ingredient in cigarettes sustaining addiction. Cotinine is the major metabolite of nicotine that produces a myriad of neurobehavioral effects. Cotinine supported self-administration and rats with a history of intravenous self-administration of cotinine exhibited relapse-like drug-seeking behavior, suggesting cotinine may also be reinforcing. To date, a potential contribution of cotinine to nicotine reinforcement remains unknown. Nicotine metabolism is mainly catalyzed by hepatic CYP2B1 enzyme in the rat and methoxsalen is a potent CYP2B1 inhibitor. The study tested the hypothesis that methoxsalen inbibits nicotine metabolism and self-administration, and that cotinine replacement attenuates the inhibitory effects of methoxsalen. Acute methoxsalen decreased plasma cotinine levels and increased nicotine levels following subcutaneous nicotine injection. Repeated methoxsalen reduced the acquisition of nicotine self-administration, leading to fewer nicotine infusions, disruption of lever differentiation, smaller total nicotine intake, and lower plasma cotinine levels. On the other hand, methoxsalen did not alter nicotine self-administration during the maintenance phase despite great reduction of plasma cotinine levels. Cotinine replacement by mixing cotinine with nicotine for self-administration dose-dependently increased plasma cotinine levels, counteracted effects of methoxsalen, and enhanced the acquisition of self-administration. Neither basal nor nicotine-induced locomotor activity was altered by methoxsalen. These results indicate that methoxsalen depressed cotinine formation from nicotine and the acquisition of nicotine self-administration, and that replacement of plasma cotinine attenuated the inhibitory effects of methoxsalen, suggesting that cotinine may contribute to the development of nicotine reinforcement.
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Affiliation(s)
- Zheng-Ming Ding
- Department of Anesthesiology & Perioperative Medicine, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA 17033, USA
- Department of Pharmacology, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA 17033, USA
| | - Elizabeth M. Neslund
- Department of Anesthesiology & Perioperative Medicine, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA 17033, USA
| | - Dongxiao Sun
- Department of Pharmacology, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA 17033, USA
- Penn State Mass Spectrometry Core Facility, Penn State University College of Medicine, Hershey, PA 17033, USA
| | - Xiaoying Tan
- Department of Anesthesiology & Perioperative Medicine, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA 17033, USA
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Guo Y, Li S, Wang Z, Jiang F, Guan Y, Huang M, Zhong G. Nicotine Delivery and Pharmacokinetics of an Electronic Cigarette Compared With Conventional Cigarettes in Chinese Adult Smokers: A Randomized Open-Label Crossover Clinical Study. NICOTINE & TOBACCO RESEARCH : OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON NICOTINE AND TOBACCO 2022; 24:1881-1888. [PMID: 35690060 DOI: 10.1093/ntr/ntac143] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/10/2022] [Accepted: 06/10/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION To evaluate the nicotine pharmacokinetics of a commercial electronic cigarette (e-cigarette) relative to conventional cigarettes in Chinese adult smokers. AIMS AND METHODS A randomized, open-label, crossover clinical study was conducted on 23 healthy adult Chinese smokers. In two sessions, subjects used either the e-cigarettes with 30 mg/g nicotine in e-liquid or conventional cigarettes of a given brand, at one puff every 30 seconds for a total of 10 puffs. Blood samples were collected at specified time points for 4 hours after the first puff. Subjective effects on desire-to-smoke and physiological parameters such as heart rate and oxyhemoglobin saturation levels were also examined before and after using the two products. RESULTS The baseline-adjusted maximum nicotine concentration (Cmax-BL), time-to-peak nicotine concentration (Tmax), and nicotine absorption rate (Cmax-BL divided by Tmax) were found to be similar for the e-cigarette versus those of conventional cigarettes (p > .05). Total nicotine exposure measured as the area-under-curve (AUC0-t-BL) was significantly lower for the e-cigarette relative to that of conventional cigarettes. In addition, the subjects found that e-cigarettes were well tolerated under controlled puffing conditions. CONCLUSIONS The test e-cigarettes achieved similar nicotine delivery and pharmacokinetic profiles to those of the comparator cigarettes, indicating that this e-cigarette could be a potential alternative to conventional cigarettes for those adult smokers. IMPLICATIONS There are no data in the published literature on the nicotine pharmacokinetics of e-cigarettes in Chinese smokers. To the best of our knowledge, this is the first study to evaluate the nicotine delivery and pharmacokinetic profile of a commercial e-cigarette brand compared with conventional cigarettes in Chinese adult smokers. After the use of test e-cigarettes, nicotine delivery and pharmacokinetic profile were similar to those of conventional cigarettes in Chinese adult smokers.
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Affiliation(s)
- Yi Guo
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Shoufeng Li
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhi Wang
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China.,Clinical Trial Center of Dongguan KangHua Hospital, Dongguan, Guangdong, China
| | - Fulin Jiang
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yanping Guan
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Min Huang
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Guoping Zhong
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China.,Clinical Trial Center of Dongguan KangHua Hospital, Dongguan, Guangdong, China
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Park EY, Lim MK, Park E, Kim Y, Lee D, Oh K. Optimum Urine Cotinine and NNAL Levels to Distinguish Smokers from Non-Smokers by the Changes in Tobacco Control Policy in Korea from 2008 to 2018. Nicotine Tob Res 2022; 24:1821-1828. [PMID: 35609337 DOI: 10.1093/ntr/ntac133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/20/2022] [Accepted: 05/23/2022] [Indexed: 11/14/2022]
Abstract
INTRODUCTION We examined the age- and sex-specific distributions of biomarkers of tobacco smoke exposure to determine the optimal cutoffs to distinguish smokers from non-smokers over the last 10 years in Korea, during which smoking prevalence and secondhand smoke (SHS) exposure declined due to changes in tobacco control policy. METHODS We analyzed data from the Korea National Health and Nutrition Examination Survey on creatinine-adjusted urinary cotinine (2008-2018; 33 429 adults: 15 653 males and 17 776 females) and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL; 2016-2018; 6337 adults: 3091 males and 3246 females). We determined the optimal cutoffs and confidence intervals (CIs) to distinguish smokers from non-smokers using receiver operator characteristic curve analysis and bootstrapping (1000 resamples). RESULTS The optimal cutoff values of creatinine-adjusted urine cotinine and NNAL concentration were 20.9 ng/mg (95% CI: 20.8-21.0, sensitivity: 96.6%, specificity: 93.8%) and 8.9 pg/mg (95% CI: 8.8-8.9, sensitivity: 94.0%, specificity: 94.7%), respectively, in 2016-2018. The optimal cutoffs of both biomarkers increased with age and were higher in females than in males for NNAL concentration. In both sexes, the optimal cutoff of urine cotinine continuously declined over the study period. CONCLUSIONS The optimal cotinine cutoff declined along with smoking prevalence and levels of SHS exposure due to enforcement of tobacco control policies, including smoke-free ordinances and tax increases. Monitoring of biomarkers of tobacco exposure appears necessary for verification of smoking status and regulatory use. IMPLICATIONS Our results based on nationally representative data suggest that a large decrease in the optimal cutoff value of urine cotinine to distinguish smokers from non-smokers was caused by decreases in smoking prevalence and SHS exposure following enforcement of tobacco control policies over the last 10 years. We determined the optimal cutoff values of urine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), which were not previously reported in representative population in Asia, to enable more accurate estimation of exposure to tobacco smoke and proper assessment of disease risks. Gender- and age-specific differences in the optimal cutoffs require further study. Monitoring of biomarkers of tobacco smoke exposure seems necessary for verification of smoking status and regulatory use.
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Affiliation(s)
- Eun Young Park
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Min Kyung Lim
- Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, Republic of Korea
| | - Eunjung Park
- Hanyang University Institute for Rheumatology Research, Seoul, Republic of Korea
| | - Yoonjung Kim
- Division of Health and Nutrition Survey and Analysis, Bureau of Chronic Disease Prevention and Control, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Dohoon Lee
- Department of Laboratory Medicine, Hospitals, National Cancer Center, Goyang, Republic of Korea
| | - Kyungwon Oh
- Division of Health and Nutrition Survey and Analysis, Bureau of Chronic Disease Prevention and Control, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
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Luu MN, Han M, Bui TT, Tran PTT, Lim MK, Oh JK. Smoking trajectory and cancer risk: A population-based
cohort study. Tob Induc Dis 2022; 20:71. [PMID: 36118557 PMCID: PMC9413414 DOI: 10.18332/tid/152137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/30/2022] [Accepted: 07/15/2022] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Smoking behavior can change with time and lead to different health outcomes. This study explored the trajectory of smoking and its relationship with cancer incidence and mortality among Korean male adults. METHODS We used 2002–2018 data from the National Health Insurance Service (NHIS). Smoking status was repeatedly measured in four waves of general health examinations provided by the NHIS between 2002 and 2009. Cancer incidence and mortality were tracked from 2010 to 2018. Trajectory analysis was used to identify the patterns of smoking. The hazard ratio was calculated using Cox proportional regression models. RESULTS For the 2448548 men (≥20 years), 137788 cases of cancers and 41146 cancer deaths were found. We identified six trajectory groups: never smokers, former smokers, new current smokers, decreasing light smokers, steady moderate smokers, and steady heavy smokers. All smoking groups had an increased risk of cancer. The steady heavy smokers showed higher cancer incidence and mortality rate than the steady non-smokers (hazard ratio, HR=1.53; 95% CI: 1.49–1.58 and HR=2.64; 95% CI: 2.50–2.79, respectively). The cancer-specific analysis showed that the larynx and lung cancer incidence and mortality rate of the smoking group were higher than in never smokers. CONCLUSIONS Smoking, even at low doses, increases the risk of most cancers in men. Quitting or reducing smoking, especially at a young age, can lower cancer incidence and mortality. This study may provide more objective results on the relationship between smoking and cancer, because smoking behavior was examined at multiple time points.
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Affiliation(s)
- Minh N. Luu
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Republic of Korea
- Department of Research Methodology and Biostatistics, School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Minji Han
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Republic of Korea
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang-si, Republic of Korea
| | - Tra T. Bui
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Republic of Korea
| | - Phuong Thao T. Tran
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Republic of Korea
| | - Min-Kyung Lim
- Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Jin K. Oh
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Republic of Korea
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang-si, Republic of Korea
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Park BK, Seo JH, Chung JB, Choi JK. Lifestyle, body mass index, diabetes, and the risk of pancreatic cancer in a nationwide population-based cohort study with 7.4 million Korean subjects. Br J Cancer 2022; 127:549-557. [PMID: 35444288 PMCID: PMC9345883 DOI: 10.1038/s41416-022-01807-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 03/21/2022] [Accepted: 03/25/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Large-scale epidemiological studies on pancreatic cancer in non-Western populations are insufficient. We investigated the risk factors for pancreatic cancer. METHODS Using the Korean National Health Insurance database, subjects who participated in the health examination program between 2005 and 2006 were identified and followed up until 2017. Adjusted hazard ratios (HRs) for pancreatic cancer risk were estimated using a Cox proportional hazards model. RESULTS During 11.5 years follow-up, 22,543 of 7,445,947 participants were newly diagnosed with pancreatic cancer. Compared with normal-weight subjects, pancreatic cancer risk was increased in those with severe obesity (BMI ≥ 28 kg/m2) (HR = 1.16; 95% CI, 1.11-1.23). Subjects with diabetes had an increased risk compared with those without diabetes (HR = 1.48; 95% CI, 1.43-1.53). Current smokers had a higher risk than never smokers (HR = 1.43; 95% CI, 1.38-1.48). Current smoking combined with diabetes increased the risk compared with never smokers without diabetes (HR = 2.13; 95% CI, 2.00-2.28). Current smoking combined with BMI ≥ 25 kg/m2 had an increased risk compared with never smokers with BMI < 23 kg/m2 (HR = 1.55; 95% CI, 1.46-1.65). CONCLUSION Smoking, obesity, and diabetes are significant risk factors for pancreatic cancer in Koreans. Lifestyle modifications for smoking and obesity would be beneficial for pancreatic cancer prevention.
