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Cook DK, Lalonde G, Oldham MJ, Wang J, Bates A, Ullah S, Sulaiman C, Carter K, Jongsma C, Dull G, Gillman IG. A Practical Framework for Novel Electronic Nicotine Delivery System Evaluation: Chemical and Toxicological Characterization of JUUL2 Aerosol and Comparison with Reference Cigarettes. TOXICS 2024; 12:41. [PMID: 38250996 PMCID: PMC10820849 DOI: 10.3390/toxics12010041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024]
Abstract
Electronic nicotine delivery systems (ENDSs) are designed as a non-combustible alternative to cigarettes, aiming to deliver nicotine without the harmful byproducts of tobacco combustion. As the category evolves and new ENDS products emerge, it is important to continually assess the levels of toxicologically relevant chemicals in the aerosols and characterize any related toxicology. Herein, we present a proposed framework for characterizing novel ENDS products (i.e., devices and formulations) and determining the reduced risk potential utilizing analytical chemistry and in vitro toxicological studies with a qualitative risk assessment. To demonstrate this proposed framework, long-term stability studies (12 months) analyzing relevant toxicant emissions from six formulations of a next-generation product, JUUL2, were conducted and compared to reference combustible cigarette (CC) smoke under both non-intense and intense puffing regimes. In addition, in vitro cytotoxicity, mutagenicity, and genotoxicity assays were conducted on aerosol and smoke condensates. In all samples, relevant toxicants under both non-intense and intense puffing regimes were substantially lower than those observed in reference CC smoke. Furthermore, neither cytotoxicity, mutagenicity, nor genotoxicity was observed in aerosol condensates generated under both intense and non-intense puffing regimes, in contrast to results observed for reference cigarettes. Following the proposed framework, the results demonstrate that the ENDS products studied in this work generate significantly lower levels of toxicants relative to reference cigarettes and were not cytotoxic, mutagenic, or genotoxic under these in vitro assay conditions.
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Affiliation(s)
- David K. Cook
- JUUL Labs, 1000 F Street NW, Washington, DC 20004, USA (M.J.O.); (S.U.); (C.S.)
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Dempsey R, Rodrigo G, Vonmoos F, Gunduz I, Belushkin M, Esposito M. Preliminary toxicological assessment of heated tobacco products: A review of the literature and proposed strategy. Toxicol Rep 2023; 10:195-205. [PMID: 36748021 PMCID: PMC9898577 DOI: 10.1016/j.toxrep.2023.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/20/2022] [Accepted: 01/18/2023] [Indexed: 01/21/2023] Open
Abstract
Heated tobacco products (HTP) have become increasingly common in many countries worldwide. The principle of heating tobacco, without combustion, to produce a nicotine-containing aerosol with remarkably reduced levels of other known toxins, compared to combusted tobacco cigarettes, is now well established. As these products are intended as alternatives to traditional combusted products, during the early stages of their development, it is important for manufacturers to ensure that the design of the product does not lead to any unintentionally increased or new risk for the consumer, compared to the traditional products that consumers seek to replace. There is limited guidance from tobacco product regulations concerning the requirements for performing such preliminary toxicological assessments. Here, we review the published literature on studies performed on HTPs in the pursuit of such data, outline a proposed approach that is consistent with regulatory requirements, and provide a logical approach to the preliminary toxicological assessment of HTPs.
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Affiliation(s)
- Ruth Dempsey
- RD Science Speaks Consultancy Sàrl, Le Mont sur Lausanne, Switzerland,Corresponding authors.
| | - Gregory Rodrigo
- PMI R&D, Philip Morris Products S.A., Rue des Usines 56, 2000 Neuchâtel, Switzerland,Corresponding authors.
| | - Florence Vonmoos
- PMI R&D, Philip Morris Products S.A., Rue des Usines 56, 2000 Neuchâtel, Switzerland
| | - Irfan Gunduz
- PMI R&D, Philip Morris Products S.A., Rue des Usines 56, 2000 Neuchâtel, Switzerland
| | - Maxim Belushkin
- PMI R&D, Philip Morris Products S.A., Rue des Usines 56, 2000 Neuchâtel, Switzerland
| | - Marco Esposito
- PMI R&D, Philip Morris Products S.A., Rue des Usines 56, 2000 Neuchâtel, Switzerland
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3
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Schroth KRJ, Delnevo CD, Villanti AC. Closing the loopholes on a flavored cigar ban: Anticipated challenges and solutions. Prev Med 2022; 165:107197. [PMID: 35973576 PMCID: PMC10186586 DOI: 10.1016/j.ypmed.2022.107197] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 11/18/2022]
Abstract
For the first time since Congress authorized the U.S. Food and Drug Administration (FDA) to regulate tobacco in 2009, FDA proposed two tobacco product standards on May 4, 2022. After a period of public comment and agency review, if the product standards are finalized in their current form, they will ban menthol cigarettes (U.S. Food and Drug Administration, 2022b), which comprised 37% of the U.S. cigarette market in 2019 and 2020 (Federal Trade Commission, 2021), and flavored cigars (U.S. Food and Drug Administration, 2022a), which have exceeded 50% of cigar sales since 2012 (Delnevo et al., 2021b). This commentary examines potential challenges to banning flavored cigars and highlights issues FDA and Congress should consider.