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Affiliation(s)
- Byung Kyu Park
- Division of Gastroenterology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Jeong Hun Seo
- Division of Gastroenterology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
| | - Jae Bock Chung
- Division of Gastroenterology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Jung Kyu Choi
- Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
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Zhao X, Wang Y, Liang C. Cigarette smoking and risk of bladder cancer: a dose-response meta-analysis. Int Urol Nephrol 2022; 54:1169-1185. [PMID: 35332429 DOI: 10.1007/s11255-022-03173-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/08/2022] [Indexed: 01/15/2023]
Abstract
INTRODUCTION The disease burden of bladder cancer is increasing worldwide; therefore, to deal with this situation, many studies on bladder cancer have been carried out extensively. Among these studies, the risk factors studies may provide a possible way to reduce the incidence of bladder cancer. Meta-analyses and original researches have confirmed that smoking is a risk factor of bladder cancer. However, the specific dose-response relationship between smoking and bladder cancer risk was still unclear. This meta-analysis addresses this research gap by summarizing the accumulated evidences, quantitatively. METHODS Relevant studies were obtained by searching PubMed, Embase and Web of Science database since inception until August 10, 2021, without restrictions. To obtain more comprehensive data, reference lists of identified articles were also browsed. Studies that reported risk estimates (relative risks (RR) or odds ratio (OR)) with 95% confidence intervals (CIs) focusing on the association between cigarette smoking and risk of bladder cancer were included in a dose-response meta-analysis. RESULTS A non-linear dose-response relationship was confirmed between cigarette smoking and risk of bladder cancer on the basis of 8 cohorts and 44 case-control studies. The summary relative risk of developing bladder cancer for 1 more cigarettes/day (7 cohorts and 24 case-control studies) was 1.039 (95% CI 1.038-1.040, I2 = 0%), for 1 more pack-year (3 cohorts and 21 case-control studies) was 1.017(95% CI 1.016-1.019, I2 = 0%) and for 1 more year of exposure (16 case-control studies) was 1.021 (95% CI 1.020-1.023, I2 = 0%). CONCLUSION A positive non-linear dose-response relationship is confirmed between all smoking intensity, pack-years of smoking, smoking duration(years) and the risk of bladder cancer, but the plateau only occurred when smoking intensity reached 20 cigarettes/day. Further studies should report more detailed results, including those for subtypes of gender, age, region and be stratified by other risk factors to rule out residual confounding.
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Affiliation(s)
- Xiaohu Zhao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yuanli Wang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Chaozhao Liang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
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Mazumder S, Shia W, Bendik PB, Achilihu H, Sosnoff CS, Alexander JR, Luo Z, Zhu W, Pine BN, Feng J, Blount BC, Wang L. Nicotine Exposure in the U.S. Population: Total Urinary Nicotine Biomarkers in NHANES 2015-2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063660. [PMID: 35329347 PMCID: PMC8955498 DOI: 10.3390/ijerph19063660] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 02/01/2023]
Abstract
We characterize nicotine exposure in the U.S. population by measuring urinary nicotine and its major (cotinine, trans-3′-hydroxycotinine) and minor (nicotine 1′-oxide, cotinine N-oxide, and 1-(3-pyridyl)-1-butanol-4-carboxylic acid, nornicotine) metabolites in participants from the 2015−2016 National Health and Nutrition Examination Survey. This is one of the first U.S. population-based urinary nicotine biomarker reports using the derived total nicotine equivalents (i.e., TNEs) to characterize exposure. Serum cotinine data is used to stratify tobacco non-users with no detectable serum cotinine (−sCOT), non-users with detectable serum cotinine (+sCOT), and individuals who use tobacco (users). The molar concentration sum of cotinine and trans-3′-hydroxycotinine was calculated to derive the TNE2 for non-users. Additionally, for users, the molar concentration sum of nicotine and TNE2 was calculated to derive the TNE3, and the molar concentration sum of the minor metabolites and TNE3 was calculated to derive the TNE7. Sample-weighted summary statistics are reported. We also generated multiple linear regression models to analyze the association between biomarker concentrations and tobacco use status, after adjusting for select demographic factors. We found TNE7 is positively correlated with TNE3 and TNE2 (r = 0.99 and 0.98, respectively), and TNE3 is positively correlated with TNE2 (r = 0.98). The mean TNE2 concentration was elevated for the +sCOT compared with the −sCOT group (0.0143 [0.0120, 0.0172] µmol/g creatinine and 0.00188 [0.00172, 0.00205] µmol/g creatinine, respectively), and highest among users (33.5 [29.6, 37.9] µmol/g creatinine). Non-daily tobacco use was associated with 50% lower TNE7 concentrations (p < 0.0001) compared with daily use. In this report, we show tobacco use frequency and passive exposure to nicotine are important sources of nicotine exposure. Furthermore, this report provides more information on non-users than a serum biomarker report, which underscores the value of urinary nicotine biomarkers in extending the range of trace-level exposures that can be characterized.
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Affiliation(s)
- Shrila Mazumder
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
- Correspondence:
| | - Winnie Shia
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN 37830, USA
| | - Patrick B. Bendik
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN 37830, USA
| | - Honest Achilihu
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
| | - Connie S. Sosnoff
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
| | - Joseph R. Alexander
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
| | - Zuzheng Luo
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
| | - Wanzhe Zhu
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
| | - Brittany N. Pine
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN 37830, USA
| | - June Feng
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
| | - Benjamin C. Blount
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
| | - Lanqing Wang
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.S.); (P.B.B.); (H.A.); (C.S.S.); or (J.R.A.); (Z.L.); (W.Z.); (B.N.P.); (J.F.); (B.C.B.); (L.W.)
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11
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Murphy SE. Biochemistry of nicotine metabolism and its relevance to lung cancer. J Biol Chem 2021; 296:100722. [PMID: 33932402 PMCID: PMC8167289 DOI: 10.1016/j.jbc.2021.100722] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 12/27/2022] Open
Abstract
Nicotine is the key addictive constituent of tobacco. It is not a carcinogen, but it drives smoking and the continued exposure to the many carcinogens present in tobacco. The investigation into nicotine biotransformation has been ongoing for more than 60 years. The dominant pathway of nicotine metabolism in humans is the formation of cotinine, which occurs in two steps. The first step is cytochrome P450 (P450, CYP) 2A6–catalyzed 5′-oxidation to an iminium ion, and the second step is oxidation of the iminium ion to cotinine. The half-life of nicotine is longer in individuals with low P450 2A6 activity, and smokers with low activity often decrease either the intensity of their smoking or the number of cigarettes they use compared with those with “normal” activity. The effect of P450 2A6 activity on smoking may influence one's tobacco-related disease risk. This review provides an overview of nicotine metabolism and a summary of the use of nicotine metabolite biomarkers to define smoking dose. Some more recent findings, for example, the identification of uridine 5′-diphosphoglucuronosyltransferase 2B10 as the catalyst of nicotine N-glucuronidation, are discussed. We also describe epidemiology studies that establish the contribution of nicotine metabolism and CYP2A6 genotype to lung cancer risk, particularly with respect to specific racial/ethnic groups, such as those with Japanese, African, or European ancestry. We conclude that a model of nicotine metabolism and smoking dose could be combined with other lung cancer risk variables to more accurately identify former smokers at the highest risk of lung cancer and to intervene accordingly.
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Affiliation(s)
- Sharon E Murphy
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA.
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12
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Determining Optimal Cutoffs for Exhaled Carbon Monoxide and Salivary Cotinine to Identify Smokers among Korean Americans in a Smoking Cessation Clinical Trial. J Smok Cessat 2021; 2021:6678237. [PMID: 34306232 PMCID: PMC8279201 DOI: 10.1155/2021/6678237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 01/11/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction It is critical to accurately identify individuals who continue to smoke even after treatment, as this may prompt the use of more intensive and effective treatment strategies to help them attain complete abstinence. Aims This study examined optimal cutoffs for exhaled carbon monoxide (CO) and salivary cotinine to identify smokers among Korean Americans in a smoking cessation clinical trial. Methods CO and cotinine were measured three to four times over 12 months from the quit day. Statistical analysis was conducted using Receiver Operating Characteristic (ROC) curves. Results A CO cutoff of 5 parts per million provided robust sensitivity (80.8-98.3%) and perfect specificity (100%), and a salivary cotinine cutoff of level 2 (30-100 ng/ml) provided the best sensitivity (91.2-95.6%) and perfect specificity (100%). Using these cutoffs, the agreement between self-reports and the two biomarkers ranged from 88.6% to 97.7%. The areas under ROC curves (AUCs) of exhaled CO ranged from 0.90 to 0.99, all of which were significant (all p values < 0.001), and the AUCs of salivary cotinine ranged from 0.96 to 0.98 (all p values < 0.001). Conclusion Exhaled CO and salivary cotinine are complementary, and they should be used together to verify smoking abstinence for smokers in a clinical trial.
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13
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Muderrisoglu A, Babaoglu E, Korkmaz ET, Ongun MC, Karabulut E, Iskit AB, Emri S, Babaoglu MO. Effects of Genetic Polymorphisms of Drug Transporter ABCB1 (MDR1) and Cytochrome P450 Enzymes CYP2A6, CYP2B6 on Nicotine Addiction and Smoking Cessation. Front Genet 2020; 11:571997. [PMID: 33329709 PMCID: PMC7734344 DOI: 10.3389/fgene.2020.571997] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 11/12/2020] [Indexed: 01/08/2023] Open
Abstract
Objectives To determine the effects of genetic polymorphisms of ABCB1 (MDR1), CYP2A6, CYP2B6 on smoking status, and clinical outcomes of smoking cessation therapies in a Turkish population. Methods 130 smokers and 130 non-smokers were recruited. Individuals who never smoked were described as non-smokers. 130 smokers were treated with nicotine replacement therapy (NRT) (n = 40), bupropion (n = 47), bupropion + NRT (n = 15), and varenicline (n = 28). Smokers were checked by phone after 12 weeks of treatment whether they were able to quit smoking or not. Genotyping and phenotyping were performed. Results Cessation rates were as follows; 20.0% for NRT, 29.8% for bupropion, 40.0% for bupropion + NRT, 57.1% for varenicline (p = 0.013). The frequency of ABCB1 1236TT-2677TT-3435TT haplotype was significantly higher in non-smokers as compared to smokers (21.5% vs. 10.8, respectively; p = 0.018). Neither smoking status nor smoking cessation rates were associated with genetic variants of CYP2A6 (p = 0.652, p = 0.328, respectively), or variants of CYP2B6 (p = 0.514, p = 0.779, respectively). Conclusion Genetic variants of the drug transporter ABCB1 and the 1236TT-2677TT-3435TT haplotype was significantly associated with non-smoking status. Neither ABCB1 nor CYP2A6, CYP2B6 genetic variants were associated with smoking cessation rates at the 12th week of drug treatment.
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Affiliation(s)
- Ahmet Muderrisoglu
- Department of Pharmacology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Elif Babaoglu
- Department of Chest Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Elif Tugce Korkmaz
- Department of Chest Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mert C Ongun
- Department of Pharmacology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Erdem Karabulut
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Alper B Iskit
- Department of Pharmacology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Salih Emri
- Department of Chest Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Melih O Babaoglu
- Department of Pharmacology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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14
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Fang Y, Wang T, Guo YY, Zhang HF, Wen Q, Xing YR, Gao N, Qiao HL. From Genotype to Phenotype: Content and Activities of Cytochromes P450 2A6 in Human Liver In Vitro and Predicted In Vivo. J Pharmacol Exp Ther 2019; 372:320-330. [DOI: 10.1124/jpet.119.263152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 12/23/2019] [Indexed: 12/19/2022] Open
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15
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Brooks CC, Martin LJ, Pilipenko V, He H, LeMasters GK, Lockey JE, Bernstein DI, Ryan PH, Khurana Hershey GK, Biagini Myers JM. NAT1 genetic variation increases asthma risk in children with secondhand smoke exposure. J Asthma 2019; 58:284-292. [PMID: 31809667 DOI: 10.1080/02770903.2019.1694941] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE We previously reported that children exposed to secondhand smoke (SHS) that carried variants in the NAT1 gene had over two-fold higher hair cotinine levels. Our objective was to determine if NAT1 polymorphisms confer increased risk for developing asthma in children exposed to SHS. METHODS White participants in the Cincinnati Childhood Allergy and Air Pollution Study (n = 359) were genotyped for 10 NAT1 variants. Smoke exposure was defined by hair cotinine and parental report. Asthma was objectively assessed by spirometry and methacholine challenge. Findings were replicated in the Genomic Control Cohort (n = 638). RESULTS Significant associations between 5 NAT1 variants and asthma were observed in the CCAAPS exposed group compared to none in the unexposed group. There was a significant interaction between NAT1 rs13253389 and rs4921581 with smoke exposure (p = 0.02, p = 0.01) and hair cotinine level (p = 0.048, p = 0.042). Children wildtype for rs4921581 had increasing asthma risk with increasing hair cotinine level, whereas those carrying the NAT1 minor allele had an increased risk of asthma regardless of cotinine level. In the GCC, 13 NAT1 variants were associated with asthma in the smoke-exposed group, compared to 0 in the unexposed group, demonstrating gene-level replication. CONCLUSIONS Variation in the NAT1 gene modifies asthma risk in children exposed to secondhand-smoke. To our knowledge, this is the first report of a gene-environment interaction between NAT1 variants, smoke exposure, cotinine levels, and pediatric asthma. NAT1 genotype may have clinical utility as a biomarker of increased asthma risk in children exposed to smoke.
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Affiliation(s)
- Cassandra C Brooks
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Lisa J Martin
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
| | | | - Hua He
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Grace K LeMasters
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
| | - James E Lockey
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
| | - David I Bernstein
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Patrick H Ryan
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
| | - Gurjit K Khurana Hershey
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
| | - Jocelyn M Biagini Myers
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
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16
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Saccone NL, Emery LS, Sofer T, Gogarten SM, Becker DM, Bottinger EP, Chen LS, Culverhouse RC, Duan W, Hancock DB, Hosgood HD, Johnson EO, Loos RJF, Louie T, Papanicolaou G, Perreira KM, Rodriquez EJ, Schurmann C, Stilp AM, Szpiro AA, Talavera GA, Taylor KD, Thrasher JF, Yanek LR, Laurie CC, Pérez-Stable EJ, Bierut LJ, Kaplan RC. Genome-Wide Association Study of Heavy Smoking and Daily/Nondaily Smoking in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Nicotine Tob Res 2019; 20:448-457. [PMID: 28520984 DOI: 10.1093/ntr/ntx107] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 05/11/2017] [Indexed: 02/07/2023]
Abstract
Introduction Genetic variants associated with nicotine dependence have previously been identified, primarily in European-ancestry populations. No genome-wide association studies (GWAS) have been reported for smoking behaviors in Hispanics/Latinos in the United States and Latin America, who are of mixed ancestry with European, African, and American Indigenous components. Methods We examined genetic associations with smoking behaviors in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) (N = 12 741 with smoking data, 5119 ever-smokers), using ~2.3 million genotyped variants imputed to the 1000 Genomes Project phase 3. Mixed logistic regression models accounted for population structure, sampling, relatedness, sex, and age. Results The known region of CHRNA5, which encodes the α5 cholinergic nicotinic receptor subunit, was associated with heavy smoking at genome-wide significance (p ≤ 5 × 10-8) in a comparison of 1929 ever-smokers reporting cigarettes per day (CPD) > 10 versus 3156 reporting CPD ≤ 10. The functional variant rs16969968 in CHRNA5 had a p value of 2.20 × 10-7 and odds ratio (OR) of 1.32 for the minor allele (A); its minor allele frequency was 0.22 overall and similar across Hispanic/Latino background groups (Central American = 0.17; South American = 0.19; Mexican = 0.18; Puerto Rican = 0.22; Cuban = 0.29; Dominican = 0.19). CHRNA4 on chromosome 20 attained p < 10-4, supporting prior findings in non-Hispanics. For nondaily smoking, which is prevalent in Hispanic/Latino smokers, compared to daily smoking, loci on chromosomes 2 and 4 achieved genome-wide significance; replication attempts were limited by small Hispanic/Latino sample sizes. Conclusions Associations of nicotinic receptor gene variants with smoking, first reported in non-Hispanic European-ancestry populations, generalized to Hispanics/Latinos despite different patterns of smoking behavior. Implications We conducted the first large-scale genome-wide association study (GWAS) of smoking behavior in a US Hispanic/Latino cohort, and the first GWAS of daily/nondaily smoking in any population. Results show that the region of the nicotinic receptor subunit gene CHRNA5, which in non-Hispanic European-ancestry smokers has been associated with heavy smoking as well as cessation and treatment efficacy, is also significantly associated with heavy smoking in this Hispanic/Latino cohort. The results are an important addition to understanding the impact of genetic variants in understudied Hispanic/Latino smokers.
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Affiliation(s)
- Nancy L Saccone
- Department of Genetics, Washington University School of Medicine, St. Louis, MO
| | - Leslie S Emery
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Tamar Sofer
- Department of Biostatistics, University of Washington, Seattle, WA
| | | | - Diane M Becker
- GeneSTAR Research Program, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Erwin P Bottinger
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Li-Shiun Chen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | | | - Weimin Duan
- Department of Genetics, Washington University School of Medicine, St. Louis, MO
| | - Dana B Hancock
- Behavioral and Urban Health Program, Behavioral Health and Criminal Justice Division, RTI International, Research Triangle Park, NC
| | - H Dean Hosgood
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Eric O Johnson
- Fellow Program and Behavioral Health and Criminal Justice Division, RTI International, Research Triangle Park, NC
| | - Ruth J F Loos
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Tin Louie
- Department of Biostatistics, University of Washington, Seattle, WA
| | - George Papanicolaou
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Krista M Perreira
- Department of Public Policy, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Erik J Rodriquez
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.,Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA
| | - Claudia Schurmann
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Adrienne M Stilp
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Adam A Szpiro
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Gregory A Talavera
- Graduate School of Public Health, San Diego State University, San Diego, CA
| | - Kent D Taylor
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA
| | - James F Thrasher
- Department of Health Promotion, Education and Behavior, University of South Carolina, Columbia, SC
| | - Lisa R Yanek
- GeneSTAR Research Program, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Cathy C Laurie
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Eliseo J Pérez-Stable
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
| | - Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
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Akinkugbe AA, Moreno O, Brickhouse TH. Serum cotinine, vitamin D exposure levels and dental caries experience in U.S. adolescents. Community Dent Oral Epidemiol 2018; 47:185-192. [PMID: 30537281 DOI: 10.1111/cdoe.12442] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 11/13/2018] [Accepted: 11/17/2018] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Epidemiologic studies of risk and protective factors for poor oral health have mostly been among children and adults, seldom focusing on adolescents. The aims of this study were to examine whether serum cotinine, a marker of tobacco exposure, and serum vitamin D are independently associated with dental caries experience among adolescents. METHODS Cross-sectional data from 2579 adolescent participants in the 2005-2008 National Health and Nutritional Examination Survey were analysed. The exposures, cotinine and vitamin D, were measured in serum while dental caries experience was determined by screening examination, and a case defined as having ≥1 decayed or filled teeth. Survey-adjusted logistic regression estimated prevalence odds ratios (POR) and 95% confidence intervals (CI) between the respective exposures and outcome. RESULTS The overall median (IQR) serum cotinine level was 0.15 ng/mL (0.04, 1.80) while the mean (SE) serum vitamin D concentration was 68.2 nmol/L (1.36). In contrast to participants with serum cotinine ≤3 ng/L, those with levels >3 ng/L had covariate-adjusted estimate of 1.69 (1.16, 2.47) for caries experience. Each additional mean (ng/L) serum cotinine level was associated with an 8% (95% CI = 1.01, 1.16) greater adjusted prevalence odds of having caries experience. In contrast to participants with vitamin D ≥ 50 nmol/L, those with levels of30- < 50 nmol/L and <30 nmol/L had non-statistically significant adjusted estimates of 1.02 (0.72, 1.44) and 1.23 (0.70, 2.16) respectively for caries experience. CONCLUSIONS Serum cotinine is associated with dental caries experience among adolescents and while deficient (<30 nmol/L) levels of vitamin D appear to be associated with greater prevalence odds of caries experience, this association is inconclusive.
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Affiliation(s)
- Aderonke A Akinkugbe
- Oral Health Services Research Core, Philips Institute for Oral Health Research, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia.,Oral Health in Childhood and Adolescence Core of the Institute for inquiry, Innovation and Inclusion, Virginia Commonwealth University, Richmond, Virginia
| | - Oswaldo Moreno
- Oral Health in Childhood and Adolescence Core of the Institute for inquiry, Innovation and Inclusion, Virginia Commonwealth University, Richmond, Virginia.,Department of Psychology, School of Humanities and Sciences, Virginia Commonwealth University, Richmond, Virginia
| | - Tegwyn H Brickhouse
- Oral Health Services Research Core, Philips Institute for Oral Health Research, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia.,Oral Health in Childhood and Adolescence Core of the Institute for inquiry, Innovation and Inclusion, Virginia Commonwealth University, Richmond, Virginia
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18
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Pehlivan S, Uysal MA, Cagatay T, Nursal AF, Cinar CK, Erkan F, Sever U, Bingol Z, Pehlivan M, Pence S. CYP2A6 gene variants may explain smoking status in a Turkish cohort. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2018.1547177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Sacide Pehlivan
- Department of Medical Biology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Mehmet Atilla Uysal
- Department of Chest Diseases, Health Sciences University, Yedikule Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey
| | - Tulin Cagatay
- Department of Chest Diseases, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Ayse Feyda Nursal
- Department of Medical Genetics, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Cigdem Kekik Cinar
- Department of Medical Biology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Feyza Erkan
- Department of Chest Diseases, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Ulgen Sever
- Department of Medical Biology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Zuleyha Bingol
- Department of Chest Diseases, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Mustafa Pehlivan
- Department of Hematology, Gaziantep University, Faculty of Medicine, Gaziantep, Turkey
| | - Sadrettin Pence
- Department of Molecular Medicine, Istanbul University, Aziz Sancar Instutute, Istanbul, Turkey
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Neophytou AM, Oh SS, White M, Mak A, Hu D, Huntsman S, Eng C, Serebrisky D, Borrell LN, Farber HJ, Meade K, Davis A, Avila PC, Thyne SM, Rodríguez-Cintrón W, Rodríguez-Santana JR, Kumar R, Brigino-Buenaventura E, Sen S, Lenoir MA, Williams LK, Benowitz NL, Balmes JR, Eisen EA, Burchard EG. Secondhand smoke exposure and asthma outcomes among African-American and Latino children with asthma. Thorax 2018; 73:1041-1048. [PMID: 29899038 PMCID: PMC6225993 DOI: 10.1136/thoraxjnl-2017-211383] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 03/29/2018] [Accepted: 05/08/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Secondhand smoke (SHS) exposures have been linked to asthma-related outcomes but quantitative dose-responses using biomarkers of exposure have not been widely reported. OBJECTIVES Assess dose-response relationships between plasma cotinine-determined SHS exposure and asthma outcomes in minority children, a vulnerable population exposed to higher levels of SHS and under-represented in the literature. METHODS We performed analyses in 1172 Latino and African-American children with asthma from the mainland USA and Puerto Rico. We used logistic regression to assess relationships of cotinine levels ≥0.05 ng/mL with asthma exacerbations (defined as asthma-related hospitalisations, emergency room visits or oral steroid prescription) in the previous year and asthma control. The shape of dose-response relationships was assessed using a continuous exposure variable in generalised additive logistic models with penalised splines. RESULTS The OR for experiencing asthma exacerbations in the previous year for cotinine levels ≥0.05 ng/mL, compared with <0.05 ng/mL, was 1.40 (95% CI 1.03 to 1.89), while the OR for poor asthma control was 1.53 (95% CI 1.12 to 2.13). Analyses for dose-response relationships indicated increasing odds of asthma outcomes related with increasing exposure, even at cotinine levels associated with light SHS exposures. CONCLUSIONS Exposure to SHS was associated with higher odds of asthma exacerbations and having poorly controlled asthma with an increasing dose-response even at low levels of exposure. Our results support the conclusion that there are no safe levels of SHS exposures.
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Affiliation(s)
- Andreas M. Neophytou
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley CA, USA
| | - Sam S. Oh
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Marquitta White
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Angel Mak
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Donglei Hu
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Scott Huntsman
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Celeste Eng
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | | | - Luisa N. Borrell
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Harold J. Farber
- Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
| | - Kelley Meade
- Children’s Hospital and Research Center, Oakland, CA, USA
| | - Adam Davis
- Children’s Hospital and Research Center, Oakland, CA, USA
| | - Pedro C. Avila
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Shannon M. Thyne
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | | | | | - Rajesh Kumar
- Division of Allergy and Immunology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | | | - Saunak Sen
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | | | - L. Keoki Williams
- Department of Internal Medicine, Henry Ford Health System, Detroit, MI, USA
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA
| | - Neal L. Benowitz
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - John R. Balmes
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley CA, USA
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Ellen A. Eisen
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley CA, USA
| | - Esteban G. Burchard
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
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20
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Maedel C, Kainz K, Frischer T, Reinweber M, Zacharasiewicz A. Increased severity of respiratory syncytial virus airway infection due to passive smoke exposure. Pediatr Pulmonol 2018; 53:1299-1306. [PMID: 30062859 PMCID: PMC6175106 DOI: 10.1002/ppul.24137] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 07/04/2018] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Aim of this study was to analyze whether children with objectively measured second-hand cigarette smoke (SHS) exposure suffer from a more severe course of disease when hospitalized with lower respiratory tract infection (LRTI) due to respiratory syncytial virus (RSV). METHODS This prospective study was conducted at the Department of Pediatrics, Wilhelminen-Hospital, Vienna, Austria in children aged below 1 year without a history of preceding lung disease and with acute symptoms of LRTI and a positive nasopharyngeal swab for RSV. On admission, urinary cotinine was measured as a marker of recent SHS and clinical severity of LRTI was assessed by oxygen saturation SpO2 and the "admission clinical severity score" (CSSA). Parents/caregivers were asked to complete a customized questionnaire assessing risks for SHS and demographic characteristics. RESULTS After inclusion of 217 patients, data of 185 patients with a mean (SD) age of 106 days (80) were analyzed. Twenty-five patients (13.5%) were "cotinine-positive" (COT+) defined as a urinary cotinine level of ≥7 μg/L. SpO2 on admission was significantly lower in children recently exposed to SHS defined objectively by COT+ (94.8% ±2.0) in urine on admission compared to children not recently exposed (COT-) (96.8% ±3.0; P < 0.01). Disease severity, assessed via mean clinical severity score on admission (CSSA) for COT+ and COT- was 2.56 and 1.71, respectively (P = 0.03). CONCLUSIONS Recent exposure to SHS was associated with lower O2 saturation and higher clinical severity score, measured by urine cotinine levels in children hospitalized for RSV infection under 1 year of age.