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Affiliation(s)
- Kevin R J Schroth
- Rutgers Center for Tobacco Studies, New Brunswick, NJ, United States of America; Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, United States of America.
| | - Cristine D Delnevo
- Rutgers Center for Tobacco Studies, New Brunswick, NJ, United States of America; Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, United States of America
| | - Andrea C Villanti
- Rutgers Center for Tobacco Studies, New Brunswick, NJ, United States of America; Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, United States of America
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El-Kaassamani M, Yen M, Talih S, El-Hellani A. Analysis of mainstream emissions, secondhand emissions and the environmental impact of IQOS waste: a systematic review on IQOS that accounts for data source. Tob Control 2022; 33:tobaccocontrol-2021-056986. [PMID: 35568394 DOI: 10.1136/tobaccocontrol-2021-056986] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 05/05/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To highlight the general features of IQOS literature focusing on the chemical analysis of IQOS emissions. DATA SOURCES PubMed, Web of Science and Scopus databases were searched on 8 November 2021 using the terms 'heated tobacco product', 'heat-not-burn', 'IQOS' and 'tobacco heating system' with time restriction (2010-2021). The search yielded 5480 records. STUDY SELECTION Relevant publications on topics related to IQOS assessment were retrieved (n=341). Two reviewers worked separately and reached agreement by consensus. DATA EXTRACTION Data on author affiliation and funding, article type and date of publication were extracted. Publications were categorised depending on their focus and outcomes. Data on IQOS emissions from the chemical analysis category were extracted. DATA SYNTHESIS Of the included publications, 25% were published by Philip Morris International (PMI) affiliates or PMI-funded studies. PMI-sponsored publications on emissions, toxicology assessments and health effects were comparable in number to those reported by independent research, in contrast to publications on IQOS use, market trends and regulation. Data on nicotine yield, carbonyl emissions, other mainstream emissions, secondhand emissions and IQOS waste were compared between data sources to highlight agreement or disagreement between PMI-sponsored and independent research. CONCLUSIONS Our analysis showed agreement between the data sources on nicotine yield from IQOS under the same puffing conditions. Also, both sources agreed that IQOS emits significantly reduced levels of some emissions compared with combustible cigarettes. However, independent studies and examination of PMI's data showed significant increases in other emissions from and beyond the Food and Drug Administration's harmful and potentially harmful constituents list.
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Affiliation(s)
- Malak El-Kaassamani
- Department of Chemistry, American University of Beirut Faculty of Arts and Sciences, Beirut, Lebanon
| | - Miaoshan Yen
- Department of Biostatistics, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Soha Talih
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Mechanical Engineering, American University of Beirut Faculty of Engineering and Architecture, Beirut, Lebanon
| | - Ahmad El-Hellani
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Division of Environmental Health Sciences, The Ohio State University College of Public Health, Columbus, Ohio, USA
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
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Padhiary S, Samal D, Khandayataray P, Murthy MK. A systematic review report on tobacco products and its health issues in India. REVIEWS ON ENVIRONMENTAL HEALTH 2021; 36:367-389. [PMID: 33185581 DOI: 10.1515/reveh-2020-0037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 10/03/2020] [Indexed: 06/11/2023]
Abstract
India is the second country in tobacco production in the world. Smoking tobacco products included Hookah, Cohutta, Chillum, Chillum, ganja, Beedi, Mava, Cigarettes, and cigar etc. Various types of smokeless tobacco like betel quid, khaini, mishri, snuff, gutkha are used. Fifty percent of them are addicted to smokeless tobacco. Sixty eight smokeless tobacco products were available in 2010; most of them included the risk of cancer warning except for loose tobacco products. Women mostly prefer 8 out of 29 gutkha brands. Out of these 29 gutkha brands, 15 were loose tobacco packets. India is the second-largest tobacco consumer, comprises of 27.5 crore consumers which altogether greater than the population of Western Europe. From among these 27.5 crore consumers, 16.4 crore people are smokeless tobacco in takers, 6.9 crore people are exclusive smokers and 4.2 crore people are both tobacco in takers and exclusive smokers. If we take this data into consideration early mortality of 45 crore people is expected by 2050 worldwide. Female basically are prone to fewer cigarettes per day as compared to males. On the other hand, a cigarette that is consumed by females has lower nicotine content as compared to males. In developing countries, the female population has less prevalence of smoking because the level of employment is low, socio-cultural norms, and health and beauty concerns. According to the estimation by the South East Asia Region (SEAR) in the year 2000 basically from India, we encounter death of about 18% men and about 3% of women due to tobacco. Various policies have been set up to control the use of tobacco. So that threat to public health is reduced. Policies like tobacco control policy, pro-health policy are set up for this purpose. Talking about the effects on a longer-term usage of water pipe can add up to the risk of getting affected by cancers of lungs, mouth, bladders, atherosclerosis, cardiovascular and pulmonary diseases, tooth extraction, etc.