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Affiliation(s)
- Clemens Maedel
- Department of Pediatrics, Teaching Hospital of the University of Vienna, Wilhelminen Hospital, Vienna, Austria
| | - Katharina Kainz
- Department of Pediatrics, Teaching Hospital of the University of Vienna, Wilhelminen Hospital, Vienna, Austria
| | - Thomas Frischer
- Department of Pediatrics, Teaching Hospital of the University of Vienna, Wilhelminen Hospital, Vienna, Austria.,Faculty of Medicine (Medical School), Sigmund Freud University Vienna, Vienna, Austria
| | | | - Angela Zacharasiewicz
- Department of Pediatrics, Teaching Hospital of the University of Vienna, Wilhelminen Hospital, Vienna, Austria
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Bozinoff N, Le Foll B. Understanding the implications of the biobehavioral basis of nicotine addiction and its impact on the efficacy of treatment. Expert Rev Respir Med 2018; 12:793-804. [PMID: 30092681 DOI: 10.1080/17476348.2018.1507736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Tobacco use remains the leading cause of preventable death in the United States. There are efficacious behavioral and pharmacological options for smoking cessation including three FDA approved therapies - nicotine replacement therapy, varenicline and bupropion. Nevertheless, uptake of smoking cessation treatments continues to be poor and there is a need for novel smoking cessation treatments. Areas covered: This article reviews the biobehavioral basis of nicotine addiction, its implications for smoking cessation treatments, the various neurotransmitter systems involved in nicotine addictive effects, and their potential therapeutic value. Included are discussions around the role of genetic factors in predicting response to pharmacotherapy and what we know about appropriate application of pharmacotherapy and behavioral interventions for tobacco use disorder. The evidence for harm reduction measures in individuals who are not willing or able to quit smoking is also reviewed. Expert commentary: Many neurotransmitter system targets have been investigated as a result of our understanding of the underlying neurobiology of tobacco use disorder, and there remain important targets that have yet to be fully explored. rTMS or combination therapies are proposed as possible novel strategies to improve smoking cessation.
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Affiliation(s)
- Nikki Bozinoff
- a Department of Family and Community Medicine , University of Toronto , Toronto , Canada.,b Addiction Medicine Service, Acute Care Program , Centre for Addiction and Mental Health , Toronto , Canada
| | - Bernard Le Foll
- a Department of Family and Community Medicine , University of Toronto , Toronto , Canada.,b Addiction Medicine Service, Acute Care Program , Centre for Addiction and Mental Health , Toronto , Canada.,c Department of Pharmacology and Toxicology, Psychiatry, Institute of Medical Sciences , University of Toronto , Toronto , Canada.,d Centre for Addiction and Mental Health , Campbell Family Mental Health Research Institute, CAMH , Toronto , Canada.,e Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health , Toronto , Canada
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22
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Pentel PR, Raleigh MD, LeSage MG, Thisted T, Horrigan S, Biesova Z, Kalnik MW. The nicotine-degrading enzyme NicA2 reduces nicotine levels in blood, nicotine distribution to brain, and nicotine discrimination and reinforcement in rats. BMC Biotechnol 2018; 18:46. [PMID: 30041697 PMCID: PMC6056991 DOI: 10.1186/s12896-018-0457-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 07/12/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The bacterial nicotine-degrading enzyme NicA2 isolated from P. putida was studied to assess its potential use in the treatment of tobacco dependence. RESULTS Rats were pretreated with varying i.v. doses of NicA2, followed by i.v. administration of nicotine at 0.03 mg/kg. NicA2 had a rapid onset of action reducing blood and brain nicotine concentrations in a dose-related manner, with a rapid onset of action. A 5 mg/kg NicA2 dose reduced the nicotine concentration in blood by > 90% at 1 min after the nicotine dose, compared to controls. Brain nicotine concentrations were reduced by 55% at 1 min and 92% at 5 min post nicotine dose. To evaluate enzyme effects at a nicotine dosing rate equivalent to heavy smoking, rats pretreated with NicA2 at 10 mg/kg were administered 5 doses of nicotine 0.03 mg/kg i.v. over 40 min. Nicotine levels in blood were below the assay detection limit 3 min after either the first or fifth nicotine dose, and nicotine levels in brain were reduced by 82 and 84%, respectively, compared to controls. A 20 mg/kg NicA2 dose attenuated nicotine discrimination and produced extinction of nicotine self-administration (NSA) in most rats, or a compensatory increase in other rats, when administered prior to each daily NSA session. In rats showing compensation, increasing the NicA2 dose to 70 mg/kg resulted in extinction of NSA. An enzyme construct with a longer duration of action, via fusion with an albumin-binding domain, similarly reduced NSA in a 23 h nicotine access model at a dose of 70 mg/kg. CONCLUSIONS These data extend knowledge of NicA2's effects on nicotine distribution to brain and its ability to attenuate addiction-relevant behaviors in rats and support its further investigation as a treatment for tobacco use disorder.
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Affiliation(s)
- Paul R. Pentel
- University of Minnesota, 100 Church St. S.E, Minneapolis, MN 55455 USA
| | - Michael D. Raleigh
- Minneapolis Medical Research Foundation, 701 Park Ave, Minneapolis, MN 55415 USA
| | - Mark G. LeSage
- Minneapolis Medical Research Foundation, 701 Park Ave, Minneapolis, MN 55415 USA
| | - Thomas Thisted
- Antidote Therapeutics Inc, 708 Quince Orchard Road, Suite 250-C, Gaithersburg, MD 20878 USA
| | | | - Zuzana Biesova
- Antidote Therapeutics Inc, 708 Quince Orchard Road, Suite 250-C, Gaithersburg, MD 20878 USA
| | - Matthew W. Kalnik
- Antidote Therapeutics Inc, 708 Quince Orchard Road, Suite 250-C, Gaithersburg, MD 20878 USA
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Marchand M, Brossard P, Merdjan H, Lama N, Weitkunat R, Lüdicke F. Nicotine Population Pharmacokinetics in Healthy Adult Smokers: A Retrospective Analysis. Eur J Drug Metab Pharmacokinet 2018; 42:943-954. [PMID: 28283988 PMCID: PMC5681983 DOI: 10.1007/s13318-017-0405-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background and Objective Characterizing nicotine pharmacokinetics is challenging in the presence of background exposure. We performed a combined retrospective population pharmacokinetic analysis of 8 trials, including exposure to Tobacco Heating System and cigarettes (both inhaled), nicotine nasal spray and oral nicotine gum. Method Data from 4 single product use trials were used to develop a population pharmacokinetic model with Phoenix® NLME™ and to derive exposure parameters. Data from 4 separate ad libitum use studies were used for external validation. A total of 702 healthy adult smokers (54% males; 21–66 years of age; smoking ≥10 cigarettes/day; from US, Europe and Japan) were eligible for participation. Results Two-compartment linear disposition combined with zero-order absorption model was adequate to describe nicotine pharmacokinetics, and a mono-exponentially decreasing background component was utilized to account for nicotine carry-over effects. Apparent nicotine clearance was typically 0.407 L/min in males and 26% higher in females (68% inter-individual variability). Bioavailability was product-specific, decreased with increasing nicotine ISO yield, and increased with increasing body weight. Absorption duration was apparently prolonged with nicotine gum. The typical initial and terminal half-lives were 1.35 and 17 h, respectively. The presence of menthol did not impact the determinants of the area under the curve. The model adequately described the external validation data. Conclusions The population model was able to describe in different populations the nicotine pharmacokinetics after single product use and after 4 days of ad libitum use of Tobacco Heating System, cigarettes, and of different nicotine replacement therapies with various routes of administration. Electronic supplementary material The online version of this article (doi:10.1007/s13318-017-0405-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Patrick Brossard
- PMI R&D (Part of Philip Morris International Group of Companies), Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | | | - Nicola Lama
- PMI R&D (Part of Philip Morris International Group of Companies), Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Rolf Weitkunat
- PMI R&D (Part of Philip Morris International Group of Companies), Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland.
| | - Frank Lüdicke
- PMI R&D (Part of Philip Morris International Group of Companies), Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
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24
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Ezzeldin N, El-Lebedy D, Darwish A, El Bastawisy A, Abd Elaziz SH, Hassan MM, Saad-Hussein A. Association of genetic polymorphisms CYP2A6*2 rs1801272 and CYP2A6*9 rs28399433 with tobacco-induced lung Cancer: case-control study in an Egyptian population. BMC Cancer 2018; 18:525. [PMID: 29724170 PMCID: PMC5934827 DOI: 10.1186/s12885-018-4342-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 04/08/2018] [Indexed: 11/10/2022] Open
Abstract
Background Several studies have reported the role of CYP2A6 genetic polymorphisms in smoking and lung cancer risk with some contradictory results in different populations. The purpose of the current study is to assess the contribution of the CYP2A6*2 rs1801272 and CYP2A6*9 rs28399433 gene polymorphisms and tobacco smoking in the risk of lung cancer in an Egyptian population. Methods A case-control study was conducted on 150 lung cancer cases and 150 controls. All subjects were subjected to blood sampling for Extraction of genomic DNA and Genotyping of the CYP2A6 gene SNPs (CYP2A6*2 (1799 T > A) rs1801272 and CYP2A6*9 (− 48 T > G) rs28399433 by Real time PCR. Results AC and CC genotypes were detected in CYP2A6*9; and AT genotype in CYP2A6*2. The frequency of CYP2A6*2 and CYP2A6*9 were 0.7% and 3.7% respectively in the studied Egyptian population. All cancer cases with slow metabolizer variants were NSCLC. Non-smokers represented 71.4% of the CYP2A6 variants. There was no statistical significant association between risk of lung cancer, smoking habits, heaviness of smoking and the different polymorphisms of CYP2A6 genotypes. Conclusion The frequency of slow metabolizers CYP2A6*2 and CYP2A6*9 are poor in the studied Egyptian population. Our findings did not suggest any association between CYP2A6 genotypes and risk of lung cancer.
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Affiliation(s)
- Nada Ezzeldin
- Chest Diseases, National Research Center, Cairo, Egypt
| | | | - Amira Darwish
- Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt. .,National Cancer Institute (NCI), Fom-Elkhalig Square, P.O.Box: 11796, Cairo, Egypt.
| | - Ahmed El Bastawisy
- Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
| | | | | | - Amal Saad-Hussein
- Environmental Health & Preventive Medicine, National Research Center, Cairo, Egypt
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Dunbar MS, Tucker JS, Ewing BA, Parast L, Pedersen ER, Rodriguez A, D’Amico EJ. Ethnic Differences in Cigarette Use Trajectories and Health, Psychosocial, and Academic Outcomes. J Adolesc Health 2018; 62:327-333. [PMID: 29248389 PMCID: PMC6670291 DOI: 10.1016/j.jadohealth.2017.09.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 08/18/2017] [Accepted: 09/15/2017] [Indexed: 01/08/2023]
Abstract
PURPOSE Cigarette smoking among youth is associated with poorer health and psychosocial outcomes. However, few studies address how smoking may differentially relate to the emergence of disparities in functioning across races/ethnicities over adolescence. METHODS Youth (n = 2,509) were surveyed eight times from ages 11 to 18. We measured cigarette use, academic and social functioning, mental and physical health, and delinquency. Sequelae of change models controlled for sociodemographic factors, and tested whether intercept and slope for smoking trajectories were associated with outcomes at the end of high school, and examined racial/ethnic differences in outcomes assuming similar smoking trajectories across groups. RESULTS Youth were 45% Hispanic, 20% Asian, 20% white, 10% multiethnic, 2% black, and 1% other ethnicities. Higher average probability of smoking and steeper slopes of smoking trajectories were associated with poorer outcomes in multiple domains. Controlling for smoking trajectories, we observed the following disparities (vs. white youth; all p's < .05): black, Hispanic, and multiethnic youth reported lower academic performance; Asian, black, and multiethnic youth reported higher academic unpreparedness; Asian and multiethnic youth reported poorer mental health; Asian, Hispanic, and multiethnic youth reported poorer physical health; and Asian youth reported higher delinquency and poorer social functioning. CONCLUSIONS Statistically adjusting for similar smoking trajectories, racial/ethnic minority youth demonstrated poorer outcomes in multiple domains compared with white peers. Smoking may be a particularly robust marker for risk of negative outcomes in racial/ethnic minority youth. Screening for cigarette use and intervening on smoking and associated risk behaviors among minority youth may help reduce disparities in functioning.
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Affiliation(s)
- Michael S. Dunbar
- RAND Corporation, 4750 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA
| | - Joan S. Tucker
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, USA
| | - Brett A. Ewing
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, USA
| | - Layla Parast
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, USA
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26
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Kia F, Tosun N, Carlson S, Allen S. Examining characteristics associated with quitting smoking during pregnancy and relapse postpartum. Addict Behav 2018; 78:114-119. [PMID: 29149636 PMCID: PMC5783747 DOI: 10.1016/j.addbeh.2017.11.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 08/29/2017] [Accepted: 11/08/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Smoking during pregnancy is a significant public health concern that can cause adverse health outcomes for both the mother and fetus. Studies have shown only 40% of women quit smoking during pregnancy, with more than half relapsing within 6months, and up to 90% relapsing within one year. This study investigates differences in demographics and smoking-related symptomatology between pregnant smokers and pregnant quitters, as well as factors associated with postpartum relapse. METHODS Data on pregnant smokers and pregnant quitters were obtained from two separate parent studies. Data on smoking demographics and smoking-related symptomatology were collected at screening visits. RESULTS Compared to pregnant smokers, pregnant quitters had more favorable smoking characteristics (e.g., smoked fewer cigarettes per day, reported higher motivation for abstinence and less dependency). They also had more favorable relationship characteristics (e.g., were more likely to be married, less likely to have a significant other who smokes) and had less reproductive liability (e.g., fewer pregnancies, fewer children). In terms of symptomatology, pregnant quitters reported more positive affect, negative affect, physical symptoms and withdrawal but less craving. Predictors of postpartum relapse included increased maternal age, having a significant other who smokes and an increased likelihood of returning to smoking after pregnancy (self-reported prior to delivery). CONCLUSIONS Several demographics and smoking-related symptomatology were significantly different between pregnant quitters and pregnant smokers. In addition, multiple factors predicting postpartum relapse were identified. This information can inform personalized interventions for high risk pregnant smokers and pregnant quitters at risk for postpartum relapse.
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Affiliation(s)
- Farnaaz Kia
- Department of Family Medicine & Community Health, University of Minnesota, 717 Delaware Street SE, Minneapolis, MN 55414, United States.
| | - Nicole Tosun
- Department of Family Medicine & Community Health, University of Minnesota, 717 Delaware Street SE, Minneapolis, MN 55414, United States.
| | - Samantha Carlson
- Department of Family Medicine & Community Health, University of Minnesota, 717 Delaware Street SE, Minneapolis, MN 55414, United States.
| | - Sharon Allen
- Department of Family Medicine & Community Health, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN 55455, United States.
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Baurley JW, McMahan CS, Ervin CM, Pardamean B, Bergen AW. Biosignature Discovery for Substance Use Disorders Using Statistical Learning. Trends Mol Med 2018; 24:221-235. [PMID: 29409736 PMCID: PMC5836808 DOI: 10.1016/j.molmed.2017.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 12/14/2017] [Accepted: 12/14/2017] [Indexed: 12/19/2022]
Abstract
There are limited biomarkers for substance use disorders (SUDs). Traditional statistical approaches are identifying simple biomarkers in large samples, but clinical use cases are still being established. High-throughput clinical, imaging, and 'omic' technologies are generating data from SUD studies and may lead to more sophisticated and clinically useful models. However, analytic strategies suited for high-dimensional data are not regularly used. We review strategies for identifying biomarkers and biosignatures from high-dimensional data types. Focusing on penalized regression and Bayesian approaches, we address how to leverage evidence from existing studies and knowledge bases, using nicotine metabolism as an example. We posit that big data and machine learning approaches will considerably advance SUD biomarker discovery. However, translation to clinical practice, will require integrated scientific efforts.
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Affiliation(s)
- James W Baurley
- BioRealm, Culver City, CA, USA; Bina Nusantara University, Jakarta, Indonesia.
| | | | | | - Bens Pardamean
- BioRealm, Culver City, CA, USA; Bina Nusantara University, Jakarta, Indonesia
| | - Andrew W Bergen
- BioRealm, Culver City, CA, USA; Oregon Research Institute, Eugene, OR, USA
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28
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Di Ciano P, Tyndale RF, Mansouri E, Hendershot CS, Wilson AA, Lagzdins D, Houle S, Boileau I, Le Foll B. Influence of Nicotine Metabolism Ratio on [11C]-(+)-PHNO PET Binding in Tobacco Smokers. Int J Neuropsychopharmacol 2018; 21:503-512. [PMID: 29346545 PMCID: PMC6007643 DOI: 10.1093/ijnp/pyx119] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Identifying the biological basis of smoking cessation success is of growing interest. The rate of nicotine metabolism, measured by the nicotine metabolite ratio, affects multiple aspects of nicotine dependence. Fast nicotine metabolizers tend to smoke more, experience more withdrawal and craving, and have lower cessation rates compared with slow metabolizers. The nicotine metabolite ratio predicts treatment response, and differences in brain activation between fast metabolizers and slow metabolizers have been reported in fMRI studies. As reinforcing/rewarding effects of tobacco are associated with dopamine transmission, the purpose of the present study was to study the dopaminergic system in human smokers based on their nicotine metabolite ratio. METHODS The first aim of the study was to explore if there were differences in D2 and D3 receptor binding between fast metabolizers and slow metabolizers during abstinence. The second aim was to explore smoking-induced dopamine release in both groups. Participants underwent 2 [11C]-(+)-PHNO PET scans: one scan during abstinence and the other after smoking a tobacco cigarette. Subjective measures were recorded and blood was drawn for measurement of nicotine and cotinine levels. RESULTS During abstinence, slow metabolizers (n = 13) had lower [11C]-(+)-PHNO binding potential than fast metabolizers (n = 15) restricted to the D2 regions of the associative striatum and sensorimotor striatum. After smoking a cigarette, [11C]-(+)-PHNO binding potential was decreased in the limbic striatum and ventral pallidum, suggestive of increases in dopamine, but there were no nicotine metabolite ratio differences. CONCLUSIONS Further studies are required to delineate if differences in [11C]-(+)-PHNO binding between slow metabolizers and fast metabolizers at abstinence baseline are preexisting traits or induced by prolonged tobacco use.
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Affiliation(s)
- Patricia Di Ciano
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Canada
| | - Rachel F Tyndale
- Campbell Family Mental Health Research Institute Toronto, Canada,Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada,Department of Pharmacology and Toxicology,Department of Psychiatry, University of Toronto, Toronto, Canada
| | | | - Christian S Hendershot
- Campbell Family Mental Health Research Institute Toronto, Canada,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Alan A Wilson
- Campbell Family Mental Health Research Institute Toronto, Canada,Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada,Department of Psychiatry, University of Toronto, Toronto, Canada,Institute of Medical Sciences, University of Toronto, Toronto, Canada
| | - Dina Lagzdins
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, Canada
| | - Sylvain Houle
- Campbell Family Mental Health Research Institute Toronto, Canada,Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada,Department of Psychiatry, University of Toronto, Toronto, Canada,Institute of Medical Sciences, University of Toronto, Toronto, Canada
| | - Isabelle Boileau
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Canada,Addiction Imaging Research Group Toronto, Canada,Campbell Family Mental Health Research Institute Toronto, Canada,Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada,Department of Psychiatry, University of Toronto, Toronto, Canada,Institute of Medical Sciences, University of Toronto, Toronto, Canada
| | - Bernard Le Foll
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, Canada,Addictions Division, Centre for Addiction and Mental Health, Toronto, Canada,Campbell Family Mental Health Research Institute Toronto, Canada,Department of Pharmacology and Toxicology,Department of Psychiatry, University of Toronto, Toronto, Canada,Institute of Medical Sciences, University of Toronto, Toronto, Canada,Correspondence: Bernard Le Foll, MD, PhD, Centre for Addiction and Mental Health., 33 Russell Street, Toronto, Ontario, M5S 2S1 ()
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Effects of aging on the effectiveness of smoking cessation medication. Oncotarget 2017; 7:30032-6. [PMID: 27166253 PMCID: PMC5058661 DOI: 10.18632/oncotarget.9090] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 04/08/2016] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Considering the pharmacokinetic and pharmacodynamic aspects of different medications, it is plausible that the age of a smoker could affect the half-life of these drugs. The aim of this study was to compare the effectiveness of smoking cessation drugs (nicotine replacement therapy, bupropion, and varenicline) used either in isolation or in combination in adults under and over 60 years of age. METHODS Data were collected from 940 Brazilian patients participating in a smoking cessation program. Participants were prescribed smoking cessation medication to be used for at least 12 weeks and were followed for 52 weeks. RESULTS Cessation rates were significantly different among younger and older participants who were using nicotine replacement therapy (NRT) alone. Being over 60 years of age was significantly associated with increased cessation success among those who used NRT alone (OR 2.34, 95% CI: 1.36 to 4.04, p = 0.002). The effectiveness of varenicline and bupropion were not significantly different according to age groups. CONCLUSION Using age as a predictor for tailoring smoking cessation drugs might potentially lead to a more individualized prescription of smoking cessation therapy. These results should be tested in randomized controlled trials.
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Tanner JA, Tyndale RF. Variation in CYP2A6 Activity and Personalized Medicine. J Pers Med 2017; 7:jpm7040018. [PMID: 29194389 PMCID: PMC5748630 DOI: 10.3390/jpm7040018] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 11/17/2017] [Accepted: 11/27/2017] [Indexed: 12/16/2022] Open
Abstract
The cytochrome P450 2A6 (CYP2A6) enzyme metabolizes several clinically relevant substrates, including nicotine-the primary psychoactive component in cigarette smoke. The gene that encodes the CYP2A6 enzyme is highly polymorphic, resulting in extensive interindividual variation in CYP2A6 enzyme activity and the rate of metabolism of nicotine and other CYP2A6 substrates including cotinine, tegafur, letrozole, efavirenz, valproic acid, pilocarpine, artemisinin, artesunate, SM-12502, caffeine, and tyrosol. CYP2A6 expression and activity are also impacted by non-genetic factors, including induction or inhibition by pharmacological, endogenous, and dietary substances, as well as age-related changes, or interactions with other hepatic enzymes, co-enzymes, and co-factors. As variation in CYP2A6 activity is associated with smoking behavior, smoking cessation, tobacco-related lung cancer risk, and with altered metabolism and resulting clinical responses for several therapeutics, CYP2A6 expression and enzyme activity is an important clinical consideration. This review will discuss sources of variation in CYP2A6 enzyme activity, with a focus on the impact of CYP2A6 genetic variation on metabolism of the CYP2A6 substrates.
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Affiliation(s)
- Julie-Anne Tanner
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, ON M5T 1R8, Canada.
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON M5S 1A8, Canada.
| | - Rachel F Tyndale
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, ON M5T 1R8, Canada.
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON M5S 1A8, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada.
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Linakis MW, Rower JE, Roberts JK, Miller EI, Wilkins DG, Sherwin CMT. Population pharmacokinetic model of transdermal nicotine delivered from a matrix-type patch. Br J Clin Pharmacol 2017; 83:2709-2717. [PMID: 28771779 DOI: 10.1111/bcp.13393] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 07/18/2017] [Accepted: 07/24/2017] [Indexed: 12/30/2022] Open
Abstract
AIMS Nicotine addiction is an issue faced by millions of individuals worldwide. As a result, nicotine replacement therapies, such as transdermal nicotine patches, have become widely distributed and used. While the pharmacokinetics of transdermal nicotine have been extensively described using noncompartmental methods, there are few data available describing the between-subject variability in transdermal nicotine pharmacokinetics. The aim of this investigation was to use population pharmacokinetic techniques to describe this variability, particularly as it pertains to the absorption of nicotine from the transdermal patch. METHODS A population pharmacokinetic parent-metabolite model was developed using plasma concentrations from 25 participants treated with transdermal nicotine. Covariates tested in this model included: body weight, body mass index, body surface area (calculated using the Mosteller equation) and sex. RESULTS Nicotine pharmacokinetics were best described with a one-compartment model with absorption based on a Weibull distribution and first-order elimination and a single compartment for the major metabolite, cotinine. Body weight was a significant covariate on apparent volume of distribution of nicotine (exponential scaling factor 1.42). After the inclusion of body weight in the model, no other covariates were significant. CONCLUSIONS This is the first population pharmacokinetic model to describe the absorption and disposition of transdermal nicotine and its metabolism to cotinine and the pharmacokinetic variability between individuals who were administered the patch.
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Affiliation(s)
- Matthew W Linakis
- Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA.,Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah College of Pharmacy, Salt Lake City, Utah, USA
| | - Joseph E Rower
- Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Jessica K Roberts
- Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Eleanor I Miller
- Department of Pharmacology and Toxicology, Center for Human Toxicology, University of Utah, Salt Lake City, Utah, USA
| | - Diana G Wilkins
- Department of Pharmacology and Toxicology, Center for Human Toxicology, University of Utah, Salt Lake City, Utah, USA.,Division of Medical Laboratory Sciences, Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Catherine M T Sherwin
- Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA.,Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah College of Pharmacy, Salt Lake City, Utah, USA
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Huang Y, You L, Xie W, Ning L, Lang J. Smoking and risk of cholangiocarcinoma: a systematic review and meta-analysis. Oncotarget 2017; 8:100570-100581. [PMID: 29246002 PMCID: PMC5725044 DOI: 10.18632/oncotarget.20141] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 07/30/2017] [Indexed: 01/01/2023] Open
Abstract
Previous studies evaluating the association between smoking and risk of cholangiocarcinoma (CCA) have yielded controversial results. We conducted a meta-analysis to evaluate the association based on available evidence. We searched the databases of Embase, PubMed and Cochrane Central Register of Controlled Trials from inception to April 11, 2017. Studies that investigated the association between smoking and risk of CCA were included. Pooled odds ratio (OR) estimates and 95% confidence intervals (CIs) were calculated using either a random-effects or a fixed-effects model. A total of 22 studies involving 324,333 participants were identified. The summary OR of CCA was 1.31 (95% CI, 1.15 to 1.51) for smokers versus nonsmokers. The increased risk was independent of diabetes mellitus, bilious tract stone disease, and liver cirrhosis. Smokers also had increased risk of intrahepatic CCA (12 studies; OR, 1.31; 95% CI, 1.06 to 1.63) and extrahepatic CCA (12 studies; OR, 1.32; 95% CI, 1.10 to 1.59) compared with nonsmokers. The results of our meta-analysis support the hypothesis that there is a moderate association between cigarette smoking and risk of CCA.