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Affiliation(s)
- Samprit Padhiary
- Department of Bitechnology, Academy of Management and Information Technology, Vidya Vihar, IID Center, Khurda, Khordha, Odisha, India
| | - Dibyaranjan Samal
- Department of Bitechnology, Academy of Management and Information Technology, Vidya Vihar, IID Center, Khurda, Khordha, Odisha, India
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Banks E, Martin M, Harris M. Framework for the public health assessment of electronic cigarettes. Tob Control 2021; 31:608-614. [PMID: 33958423 DOI: 10.1136/tobaccocontrol-2020-056271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 03/04/2021] [Accepted: 03/08/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Electronic cigarettes (e-cigarettes) are relatively new products with substantial public health impacts. Evidence on their effects is diverse and emerging rapidly, presenting challenges to high-quality policymaking and decision-making. This paper addresses these challenges by developing and presenting a framework for the public health assessment of e-cigarettes, using the Australian context as an example. METHODS Framework development involved stakeholder engagement, development of guiding principles, and consideration of existing relevant frameworks and the evidence requirements of current policy options, identified in published and grey literature. RESULTS Guiding principles include the need for the framework to: be evidence based; include consideration of the likely balance of benefits and risks of e-cigarettes, uncertainty and safety; support equity; support the ongoing application of evidence to high-quality policy and practice; and consider potential competing interests. The framework draws upon: health technology assessment; health impact assessment; environmental health risk assessment; healthcare recommendations evidence evaluation; consumer goods regulation; medicine and chemical scheduling; tobacco product evaluation; previous reviews and the precautionary principle. Final framework components are: (1) characterisation of products under consideration; (2) definition of populations of interest; (3) characterisation of tobacco smoking, control and impacts on health and well-being; (4) review of evidence on patterns of e-cigarette use; (5) review of evidence on e-cigarette use and health outcomes; (6) assessment of likely risks, benefits and safety; (7) identification and assessment of policy options to optimise health outcomes. CONCLUSIONS Structured and ongoing public health assessment of e-cigarette use is likely to support health through enhancing evidence-based decision-making.
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Affiliation(s)
- Emily Banks
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Melonie Martin
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Miranda Harris
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
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Giralt A, Iskandar AR, Martin F, Moschini E, Serchi T, Kondylis A, Marescotti D, Leroy P, Ortega-Torres L, Majeed S, Merg C, Trivedi K, Guedj E, Frentzel S, Ivanov NV, Peitsch MC, Gutleb AC, Hoeng J. Comparison of the biological impact of aerosol of e-vapor device with MESH® technology and cigarette smoke on human bronchial and alveolar cultures. Toxicol Lett 2021; 337:98-110. [PMID: 33220401 DOI: 10.1016/j.toxlet.2020.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/02/2020] [Accepted: 11/08/2020] [Indexed: 11/30/2022]
Abstract
Exposure to aerosol from electronic vapor (e-vapor) products has been suggested to result in less risk of harm to smokers than cigarette smoke (CS) exposure. Although many studies on e-vapor products have tested the effects of liquid formulations on cell cultures, few have evaluated the effects of aerosolized formulations. We examined the effects of acute exposure to the aerosol of an e-vapor device that uses the MESH® technology (IQOS® MESH, Philip Morris International) and to CS from the 3R4F reference cigarette on human organotypic bronchial epithelial culture and alveolar triculture models. In contrast to 3R4F CS exposure, exposure to the IQOS MESH aerosol (Classic Tobacco flavor) did not cause cytotoxicity in bronchial epithelial cultures or alveolar tricultures despite its greater concentrations of deposited nicotine (3- and 4-fold, respectively). CS exposure caused a marked decrease in the frequency and active area of ciliary beating in bronchial cultures, whereas IQOS MESH aerosol exposure did not. Global mRNA expression and secreted protein profiles revealed a significantly lower impact of IQOS MESH aerosol exposure than 3R4F CS exposure. Overall, our whole aerosol exposure study shows a clearly reduced impact of IQOS MESH aerosol relative to CS in bronchial and alveolar cultures, even at greater nicotine doses.
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Affiliation(s)
- Albert Giralt
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Anita R Iskandar
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland.
| | - Florian Martin
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Elisa Moschini
- Department of Environmental Research and Innovation, Luxembourg Institute of Science and Technology, Luxembourg
| | - Tomasso Serchi
- Department of Environmental Research and Innovation, Luxembourg Institute of Science and Technology, Luxembourg
| | - Athanasios Kondylis
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Diego Marescotti
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Patrice Leroy
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Laura Ortega-Torres
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Shoaib Majeed
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Celine Merg
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Keyur Trivedi
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Emmanuel Guedj
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Stefan Frentzel
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Nikolai V Ivanov
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Manuel C Peitsch
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Arno C Gutleb
- Department of Environmental Research and Innovation, Luxembourg Institute of Science and Technology, Luxembourg
| | - Julia Hoeng
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
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Schlage WK, Titz B, Iskandar A, Poussin C, Van der Toorn M, Wong ET, Pratte P, Maeder S, Schaller JP, Pospisil P, Boue S, Vuillaume G, Leroy P, Martin F, Ivanov NV, Peitsch MC, Hoeng J. Comparing the preclinical risk profile of inhalable candidate and potential candidate modified risk tobacco products: A bridging use case. Toxicol Rep 2020; 7:1187-1206. [PMID: 32995294 PMCID: PMC7502378 DOI: 10.1016/j.toxrep.2020.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/24/2020] [Accepted: 09/01/2020] [Indexed: 11/25/2022] Open
Abstract
Heated tobacco products tested for reduced exposure and reduced risk properties. Bridging opportunities for nonclinical results from two heated tobacco products. Similarly reduced impact on apical and molecular endpoints relative to cigarettes. Evidence evaluated along a “causal chain of events leading to disease” (CELSD). Representative assays along CELSD could support nonclinical substantial equivalence.