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Affiliation(s)
- Yuenan Huang
- Department of General Surgery, The Second Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Liuping You
- Department of General Surgery, The Second Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Weimin Xie
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Ning
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jinghe Lang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Morgan BW, Leifheit KM, Romero KM, Gilman RH, Bernabe-Ortiz A, Miranda JJ, Feldman HI, Lima JJ, Checkley W. Low cigarette smoking prevalence in peri-urban Peru: results from a population-based study of tobacco use by self-report and urine cotinine. Tob Induc Dis 2017; 15:32. [PMID: 28736513 PMCID: PMC5521105 DOI: 10.1186/s12971-017-0137-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 07/12/2017] [Indexed: 12/18/2022] Open
Abstract
Background A recent study found lower self-reported prevalence of tobacco smoking in a peri-urban area of Lima, Peru than previously reported in urban samples. These regions encompass substantial proportions of Peru’s population – ones at greater risk of disease due to reduced healthcare access – but have been less often studied. We validate low smoking prevalence with urine cotinine and characterize chronic disease and lung function outcomes between non-, occasional, and daily smokers. Methods Data are from the CRONICAS Cohort Study, a population-based longitudinal study in four low-resource Peruvian settings, which began in 2010. Of a baseline cohort of 2978 adults, we prospectively followed 2583 (87%) to determine prevalence of chronic illness. Results In a baseline sub-sample of 382 participants, median adjusted cotinine was 0.0 mcg/mg (IQR 0–0) for both self-reported non-smokers and occasional smokers compared to 172.3 mcg/mg (IQR 0–709.2) for daily smokers. Creatinine-adjusted cotinine validated daily smoking prevalence of 4.7% at a cutoff of 100 mcg/mg. Kappa statistic for daily smoking and creatinine- adjusted cotinine ≥100 mcg/mg was 0.65 (95% CI 0.47, 0.83), indicating substantial agreement. At baseline, we found 3.3% daily and 8.9% occasional smoking by self-report for the full cohort. Follow-up indicated little difference in chronic disease prevalence between groups. Daily smokers trended toward having a greater decline in FVC (−1%; 95% CI -2.9, 0.8) and FEV1 (−1.3%; 95% CI -3.2, 0.6) over 40 months when compared to non-smokers, whereas the decline in lung function for occasional smokers was similar compared to non-smokers (−0.2% FVC; 95% CI -1.5, 1.0) and (0% FEV1; 95% CI -1.3, 1.3). Conclusions Our data places Peru within a previously-described pattern of smoking found in much of Latin America, favoring occasional over daily smoking and low cigarette consumption. We determine that there are not significant differences between smoking groups concerning chronic disease outcomes. We favor distinguishing between daily and occasional smokers in order to accurately characterize these low-use populations. Electronic supplementary material The online version of this article (doi:10.1186/s12971-017-0137-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Brooks W Morgan
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, 1830 E. Monument St, Baltimore, Maryland 21205 USA
| | - Kathryn M Leifheit
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe St, Baltimore, Maryland 21205 USA
| | - Karina M Romero
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, 1830 E. Monument St, Baltimore, Maryland 21205 USA.,Biomedical Research Unit, A.B. PRISMA, Carlos Gonzales 251, 15088 San Miguel, Peru
| | - Robert H Gilman
- Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe St, Baltimore, Maryland 21205 USA
| | - Antonio Bernabe-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, 31 Av. Honorio Delgado 430, 15102 Lima, Peru
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, 31 Av. Honorio Delgado 430, 15102 Lima, Peru
| | - Harold I Feldman
- Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, Pennsylvania 19104 USA
| | - John J Lima
- Center for Pharmacogenomics and Translational Research, Nemours Children Clinic, 14785 Old St. Augustine Rd, Jacksonville, Florida 32258 USA
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, 1830 E. Monument St, Baltimore, Maryland 21205 USA.,Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe St, Baltimore, Maryland 21205 USA
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Park SL, Murphy SE, Wilkens LR, Stram DO, Hecht SS, Le Marchand L. Association of CYP2A6 activity with lung cancer incidence in smokers: The multiethnic cohort study. PLoS One 2017; 12:e0178435. [PMID: 28542511 PMCID: PMC5444837 DOI: 10.1371/journal.pone.0178435] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 05/12/2017] [Indexed: 12/21/2022] Open
Abstract
While smoking is the primary cause of lung cancer, only 11-24% of smokers develop the malignancy over their lifetime. The primary addictive agent in tobacco smoke is nicotine and variation in nicotine metabolism may influence the smoking levels of an individual. Therefore, inter-individual variation in lung cancer risk among smokers may be due in part to differences in the activity of enzymes involved in nicotine metabolism. In most smokers, cytochrome P450 2A6 (CYP2A6)-catalyzed C-oxidation accounts for >75% of nicotine metabolism, and the activity of this enzyme has been shown to correlate with the amount of nicotine and carcinogens drawn from cigarettes. We prospectively evaluated the association of urinary biomarkers of nicotine uptake (total nicotine equivalents [TNE]) and CYP2A6 activity (ratio of urinary total trans-3'-hydroxycotinine to cotinine) with lung cancer risk among 2,309 Multiethnic Cohort Study participants who were current smokers at time of urine collection; 92 cases were diagnosed during a mean follow-up of 9.5 years. We found that higher CYP2A6 activity and TNE was associated with increased lung cancer risk after adjusting for age, sex, race/ethnicity, body mass index, smoking duration, and urinary creatinine (p's = 0.002). The association for CYP2A6 activity remained even after adjusting for self-reported cigarettes per day (CPD) (Hazard Ratio [HR] per unit increase in log-CYP2A6 activity = 1.52; p = 0.005) and after adjusting for TNE (HR = 1.46; p = 0.01). In contrast, the association between TNE and lung cancer risk was of borderline statistical significance when adjusted for CPD (HR = 1.53; p = 0.06) and not statistically significant when further adjusted for CYP2A6 activity (HR = 1.30; p = 0.22). These findings suggest that CYP2A6 activity provides information on lung cancer risk that is not captured by smoking history or a (short-term) biomarker of dose. CYP2A6 activity should be further studied as a risk biomarker for smoking-related lung cancer.
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Affiliation(s)
- Sungshim L. Park
- Department of Preventive Medicine, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Sharon E. Murphy
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Lynne R. Wilkens
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii, United States of America
| | - Daniel O. Stram
- Department of Preventive Medicine, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Stephen S. Hecht
- Department of Preventive Medicine, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Loïc Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii, United States of America
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Tanner JA, Henderson JA, Buchwald D, Howard BV, Henderson PN, Tyndale RF. Variation in CYP2A6 and nicotine metabolism among two American Indian tribal groups differing in smoking patterns and risk for tobacco-related cancer. Pharmacogenet Genomics 2017; 27:169-178. [PMID: 28181923 PMCID: PMC5382092 DOI: 10.1097/fpc.0000000000000271] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The Northern Plains (NP) and Southwest (SW) American Indian populations differ in their smoking patterns and lung cancer incidence. We aimed to compare CYP2A6 genetic variation and CYP2A6 enzyme activity (representative of the rate of nicotine metabolism) between the two tribal populations as these have previously been associated with differences in smoking, quitting, and lung cancer risk. PARTICIPANTS AND METHODS American Indians (N=636) were recruited from two different tribal populations (NP in South Dakota, SW in Arizona) as part of a study carried out as part of the Collaborative to Improve Native Cancer Outcomes P50 Project. A questionnaire assessed smoking-related traits and demographics. Participants were genotyped for CYP2A6 genetic variants *1B, *2, *4, *7, *9, *12, *17, and *35. Plasma and/or saliva samples were used to measure nicotine's metabolites cotinine and 3'-hydroxycotinine and determine CYP2A6 activity (3'-hydroxycotinine/cotinine, i.e. the nicotine metabolite ratio, NMR). RESULTS The overall frequency of genetically reduced nicotine metabolizers, those with CYP2A6 decrease-of-function or loss-of-function alleles, was lower in the NP compared with the SW (P=0.0006). The CYP2A6 genotype was associated with NMR in both tribal groups (NP, P<0.0001; SW, P=0.04). Notably, the rate of nicotine metabolism was higher in NP compared with SW smokers (P=0.03), and in comparison with other ethnic groups in the USA. Of the variables studied, the CYP2A6 genotype was the only variable to significantly independently influence NMR among smokers in both tribal populations (NP, P<0.001; SW, P=0.05). CONCLUSION Unique CYP2A6 allelic patterns and rates of nicotine metabolism among these American Indian populations suggest different risks for smoking, and tobacco-related disease.
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Affiliation(s)
- Julie-Anne Tanner
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | | | - Dedra Buchwald
- Elson S. Floyd College of Medicine, Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, Washington
| | - Barbara V. Howard
- MedStar Health Research Institute, Hyattsville, Maryland; the Georgetown-Howard Universities Center for Clinical and Translational Sciences, Washington, District of Columbia
| | | | - Rachel F. Tyndale
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Buathong N, Kalayasiri R, Chaliyavilaskul P, Phetnoi K, Ratananupong T. Association of cytochrome P450 2A6 polymorphism, anxiety, and environmental factors with cigarette smoking by Thai adults. ASIAN BIOMED 2017. [DOI: 10.5372/1905-7415.1002.476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Abstract
Background
The effects and associations of genetic variation, psychological, and environment factors associated with cigarette smoking and nicotine dependence remain largely unknown.
Objective
To determine the influence and association of functional genetic polymorphisms of cytochrome P450 2A6 (CYP2A6), anxiety, and environmental factors on cigarette smoking and nicotine dependence.
Method
A cross-sectional study was conducted at King Chulalongkorn Memorial Hospital, Thailand between October 2014 and June 2015. We recruited 127 Thai adult smokers when they visited for an annual physical check-up. Participants completed questionnaires regarding demographic characteristics, The Fagerstrom Test for Nicotine Dependence, and The Thai Hospital Anxiety and Depression Scale. Blood was collected for CYP2A6 genotyping to determine the enzyme metabolism level/group.
Results
Factors associated with significantly greater cigarette consumption were age and being ultrarapid/ extensive metabolizers (UM/EM). Anxiety and smoking by household family members were significantly associated with the degree of nicotine dependence. We observed associations between severe nicotine dependence and genotype (UM/EM) and age (b = 0.037; P = 0.005), intermediate metabolizers (IM) and age (b = 0.031; P = 0.43), UM/EM and anxiety (b = 0.258; P < 0.001), IM and anxiety (b = 0.285; P < 0.001), UM/EM and household smoking in the family members (b = 1.427; P = 0.003), and IM and smoking by household family members (b = 1.293; P = 0.024).
Conclusions
Information regarding the association between the gene encoding enzyme metabolism, anxiety, and their interactions may be beneficial for selecting treatment choices for smoking cessation for individual genotypic metabolizers.
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Affiliation(s)
- Napakkawat Buathong
- Department of Psychiatry , Faculty of Medicine , Chulalongkorn University , Bangkok 10330 , Thailand
| | - Rasmon Kalayasiri
- Department of Psychiatry , Faculty of Medicine , Chulalongkorn University , Bangkok 10330 , Thailand
| | - Pajaree Chaliyavilaskul
- Clinical Pharmacokinetics Research Unit in Renal and Cardiovascular Diseases , Faculty of Medicine , Chulalongkorn University , Bangkok 10330 , Thailand
- Department of Pharmacology , Faculty of Medicine , Chulalongkorn University , Bangkok 10330 , Thailand
| | - Khwanruan Phetnoi
- Department of Pharmacology , Graduate school , Chulalongkorn University , Bangkok 10330 , Thailand
| | - Thanapoom Ratananupong
- Department of Preventive and Social Medicine , Faculty of Medicine , Chulalongkorn University , Bangkok 10330 , Thailand
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Jain RB. Analysis of self-reported versus biomarker based smoking prevalence: methodology to compute corrected smoking prevalence rates. Biomarkers 2017; 22:476-487. [DOI: 10.1080/1354750x.2016.1278264] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Simmons VN, Pineiro B, Hooper MW, Gray JE, Brandon TH. Tobacco-Related Health Disparities Across the Cancer Care Continuum. Cancer Control 2016; 23:434-441. [PMID: 27842333 PMCID: PMC5972388 DOI: 10.1177/107327481602300415] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Use of tobacco is the leading preventable cause of death in the United States. Racial/ethnic minorities and individuals of low socioeconomic status disproportionately experience tobacco-related disease and illness. Unique challenges and circumstances exist at each point in the cancer care continuum that may contribute to the greater cancer burden experienced by these groups. METHODS We reviewed tobacco-related disparities from cancer prevention to cancer survivorship. We also describe research that seeks to reduce tobacco-related disparities. RESULTS Racial/ethnic minorities and low-income individuals experience unique social and environmental contextual challenges such as greater environmental cues to smoke and greater levels of perceived stress and social discrimination. Clinical practice guidelines support the effectiveness of pharmacotherapy and behavioral counseling for racial and ethnic minorities, yet smoking cessation rates are lower in this group when compared with non-Hispanic whites. Superior efficacy for culturally adapted interventions has not yet been established. CONCLUSIONS To reduce health disparities in this population, a comprehensive strategy is needed with efforts directed at each point along the cancer care continuum. Strategies are needed to reduce the impact of contextual factors such as targeted tobacco marketing and social discrimination on smoking initiation and maintenance. Future efforts should focus on increasing the use of evidence-based cessation treatment methods and studying its effectiveness in these populations. Attention must also be focused on improving treatment outcomes by reducing smoking in diverse racial and ethnic patient populations.
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Affiliation(s)
- Vani Nath Simmons
- Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA.
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Allenby CE, Boylan KA, Lerman C, Falcone M. Precision Medicine for Tobacco Dependence: Development and Validation of the Nicotine Metabolite Ratio. J Neuroimmune Pharmacol 2016; 11:471-83. [PMID: 26872457 PMCID: PMC5479354 DOI: 10.1007/s11481-016-9656-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 02/08/2016] [Indexed: 10/22/2022]
Abstract
Quitting smoking significantly reduces the risk of tobacco-related morbidity and mortality, yet there is a high rate of relapse amongst smokers who try to quit. Phenotypic biomarkers have the potential to improve smoking cessation outcomes by identifying the best available treatment for an individual smoker. In this review, we introduce the nicotine metabolite ratio (NMR) as a reliable and stable phenotypic measure of nicotine metabolism that can guide smoking cessation treatment among smokers who wish to quit. We address how the NMR accounts for sources of variation in nicotine metabolism including genotype and other biological and environmental factors such as estrogen levels, alcohol use, body mass index, or menthol exposure. Then, we highlight clinical trials that validate the NMR as a biomarker to predict therapeutic response to different pharmacotherapies for smoking cessation. Current evidence supports the use of nicotine replacement therapy for slow metabolizers, and non-nicotine treatments such as varenicline for normal metabolizers. Finally, we discuss future research directions to elucidate mechanisms underlying NMR associations with treatment response, and facilitate the implementation of the NMR as biomarker in clinical practice to guide smoking cessation.
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Affiliation(s)
- Cheyenne E Allenby
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA, 19104, USA
| | - Kelly A Boylan
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA, 19104, USA
| | - Caryn Lerman
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA, 19104, USA
| | - Mary Falcone
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA, 19104, USA.
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Burden of cancer attributable to tobacco smoking in member countries of the Association of Southeast Asian Nations (ASEAN), 2012. Cancer Epidemiol 2016; 44:84-90. [PMID: 27513722 DOI: 10.1016/j.canep.2016.08.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 07/30/2016] [Accepted: 08/03/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Cancer is an increasing problem in ASEAN (Association of Southeast Asian Nations). Tobacco use is a well-established risk factor for many types of cancers. Evidence on burden of cancer attributable to tobacco is essential to raise public and political awareness of the negative effects of tobacco on cancer and to be used to stimulate political action aims at reducing smoking prevalence in ASEAN member countries. The objective of this study was to estimate burden of cancer attributable to tobacco smoking in ASEAN, 2012. METHODS In this study, smoking prevalence was combined with Relative Risks (RRs) of cancer to obtain Smoking Attributable Fractions (SAFs). Cancer incidence and mortality data among individuals aged 15 years and older were derived from GLOBOCAN 2012. Fourteen types of cancer were included in the analysis. Sensitivity analyses were conducted to examine the impact of the use of alternative RRs and the use of alternative prevalence of smoking in some countries. RESULTS The findings showed that tobacco smoking was responsible for 131,502 cancer incidence and 105,830 cancer mortality in ASEAN countries in 2012. In other words, tobacco smoking was accounted for 28.4% (43.3% in male and 8.5% in female) of cancer incidence and 30.5% (44.2% in male and 9.4% in female) of cancer mortality in ASEAN. When looking at the types of cancer, lung cancer showed the strongest association with tobacco smoking. Incidence of cancer and cancer mortality attributable to tobacco smoking varied by countries due to the differences in size of population, background risk of cancer, and prevalence of smoking in each country. According to the sensitivity analyses, RRs of lung cancer, pharynx cancer, and larynx cancer used in the estimates have significant impact on the estimates. CONCLUSIONS As about one-third of cancer incidence and mortality in ASEAN are attributable to tobacco smoking ASEAN member countries are strongly encouraged to put in place stronger tobacco control policies and to strengthen the existing tobacco control measure in order to effectively control cancer.
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Campo L, Polledri E, Bechtold P, Gatti G, Ranzi A, Lauriola P, Goldoni CA, Bertazzi PA, Fustinoni S. Determinants of active and environmental exposure to tobacco smoke and upper reference value of urinary cotinine in not exposed individuals. ENVIRONMENTAL RESEARCH 2016; 148:154-163. [PMID: 27060750 DOI: 10.1016/j.envres.2016.03.029] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 03/02/2016] [Accepted: 03/22/2016] [Indexed: 06/05/2023]
Abstract
The aims of this study were (1) to explore the behavioral and sociodemographic factors influencing urinary cotinine (COT-U) levels in active smokers and in environmental tobacco smoke (ETS)-exposed individuals, (2) to assess the specificity and sensitivity of the questionnaire for identifying active smokers and nonsmokers, and (3) to derive the upper reference value of COT-U in non-ETS exposed individuals. The COT-U levels of 495 adults (age range 18-69 years) who classified themselves as active smokers (29%) or as nonsmokers with (17%) or without (83%) ETS exposure were quantified by LC-MS-MS (quantification limit: 0.1µg/L, range of linearity: 0.1-4000µg/L). Median COT-U levels in these groups were 883, 1.38, and 0.39µg/L, respectively. Significant determinants of COT-U levels in active smokers were the number of cigarettes per day, type of smoking product, smoking environment, as well as time between the last cigarette and urine collection. Among ETS-exposed nonsmokers, significant determinants were living with smokers, being exposed to smoke at home, ETS exposure duration, as well as time between the last exposure and urine collection. When a 30-µg/L COT-U cut-off value was used to identify active daily smoking, the sensitivity and specificity of the questionnaire were 94% and 98%, respectively. For ETS exposure, the COT-U value of 1.78 (0.90 confidence interval 1.75-1.78) µg/L, corresponding to the 95th percentiles of the COT-U distribution in non-ETS-exposed participants, is proposed as upper reference value to identify environmental exposure.
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Affiliation(s)
- Laura Campo
- Department of Clinical Sciences and Community Health, University of Milan and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
| | - Elisa Polledri
- Department of Clinical Sciences and Community Health, University of Milan and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Petra Bechtold
- Department of Public Health, Local Health Unit, Modena, Italy
| | - Giulia Gatti
- Department of Public Health, Local Health Unit, Modena, Italy
| | - Andrea Ranzi
- Environmental Health Reference Centre, Regional Agency for Environmental Prevention of Emilia Romagna, Modena, Italy
| | - Paolo Lauriola
- Environmental Health Reference Centre, Regional Agency for Environmental Prevention of Emilia Romagna, Modena, Italy
| | | | - Pier Alberto Bertazzi
- Department of Clinical Sciences and Community Health, University of Milan and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Silvia Fustinoni
- Department of Clinical Sciences and Community Health, University of Milan and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
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Perlman SE, Chernov C, Farley SM, Greene CM, Aldous KM, Freeman A, Rodriguez-Lopez J, Thorpe LE. Exposure to Secondhand Smoke Among Nonsmokers in New York City in the Context of Recent Tobacco Control Policies: Current Status, Changes Over the Past Decade, and National Comparisons. Nicotine Tob Res 2016; 18:2065-2074. [PMID: 27190401 DOI: 10.1093/ntr/ntw135] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 05/04/2016] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Exposure to secondhand smoke is hazardous and can cause cancer, coronary heart disease, and birth defects. New York City (NYC) and other jurisdictions have established smoke-free air laws in the past 10-15 years. METHODS NYC Health and Nutrition Examination Survey (HANES) 2013-2014 was a population-based survey of NYC residents, aged 20 years and older, in which biospecimens were collected and cotinine levels were measured. Secondhand smoke exposure was assessed by demographics and risk factors and compared with that from NYC HANES 2004 and national HANES. RESULTS More than a third (37.1%, 95% confidence interval [CI] = 33.3%-41.2%) of nonsmoking adult New Yorkers were exposed to secondhand smoke, defined as a cotinine level of 0.05-10ng/mL. This was significantly lower than in 2004 NYC HANES, when 56.7% (95% CI = 53.6%-59.7%) of nonsmokers were exposed to secondhand smoke, but was greater than the proportion of adults exposed nationwide, as measured by national HANES (24.4%, 95% CI = 22.0%-26.9% in 2011-2012). Men, non-Hispanic blacks, adults aged 20-39, those with less education, and those living in high-poverty neighborhoods were more likely to be exposed. CONCLUSIONS There has been a large decrease in secondhand smoke exposure in NYC, although disparities persist. The decrease may be the result of successful policies to limit exposure to secondhand smoke in public places and of smokers smoking fewer cigarettes per day. Yet NYC residents still experience more secondhand smoke exposure than US residents overall. Possible explanations include multiunit housing, greater population density, and pedestrian exposure. IMPLICATIONS Measuring exposure to secondhand smoke can be difficult, and few studies have monitored changes over time. This study uses serum cotinine, a nicotine metabolite, from a local population-based examination survey, the NYC HANES 2013-2014, to examine exposure to secondhand smoke in an urban area that has implemented stringent antismoking laws. Comparison with NYC HANES conducted 10 years ago allows for an assessment of changes in the last decade in the context of municipal tobacco control policies. Results may be helpful to jurisdictions considering implementing similar tobacco control policies.
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Affiliation(s)
- Sharon E Perlman
- Division of Epidemiology, New York City Department of Health and Mental Hygiene , New York, NY
| | - Claudia Chernov
- Division of Epidemiology, New York City Department of Health and Mental Hygiene , New York, NY
| | - Shannon M Farley
- Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene , New York, NY
| | - Carolyn M Greene
- Division of Epidemiology, New York City Department of Health and Mental Hygiene , New York, NY
| | - Kenneth M Aldous
- Division of Environmental Health Sciences, New York State Department of Health, Wadsworth Center , Albany, NY
| | - Amy Freeman
- Department of Population Health, New York University School of Medicine
| | | | - Lorna E Thorpe
- School of Public Health, City University of New York , New York, NY
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van Osch FH, Jochems SH, van Schooten FJ, Bryan RT, Zeegers MP. Quantified relations between exposure to tobacco smoking and bladder cancer risk: a meta-analysis of 89 observational studies. Int J Epidemiol 2016; 45:857-70. [PMID: 27097748 DOI: 10.1093/ije/dyw044] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Smoking is a major risk factor for bladder cancer (BC). This meta-analysis updates previous reviews on smoking characteristics and BC risk, and provides a more quantitative estimation of the dose-response relationship between smoking characteristics and BC risk. METHODS In total, 89 studies comprising data from 57 145 BC cases were included and summary odds ratios (SORs) were calculated. Dose-response meta-analyses modelled relationships between smoking intensity, duration, pack-years and cessation and BC risk. Sources of heterogeneity were explored and sensitivity analyses were conducted to test the robustness of findings. RESULTS Current smokers (SOR = 3.14, 95% CI = 2.53-3.75) and former smokers(SOR = 1.83, 95% CI = 1.52-2.14) had an increased risk of BC compared with never smokers. Age at first exposure was negatively associated with BC risk. BC risk increased gradually by smoking duration and a risk plateau at smoking 15 cigarettes a day and 50 pack-years was observed. Smoking cessation is most beneficial from 20 years before diagnosis. The population-attributable risk of BC for smokers has decreased from 50% to 43% in men and from 35% to 26% in women from Europe since estimated in 2000. Results were homogeneous between sources of heterogeneity, except for lower risk estimates found in studies of Asian populations. CONCLUSIONS Active smokers are at an increased risk of BC. Dose-response meta-analyses showed a BC risk plateau for smoking intensity and indicate that even after long-term smoking cessation, an elevated risk of bladder cancer remains.