Cigarette smoking causes major preventable diseases, morbidity, and mortality worldwide. Smoking cessation and prevention of smoking initiation are the preferred means for reducing these risks. Less harmful tobacco products, termed modified-risk tobacco products (MRTP), are being developed as a potential alternative for current adult smokers who would otherwise continue smoking. According to a regulatory framework issued by the US Food and Drug Administration, a manufacturer must provide comprehensive scientific evidence that the product significantly reduces harm and the risk of tobacco-related diseases, in order to obtain marketing authorization for a new MRTP. For new tobacco products similar to an already approved predicate product, the FDA has foreseen a simplified procedure for assessing “substantial equivalence”. In this article, we present a use case that bridges the nonclinical evidence from previous studies demonstrating the relatively reduced harm potential of two heat-not-burn products based on different tobacco heating principles. The nonclinical evidence was collected along a “causal chain of events leading to disease” (CELSD) to systematically follow the consequences of reduced exposure to toxicants (relative to cigarette smoke) through increasing levels of biological complexity up to disease manifestation in animal models of human disease. This approach leverages the principles of systems biology and toxicology as a basis for further extrapolation to human studies. The experimental results demonstrate a similarly reduced impact of both products on apical and molecular endpoints, no novel effects not seen with cigarette smoke exposure, and an effect of switching from cigarettes to either MRTP that is comparable to that of complete smoking cessation. Ideally, a subset of representative assays from the presented sequence along the CELSD could be sufficient for predicting similarity or substantial equivalence in the nonclinical impact of novel products; this would require further validation, for which the present use case could serve as a starting point.
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Key Words
- BIF, biological impact factor
- CELSD, causal chain of events leading to disease
- CHTP, carbon heated tobacco product
- CS, cigarette smoke
- CVD, cardiovascular disease
- GVP, gas/vapor phase
- HPHC, harmful and potentially harmful constituents
- MRTP, modified risk tobacco product
- Modified risk tobacco product (MRTP)
- NPA, network perturbation amplitude
- PMI, Philip Morris International
- RBIF, relative BIF
- Substantial equivalence
- Systems toxicology
- THS, Tobacco Heating System
- TPM, total particulate matter
- Tobacco harm reduction
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Affiliation(s)
| | - Bjoern Titz
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - Anita Iskandar
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - Carine Poussin
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - Marco Van der Toorn
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - Ee Tsin Wong
- PMI R&D, Philip Morris International Research Laboratories Pte. Ltd., Science Park II, Singapore
| | - Pascal Pratte
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - Serge Maeder
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - Jean-Pierre Schaller
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - Pavel Pospisil
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - Stephanie Boue
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - Grégory Vuillaume
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - Patrice Leroy
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - Florian Martin
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - Nikolai V Ivanov
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - Manuel C Peitsch
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - Julia Hoeng
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
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Haziza C, de La Bourdonnaye G, Donelli A, Skiada D, Poux V, Weitkunat R, Baker G, Picavet P, Lüdicke F. Favorable Changes in Biomarkers of Potential Harm to Reduce the Adverse Health Effects of Smoking in Smokers Switching to the Menthol Tobacco Heating System 2.2 for 3 Months (Part 2). Nicotine Tob Res 2020; 22:549-559. [PMID: 31125079 PMCID: PMC7164580 DOI: 10.1093/ntr/ntz084] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 05/23/2019] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Tobacco Heating System (THS) 2.2, a candidate modified-risk tobacco product, aims at offering an alternative to cigarettes for smokers while substantially reducing the exposure to harmful and potentially harmful constituents found in cigarette smoke. METHODS One hundred and sixty healthy adult US smokers participated in this randomized, three-arm parallel group, controlled clinical study. Subjects were randomized in a 2:1:1 ratio to menthol Tobacco Heating System 2.2 (mTHS), menthol cigarette, or smoking abstinence for 5 days in confinement and 86 subsequent ambulatory days. Endpoints included biomarkers of exposure to harmful and potentially harmful constituents (reported in our co-publication, Part 1) and biomarkers of potential harm (BOPH). RESULTS Compliance (protocol and allocated product exposure) was 51% and 18% in the mTHS and smoking abstinence arms, respectively, on day 90. Nonetheless, favorable changes in BOPHs of lipid metabolism (total cholesterol and high- and low-density cholesterol), endothelial dysfunction (soluble intercellular adhesion molecule-1), oxidative stress (8-epi-prostaglandin F2α), and cardiovascular risk factors (eg, high-sensitivity C-reactive protein) were observed in the mTHS group. Favorable effects in other BOPHs, including ones related to platelet activation (11-dehydrothromboxane B2) and metabolic syndrome (glucose), were more pronounced in normal weight subjects. CONCLUSIONS The results suggest that the reduced exposure demonstrated when switching to mTHS is associated with overall improvements in BOPHs, which are indicative of pathomechanistic pathways underlying the development of smoking-related diseases, with some stronger effects in normal weight subjects. IMPLICATIONS Switching to mTHS was associated with favorable changes for some BOPHs indicative of biological pathway alterations (eg, oxidative stress and endothelial dysfunction). The results suggest that switching to mTHS has the potential to reduce the adverse health effects of smoking and ultimately the risk of smoking-related diseases. Switching to mTHS for 90 days led to reductions in a number of biomarkers of exposure in smokers, relative to those who continued smoking cigarettes, which were close to those observed when stopping smoking (reported in our co-publication, Part 1). Initial findings suggest reduced levels of 8-epi-prostaglandin F2α and intercellular adhesion molecule 1, when switching to mTHS for 90 days. These changes are comparable to what is observed upon smoking cessation. In normal weight subjects, additional favorable changes were seen in 11-dehydrothromboxane B2, fibrinogen, homocysteine, hs-CRP, percentage of predicted forced expiratory volume in 1 second, systolic blood pressure, diastolic blood pressure, glucose, high-density lipoprotein, apolipoprotein A1, and triglycerides. TRIAL REGISTRATION NCT01989156.
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Affiliation(s)
- Christelle Haziza
- PMI Research and Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | | | - Andrea Donelli
- PMI Research and Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Dimitra Skiada
- PMI Research and Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Valerie Poux
- PMI Research and Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Rolf Weitkunat
- PMI Research and Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Gizelle Baker
- PMI Research and Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Patrick Picavet
- PMI Research and Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Frank Lüdicke
- PMI Research and Development, Philip Morris Products S.A., Neuchâtel, Switzerland
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10
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Lee SJ, Rees VW, Yossefy N, Emmons KM, Tan ASL. Youth and Young Adult Use of Pod-Based Electronic Cigarettes From 2015 to 2019: A Systematic Review. JAMA Pediatr 2020; 174:714-720. [PMID: 32478809 PMCID: PMC7863733 DOI: 10.1001/jamapediatrics.2020.0259] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE The use of electronic cigarettes (e-cigarettes) has rapidly increased among youth and young adults, but knowledge gaps exist on the potential health effects of using recently introduced pod-based e-cigarettes. OBJECTIVE To conduct a systematic review of recent peer-reviewed scientific literature on pod-based e-cigarettes. EVIDENCE REVIEW A search of online databases, including PubMed, Web of Science, Embase, and EBSCO HOST, was conducted to identify pod-based e-cigarette-associated articles from June 2015 (the time when JUUL [JUUL Labs] was introduced) to June 2019. We included English-language articles that presented primary data on pod-based e-cigarettes. FINDINGS Pod-based e-cigarettes represent a substantial evolution in design by increasing the efficient delivery of nicotine. While these products may contain less harmful constituents than other types of e-cigarettes and cigarettes, there is no evidence that the levels found are safe among youth. There is evidence for higher nicotine dependence associated with their use. Pod-based e-cigarette brands, compared with other e-cigarette brands, have targeted youth and young adults with social media marketing. There was less discussion about the use of these products as smoking cessation devices or their health risks on social media. The social acceptability and favorable perceptions of pod-based e-cigarettes may underlie the use of these products. CONCLUSIONS AND RELEVANCE The appeal and dependence potential of pod-based e-cigarettes for youth emphasize the need for stronger regulations on product design, social media, marketing channels, and youth access together with health communications that emphasize the risks of nicotine dependence.
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Affiliation(s)
- Stella Juhyun Lee
- Department of Media and Communication, Konkuk University, Seoul, South Korea
| | - Vaughan W. Rees
- Harvard T. H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, Massachusetts
| | - Noam Yossefy
- Harvard T. H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, Massachusetts
| | - Karen M. Emmons
- Harvard T. H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, Massachusetts
| | - Andy S. L. Tan
- Harvard T. H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, Massachusetts,Dana-Farber Cancer Institute, Population Sciences Division, Center for Community Based Research, Boston, Massachusetts
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11
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Berman ML, Glasser AM. Nicotine Reduction in Cigarettes: Literature Review and Gap Analysis. Nicotine Tob Res 2020; 21:S133-S144. [PMID: 31867659 PMCID: PMC6939782 DOI: 10.1093/ntr/ntz162] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 08/28/2019] [Indexed: 11/13/2022]
Abstract
BACKGROUND The US Food and Drug Administration (FDA) is considering reducing nicotine levels in cigarettes to "minimally or non-addictive levels." However, important research gaps remain, and the FDA must determine when the available research is sufficient to support moving forward. METHODS The authors conducted a systematic review of research articles in PubMed relating to nicotine reduction. Building on a review of risk assessment best practices, the authors also developed a risk assessment framework for tobacco regulation and used it to guide a gap analysis of nicotine reduction research. RESULTS The final sample consisted of 78 articles. The majority examined either nicotine dependence on very low nicotine cigarettes (VLNCs) or markers of potential health effects of using VLNCs. One-third of the identified articles reported results from four large randomized controlled trials (RCTs). While these studies report promising results and suggest that a nicotine reduction rule would be a powerful tool to reduce cigarette smoking, our gap analysis suggests that there is a need for studies that better reflect the use and availability of a wide range of tobacco/nicotine products and the potential for dual- or multi-product use. CONCLUSION The current body of research on nicotine reduction is weighted towards RCTs, which is appropriate for a policy that has not yet been implemented anywhere in the world. The FDA must consider a wide range of factors that may impact a product standard's public health impact, including those difficult to assess in RCTs, such as a nicotine reduction rule's impact on smoking initiation and relapse. IMPLICATIONS This systematic review presents a gap analysis based on a risk assessment framework to help identify remaining research priorities to inform FDA's potential product standard to reduce nicotine levels in cigarettes. Quickly addressing those gaps would support the FDA's effort to develop a nicotine reduction product standard that will be effective and withstand legal challenges.