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Affiliation(s)
- Frits Hm van Osch
- Department of Complex Genetics, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands, Department of Complex Genetics, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands,
| | - Sylvia Hj Jochems
- Department of Complex Genetics, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Frederik-Jan van Schooten
- Department of Pharmacology and Toxicology, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands and
| | - Richard T Bryan
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Maurice P Zeegers
- Department of Complex Genetics, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK, Department of Complex Genetics, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
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Ross KC, Dempsey DA, St Helen G, Delucchi K, Benowitz NL. The Influence of Puff Characteristics, Nicotine Dependence, and Rate of Nicotine Metabolism on Daily Nicotine Exposure in African American Smokers. Cancer Epidemiol Biomarkers Prev 2016; 25:936-43. [PMID: 27030603 DOI: 10.1158/1055-9965.epi-15-1034] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 03/16/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND African American (AA) smokers experience greater tobacco-related disease burden than Whites, despite smoking fewer cigarettes per day (CPD). Understanding factors that influence daily nicotine intake in AA smokers is an important step toward decreasing tobacco-related health disparities. One factor of interest is smoking topography, or the study of puffing behavior. AIMS (i) to create a model using puff characteristics, nicotine dependence, and nicotine metabolism to predict daily nicotine exposure, and (ii) to compare puff characteristics and nicotine intake from two cigarettes smoked at different times to ensure the reliability of the puff characteristics included in our model. METHODS Sixty AA smokers smoked their preferred brand of cigarette at two time points through a topography device. Plasma nicotine, expired CO, and changes in subjective measures were measured before and after each cigarette. Total nicotine equivalents (TNE) was measured from 24-hour urine collected during ad libitum smoking. RESULTS In a model predicting daily nicotine exposure, total puff volume, CPD, sex, and menthol status were significant predictors (R(2) = 0.44, P < 0.001). Total puff volume was significantly greater and inter-puff intervals were significantly shorter after ad lib smoking compared with the first cigarette of the day, but puffing behaviors for both cigarettes were highly correlated (r range = 0.69-0.89, P < 0.001) within-subjects. CONCLUSION This is the first study, to our knowledge, to show that puff characteristics of individual cigarettes are predictive of daily nicotine intake. IMPACT These findings enhance our understanding of the relationship between smoking behavior and nicotine intake in AA smokers. Cancer Epidemiol Biomarkers Prev; 25(6); 936-43. ©2016 AACR.
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Affiliation(s)
- Kathryn C Ross
- Center for Tobacco Control, Research, and Education, University of California, San Francisco, San Francisco, California. Division of Clinical Pharmacology and Experimental Therapeutics, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Delia A Dempsey
- Division of Clinical Pharmacology and Experimental Therapeutics, Department of Medicine, University of California, San Francisco, San Francisco, California. Departments of Pediatrics and Medicine, University of California, San Francisco, San Francisco, California
| | - Gideon St Helen
- Center for Tobacco Control, Research, and Education, University of California, San Francisco, San Francisco, California. Division of Clinical Pharmacology and Experimental Therapeutics, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Kevin Delucchi
- Department of Psychiatry, University of California, San Francisco, San Francisco, California
| | - Neal L Benowitz
- Center for Tobacco Control, Research, and Education, University of California, San Francisco, San Francisco, California. Division of Clinical Pharmacology and Experimental Therapeutics, Department of Medicine, University of California, San Francisco, San Francisco, California. Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, California.
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45
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Beach SRH, Gerrard M, Gibbons FX, Brody GH, Philibert RA. A Role for Epigenetics in Broadening the Scope of Pediatric Care in the Prevention of Adolescent Smoking. ACTA ACUST UNITED AC 2016; 1:91-97. [PMID: 27500081 DOI: 10.2174/2214083201999140320153918] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Adolescence presents a critical opportunity to support the development of healthy patterns of behavior and prevent future health problems. Unfortunately, there is not yet a well-developed prevention model that allows pediatricians to initiate and monitor prevention efforts for the substantial minority of individuals who engage in risky behavior during adolescence. We suggest that recently developed epigenetic technologies may provide a bridge to a new prevention paradigm in which pediatricians screen for indicated smoking prevention services. Specifically, since currently available tobacco use screening measures are insensitive to low levels of use, newly developed methylation based approaches may enhance the sensitivity of the initial screening for nascent smoking behavior as well monitoring of outcomes. We conclude that the incorporation of Next Gen screening technologies into standard pediatric evaluations may allow for more effective referral to prevention programming for tobacco use. In addition to the potential direct impact on long-term enhancement of health outcomes secondary to smoking prevention, well-established links between smoking and other risk behaviors suggest that expanded referral for nascent smoking may also create opportunities to address other risky adolescent behaviors, and so decrease several interrelated drivers of long-term health care costs.
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Affiliation(s)
- Steven R H Beach
- The Center for Family Research, University of Georgia, Athens, GA, USA
| | - Meg Gerrard
- University of Connecticut, Department of Psychology, Storrs, CT
| | | | - Gene H Brody
- The Center for Family Research, University of Georgia, Athens, GA, USA
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Wang H, Park SL, Stram DO, Haiman CA, Wilkens LR, Hecht SS, Kolonel LN, Murphy SE, Le Marchand L. Associations Between Genetic Ancestries and Nicotine Metabolism Biomarkers in the Multiethnic Cohort Study. Am J Epidemiol 2015; 182:945-51. [PMID: 26568573 DOI: 10.1093/aje/kwv138] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 05/19/2015] [Indexed: 01/18/2023] Open
Abstract
Differences in internal dose of nicotine and tobacco-derived carcinogens among ethnic/racial groups have been observed. In this study, we explicitly examined the relationships between genetic ancestries (genome-wide average) and 19 tobacco-derived biomarkers in smokers from 3 admixed groups in the Multiethnic Cohort Study (1993-present), namely, African ancestry in African Americans (n = 362), Amerindian ancestry in Latinos (n = 437), and Asian and Native Hawaiian ancestries in Native Hawaiians (n = 300). After multiple comparison adjustment, both African and Asian ancestries were significantly related to a greater level of free cotinine; African ancestry was also significantly related to lower cotinine glucuronidation (P's < 0.00156). The predicted decrease in cotinine glucuronidation was 8.6% (P = 4.5 × 10(-6)) per a 20% increase in African ancestry. Follow-up admixture mapping revealed that African ancestry in a 12-Mb region on chromosome 4q was related to lower cotinine glucuronidation (P's < 2.7 × 10(-7), smallest P = 1.5 × 10(-9)), although this is the same region reported in our previous genome-wide association study. Our results implicate a genetic ancestral component in the observed ethnic/racial variation in nicotine metabolism. Further studies are needed to identify the underlying genetic variation that could potentially be ethnic/racial specific.
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47
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Effect of nicotine on auditory pathways: An unexplored domain. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2015. [DOI: 10.1016/j.injms.2015.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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48
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Dubroff JG, Doot RK, Falcone M, Schnoll RA, Ray R, Tyndale RF, Brody AL, Hou C, Schmitz A, Lerman C. Decreased Nicotinic Receptor Availability in Smokers with Slow Rates of Nicotine Metabolism. J Nucl Med 2015; 56:1724-9. [PMID: 26272810 DOI: 10.2967/jnumed.115.155002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 07/14/2015] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED The nicotine metabolite ratio (NMR), a stable measure of hepatic nicotine metabolism via the CYP2A6 pathway and total nicotine clearance, is a predictive biomarker of response to nicotine replacement therapy, with increased quit rates in slower metabolizers. Nicotine binds directly to nicotinic acetylcholine receptors (nAChRs) to exert its psychoactive effects. This study examined the relationship between NMR and nAChR (α4β2* subtype) availability using PET imaging of the radiotracer 2-(18)F-fluoro-3-(2(S)-azetidinylmethoxy)pyridine (2-(18)F-FA-85380, or 2-(18)F-FA). METHODS Twenty-four smokers-12 slow metabolizers (NMR < 0.26) and 12 normal metabolizers (NMR ≥ 0.26)-underwent 2-(18)F-FA-PET brain imaging after overnight nicotine abstinence (18 h before scanning), using a validated bolus-plus-infusion protocol. Availability of nAChRs was compared between NMR groups in a priori volumes of interest, with total distribution volume (VT/fP) being the measure of nAChR availability. Cravings to smoke were assessed before and after the scans. RESULTS Thalamic nAChR α4β2* availability was significantly reduced in slow nicotine metabolizers (P = 0.04). Slow metabolizers exhibited greater reductions in cravings after scanning than normal metabolizers; however, craving was unrelated to nAChR availability. CONCLUSION The rate of nicotine metabolism is associated with thalamic nAChR availability. Additional studies could examine whether altered nAChR availability underlies the differences in treatment response between slow and normal metabolizers of nicotine.
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Affiliation(s)
- Jacob G Dubroff
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Robert K Doot
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mary Falcone
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Robert A Schnoll
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Riju Ray
- Global Medical Affairs, GlaxoSmithKline, Brussels, Belgium
| | - Rachel F Tyndale
- Department of Pharmacology and Toxicology, and Department of Psychiatry, CAMH, University of Toronto, Toronto, Canada
| | - Arthur L Brody
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California; and Department of Psychiatry, Veterans Administration Greater Los Angeles Healthcare System, Los Angeles, California
| | - Catherine Hou
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Alexander Schmitz
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Caryn Lerman
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
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Chung S, Kim SS, Kini N, Fang HJ, Kalman D, Ziedonis DM. Smoking topography in Korean American and white men: preliminary findings. J Immigr Minor Health 2015; 17:860-6. [PMID: 24068611 PMCID: PMC3966984 DOI: 10.1007/s10903-013-9921-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
UNLABELLED This is the first study of Korean Americans' smoking behavior using a topography device. Korean American men smoke at higher rates than the general U.S. POPULATION Korean American and White men were compared based on standard tobacco assessment and smoking topography measures. They smoked their preferred brand of cigarettes ad libitum with a portable smoking topography device for 24 h. Compared to White men (N = 26), Korean American men (N = 27) were more likely to smoke low nicotine-yield cigarettes (p < 0.001) and have lower Fagerstrom nicotine dependence scores (p = 0.04). Koreans smoked fewer cigarettes with the device (p = 0.01) than Whites. Controlling for the number of cigarettes smoked, Koreans smoked with higher average puff flows (p = 0.05), greater peak puff flows (p = 0.02), and shorter interpuff intervals (p < 0.001) than Whites. Puff counts, puff volumes, and puff durations did not differ between the two groups. This study offers preliminary insight into unique smoking patterns among Korean American men who are likely to smoke low nicotine-yield cigarettes. We found that Korean American men compensated their lower number and low nicotine-yield cigarettes by smoking with greater puff flows and shorter interpuff intervals than White men, which may suggest exposures to similar amounts of nicotine and harmful tobacco toxins by both groups. Clinicians will need to consider in identifying and treating smokers in a mutually aggressive manner, irrespective of cigarette type and number of cigarette smoked per day.
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Affiliation(s)
- Sangkeun Chung
- Department of Psychiatry, Chonbuk National University Hospital, and Chonbuk National University Medical School, Jeonju, South Korea
| | - Sun S Kim
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Nisha Kini
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Hua J Fang
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - David Kalman
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Douglas M. Ziedonis
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
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Fagan P, Moolchan ET, Pokhrel P, Herzog T, Cassel KD, Pagano I, Franke AA, Kaholokula JK, Sy A, Alexander LA, Trinidad DR, Sakuma KL, Johnson CA, Antonio A, Jorgensen D, Lynch T, Kawamoto C, Clanton MS. Biomarkers of tobacco smoke exposure in racial/ethnic groups at high risk for lung cancer. Am J Public Health 2015; 105:1237-45. [PMID: 25880962 DOI: 10.2105/ajph.2014.302492] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES We examined biomarkers of tobacco smoke exposure among Native Hawaiians, Filipinos, and Whites, groups that have different lung cancer risk. METHODS We collected survey data and height, weight, saliva, and carbon monoxide (CO) levels from a sample of daily smokers aged 18-35 (n = 179). Mean measures of nicotine, cotinine, cotinine/cigarettes per day ratio, trans 3' hydroxycotinine, the nicotine metabolite ratio (NMR), and expired CO were compared among racial/ethnic groups. RESULTS The geometric means for cotinine, the cotinine/cigarettes per day ratio, and CO did not significantly differ among racial/ethnic groups in the adjusted models. After adjusting for gender, body mass index, menthol smoking, Hispanic ethnicity, and number of cigarettes smoked per day, the NMR was significantly higher among Whites than among Native Hawaiians and Filipinos (NMR = 0.33, 0.20, 0.19, P ≤ .001). The NMR increased with increasing White parental ancestry. The NMR was not significantly correlated with social-environmental stressors. CONCLUSIONS Racial/ethnic groups with higher rates of lung cancer had slower nicotine metabolism than Whites. The complex relationship between lung cancer risk and nicotine metabolism among racial/ethnic groups needs further clarification.
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Affiliation(s)
- Pebbles Fagan
- Pebbles Fagan, Pallav Pokhrel, Thaddeus Herzog, Kevin D. Cassel, Ian Pagano, Adrian A. Franke, Alyssa Antonio, Dorothy Jorgensen, Tania Lynch, and Crissy Kawamoto are with the University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu. Eric T. Moolchan is an independent consultant, Cambridge, MA. Joseph Keawe'aimoku Kaholokula is with the John A. Burns School of Medicine, University of Hawaii at Manoa. Angela Sy is with the School of Nursing and Dental Hygiene, University of Hawaii at Manoa. Linda A. Alexander is with the University of Kentucky College of Public Health, Lexington. Dennis R. Trinidad and C. Anderson Johnson are with the School of Community and Global Health, Claremont Graduate University, CA. Kari-Lyn Sakuma is with the College of Public Health and Human Sciences, Oregon State University, Corvallis. Mark S. Clanton is with the TMF Health Quality Institute, Austin, TX
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