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Affiliation(s)
- Micah L Berman
- College of Public Health, Ohio State University, Columbus, OH.,Moritz College of Law, Ohio State University, Columbus, OH
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12
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Boué S, Goedertier D, Hoeng J, Kuczaj A, Majeed S, Mathis C, May A, Phillips B, Peitsch MC, Radtke F, Schlage WK, Tan WT, Vanscheeuwijck P. State-of-the-art methods and devices for the generation, exposure, and collection of aerosols from heat-not-burn tobacco products. TOXICOLOGY RESEARCH AND APPLICATION 2020. [DOI: 10.1177/2397847319897869] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Tobacco harm reduction is increasingly recognized as a promising approach to accelerate the decline in smoking prevalence and smoking-related population harm. Potential modified risk tobacco products (MRTPs) must undergo a rigorous premarket toxicological risk assessment. The ability to reproducibly generate, collect, and use aerosols is critical for the characterization, and preclinical assessment of aerosol-based candidate MRTPs (cMRTPs), such as noncombusted cigarettes, also referred to as heated tobacco products, tobacco heating products, or heat-not-burn (HNB) tobacco products. HNB tobacco products generate a nicotine-containing aerosol by heating tobacco instead of burning it. The aerosols generated by HNB products are qualitatively and quantitatively highly different from cigarette smoke (CS). This constitutes technical and experimental challenges comparing the toxicity of HNB aerosols with CS. The methods and experimental setups that have been developed for the study of CS cannot be directly transposed to the study of HNB aerosols. Significant research efforts are dedicated to the development, characterization, and validation of experimental setups and methods suitable for HNB aerosols. They are described in this review, with a particular focus on the Tobacco Heating System version 2.2. This is intended to support further studies, the objective evaluation and verification of existing evidence, and the development of scientifically substantiated HNB MRTPs.
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Affiliation(s)
- Stéphanie Boué
- Philip Morris International (PMI) Research & Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Didier Goedertier
- Philip Morris International (PMI) Research & Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Julia Hoeng
- Philip Morris International (PMI) Research & Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Arkadiusz Kuczaj
- Philip Morris International (PMI) Research & Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Shoaib Majeed
- Philip Morris International (PMI) Research & Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Carole Mathis
- Philip Morris International (PMI) Research & Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Anne May
- Consultants in Science, Epalinges, Switzerland
| | - Blaine Phillips
- Philip Morris International (PMI) Research & Development, Philip Morris International Research Laboratories Pte. Ltd, Science Park II, Singapore
| | - Manuel C Peitsch
- Philip Morris International (PMI) Research & Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Falk Radtke
- Philip Morris International (PMI) Research & Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | | | - Wei Teck Tan
- Philip Morris International (PMI) Research & Development, Philip Morris International Research Laboratories Pte. Ltd, Science Park II, Singapore
| | - Patrick Vanscheeuwijck
- Philip Morris International (PMI) Research & Development, Philip Morris Products S.A., Neuchâtel, Switzerland
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13
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Jacob M. Looking Back and Ahead: The Food and Drug Administration's Regulation of the Tobacco Industry and Next-Generation Products. Adv Dent Res 2019; 30:22-25. [PMID: 31538803 PMCID: PMC6755717 DOI: 10.1177/0022034519872472] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Regulatory policy toward tobacco significantly affects oral health because tobacco use is a driver of diseases that manifest themselves in or near the oral cavity. Tobacco use in the United States has been associated with millions of cases of periodontal disease. Researchers have identified the role of combusted and noncombusted tobacco products in promoting cancers of the head and neck, leading to disease and premature death. Tobacco companies have moved increasingly toward so-called next-generation products (NGPs)-products that may emit fewer toxins than combustible forms of tobacco. Although NGPs may negatively affect the lungs and other bodily systems, they shift the injection site of nicotine from the lungs to the oral cavity and oral tissues. Because the long-term effects of NGPs are unknown, this tobacco marketing development has profound implications for oral disease. The US Food and Drug Administration exercises regulatory authority over tobacco products. The tobacco industry has avoided meaningful regulation of its products, especially smokeless forms. By publishing new research, oral health scientists can meaningfully shape the climate in which the administration's policy making occurs.
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Affiliation(s)
- M Jacob
- Jacob Strategies LLC, Washington, DC, USA
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14
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Berman ML, Bickel WK, Harris AC, LeSage MG, O'Connor RJ, Stepanov I, Shields PG, Hatsukami DK. Consortium on Methods Evaluating Tobacco: Research Tools to Inform US Food and Drug Administration Regulation of Snus. Nicotine Tob Res 2019; 20:1292-1300. [PMID: 29059363 DOI: 10.1093/ntr/ntx228] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 09/28/2017] [Indexed: 11/13/2022]
Abstract
Introduction The US Food and Drug Administration (FDA) has purview over tobacco products. To set policy, the FDA must rely on sound science, yet most existing tobacco research methods have not been designed to specifically inform regulation. The NCI and FDA-funded Consortium on Methods Evaluating Tobacco (COMET) was established to develop and assess valid and reliable methods for tobacco product evaluation. The goal of this article is to describe these assessment methods using a US manufactured "snus" as the test product. Methods In designing studies that could inform FDA regulation, COMET has taken a multidisciplinary approach that includes experimental animal models and a range of human studies that examine tobacco product appeal, addictiveness, and toxicity. This article integrates COMET's findings over the last 4 years. Results Consistency in results was observed across the various studies, lending validity to our methods. Studies showed low abuse liability for snus and low levels of consumer demand. Toxicity was less than cigarettes on some biomarkers but higher than medicinal nicotine. Conclusions Using our study methods and the convergence of results, the snus that we tested as a potential modified risk tobacco product is likely to neither result in substantial public health harm nor benefit. Implications This review describes methods that were used to assess the appeal, abuse liability, and toxicity of snus. These methods included animal, behavioral economics, consumer perception studies, and clinical trials. Across these varied methods, study results showed low abuse-liability and appeal of the snus product we tested. In several studies, demand for snus was lower than for less toxic nicotine gum. The consistency and convergence of results across a range of multi-disciplinary studies lends validity to our methods and suggests that promotion of snus as a modified risk tobacco products is unlikely to produce substantial public health benefit or harm.
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Affiliation(s)
- Micah L Berman
- College of Public Health, Ohio State University, Columbus, OH.,Moritz College of Law, Ohio State University, Columbus, OH
| | | | - Andrew C Harris
- Minneapolis Medical Research Foundation, Minneapolis, MN.,Department of Medicine, University of Minnesota, Minneapolis, MN.,Department of Psychology, University of Minnesota, Minneapolis, MN
| | - Mark G LeSage
- Minneapolis Medical Research Foundation, Minneapolis, MN.,Department of Medicine, University of Minnesota, Minneapolis, MN.,Department of Psychology, University of Minnesota, Minneapolis, MN
| | | | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Peter G Shields
- Comprehensive Cancer Center, Ohio State University, Columbus, OH
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15
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Boué S, Schlage WK, Page D, Hoeng J, Peitsch MC. Toxicological assessment of Tobacco Heating System 2.2: Findings from an independent peer review. Regul Toxicol Pharmacol 2019; 104:115-127. [PMID: 30878573 DOI: 10.1016/j.yrtph.2019.03.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 02/12/2019] [Accepted: 03/09/2019] [Indexed: 01/09/2023]
Abstract
Offering safer alternatives to cigarettes, such as e-cigarettes and heated tobacco products, to smokers who are not willing to quit could reduce the harm caused by smoking. Extensive and rigorous scientific studies are conducted to assess the relative risk of such potentially modified risk tobacco products compared with that of smoking cigarettes. In addition to the peer review of publications reporting individual studies, we aimed to gauge the plausibility of the evidence to the scientific community and appreciate likely necessary additions prior to regulatory submission. Therefore, we sponsored a two-tier peer review organized by an independent third party who identified, recruited, and managed 7 panels of 5-12 experts whose identity remains unknown to us. The reviewers had access to all publications and raw data from preclinical and clinical studies via a web portal. The reviewers were asked questions regarding study design, methods, quality of data, and interpretation of results to judge the validity of the conclusions regarding the relative effects of the Tobacco Heating System 2.2 compared with cigarettes. Once their conclusions were submitted, the experts had the opportunity to participate in an anonymized online debate with their fellow panel members. We present here the results obtained from this innovative peer review effort which revealed supportive or very supportive of the study methods and results, and support the robustness of the studies and validity of the conclusions.
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Affiliation(s)
- Stéphanie Boué
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland.
| | - Walter K Schlage
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - David Page
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - Julia Hoeng
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - Manuel C Peitsch
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
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16
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Roulet S, Chrea C, Kanitscheider C, Kallischnigg G, Magnani P, Weitkunat R. Potential predictors of adoption of the Tobacco Heating System by U.S. adult smokers: An actual use study. F1000Res 2019; 8:214. [PMID: 31559015 PMCID: PMC6743249 DOI: 10.12688/f1000research.17606.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 11/20/2022] Open
Abstract
Background: This was a pre-market, observational, actual use study with the Tobacco Heating System (THS), a candidate modified risk tobacco product. The main goal of the study was to describe THS adoption within current adult daily smokers by replicating the usage of THS in real-world conditions with participants being able to consume cigarettes, THS, and any other nicotine-containing products (e.g., e-cigarettes, cigars, etc.) ad libitum. Methods: This study assessed self-reported stick-by-stick consumption of THS compared with the use of commercial cigarettes over six weeks. The aim of the analysis was to identify potential predictors for adoption of THS using stepwise logistic regression analysis. Results: By the end of the observational period (in Week 6), 14.6% of participants (n=965) had adopted THS meaning that THS formed 70% or more of their total tobacco consumption. The main predictors of adoption were the liking of the smell, taste, aftertaste, and ease of use of THS. The proportion of adoption was higher in participants aged 44 years and older and in Hispanic or Latino adult smokers. Additionally, adoption of THS was more likely in participants who had never attempted to quit smoking and in participants who smoked up to 10 cigarettes per day. Finally, the adoption of THS was higher in participants who consumed both regular and menthol THS compared with those who consumed only one THS variant. Conclusions: The findings suggest that the introduction of THS in the U.S. has the potential to result in adoption by current adult smokers who would otherwise continue to smoke cigarettes, and that the adoption of THS is unlikely to result in an increase of tobacco consumption. Post-marketing studies will provide further insights on THS adoption and THS use patterns to allow assessment of the impact of the THS at the individual and the overall population level.
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Affiliation(s)
- Steve Roulet
- Science and Innovation, Philip Morris International Management S.A., Lausanne, 1007, Switzerland
| | - Christelle Chrea
- Science and Innovation, Philip Morris Products S.A., Neuchatel, 2000, Switzerland
| | | | - Gerd Kallischnigg
- ARGUS Statistics and Information Systems in Environment and Public Health GmbH, Berlin, Germany
| | - Pierpaolo Magnani
- Science and Innovation, Philip Morris International Management S.A., Lausanne, 1007, Switzerland
| | - Rolf Weitkunat
- Science and Innovation, Philip Morris Products S.A., Neuchatel, 2000, Switzerland
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17
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Roulet S, Chrea C, Kanitscheider C, Kallischnigg G, Magnani P, Weitkunat R. Potential predictors of adoption of the Tobacco Heating System by U.S. adult smokers: An actual use study. F1000Res 2019; 8:214. [PMID: 31559015 PMCID: PMC6743249 DOI: 10.12688/f1000research.17606.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/18/2019] [Indexed: 12/17/2023] Open
Abstract
Background: This was a pre-market actual use study with the Tobacco Heating System (THS), a candidate modified risk tobacco product, conducted with adult smokers in eight cities in the United States. The main goal of the study was to describe THS adoption in a real-world setting. The aim of this analysis was to identify potential predictors for adoption of THS using stepwise logistic regression method. Methods: This actual use study was an observational study assessing self-reported stick-by-stick consumption of the THS product compared with the use of commercial cigarettes over six weeks. The study aimed at replicating the usage of THS in real-world conditions with participants being able to consume cigarettes, THS, and any other nicotine-containing products (e.g., e-cigarettes, cigars, etc.) ad libitum. Results: 14.6% of participants adopted THS, which comprised 70% or more of their total tobacco consumption by the end of the observational period (in Week 6). The main predictors of adoption were the liking of the smell, taste, aftertaste, and ease of use of THS. The proportion of adoption was higher in participants aged 44 years and older and in Hispanic or Latino adult smokers. Additionally, adoption of THS was more likely in participants who had never attempted to quit smoking and in participants who smoked up to 10 cigarettes per day. Finally, the adoption of THS was higher in participants who consumed both regular and menthol THS compared with those who consumed only one THS variant. Conclusions: The main predictors of THS adoption were positive sensory assessment and the ease of use. Socio-demographic characteristics and smoking habits appeared much less important. Post-marketing studies will provide further insights on the impact of the THS at the individual and the overall population level.
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Affiliation(s)
- Steve Roulet
- Science and Innovation, Philip Morris International Management S.A., Lausanne, 1007, Switzerland
| | - Christelle Chrea
- Science and Innovation, Philip Morris Products S.A., Neuchatel, 2000, Switzerland
| | | | - Gerd Kallischnigg
- ARGUS Statistics and Information Systems in Environment and Public Health GmbH, Berlin, Germany
| | - Pierpaolo Magnani
- Science and Innovation, Philip Morris International Management S.A., Lausanne, 1007, Switzerland
| | - Rolf Weitkunat
- Science and Innovation, Philip Morris Products S.A., Neuchatel, 2000, Switzerland
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18
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Gupta AK, Tulsyan S, Bharadwaj M, Mehrotra R. Grass roots approach to control levels of carcinogenic nitrosamines, NNN and NNK in smokeless tobacco products. Food Chem Toxicol 2019; 124:359-366. [DOI: 10.1016/j.fct.2018.12.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 09/06/2018] [Accepted: 12/08/2018] [Indexed: 12/16/2022]
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19
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Chrea C, Acquadro C, Afolalu EF, Spies E, Salzberger T, Abetz-Webb L, Cano S, Arnould B, Mainy N, Rose J, Weitkunat R. Developing fit-for-purpose self-report instruments for assessing consumer responses to tobacco and nicotine products: the ABOUT™ Toolbox initiative. F1000Res 2018; 7:1878. [PMID: 30906527 PMCID: PMC6415329 DOI: 10.12688/f1000research.16810.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/22/2018] [Indexed: 12/24/2022] Open
Abstract
Background. Determining the public health impact of tobacco harm reduction strategies requires the assessment of consumer perception and behavior associated with tobacco and nicotine products (TNPs) with different exposure and risk profiles. In this context, rigorous methods to develop and validate psychometrically sound self-report instruments to measure consumers' responses to TNPs are needed. Methods. Consistent with best practice guidelines, including the U.S. Food and Drug Administration's "Guidance for Industry Patient-Reported Outcome Measures: Use in Medical Product Development to Support Labeling Claims," scientifically designed, fit-for-purpose, reliable, and valid instruments are now being applied to tobacco regulatory research. Results. This brief report presents the ABOUT™ Toolbox ( Assessment of Behavioral OUtcomes related to Tobacco and nicotine products) initiative. This communication: (1) describes the methodological steps followed for the development and validation of the measurement instruments included in the ABOUT™ Toolbox, (2) presents a summary of the high-priority tobacco-related domains that are currently covered in the ABOUT™ Toolbox (i.e., risk perception, dependence, product experience, health and functioning, and use history), and (3) details how the measurement instruments are made accessible to the scientific community. Conclusions. By making the ABOUT™ Toolbox available to the tobacco research and public health community, we envision a rapidly expanding knowledge base, with the goals of (1) supporting consumer perception and behavior research to allow comparisons across a wide spectrum of TNPs, (2) enabling public health and regulatory communities to make better-informed decisions for future regulation of TNPs, and (3) enhancing surveillance activities associated with the impact of TNPs on population health.
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Affiliation(s)
- Christelle Chrea
- PMI R&D, Philip Morris Products S.A., Neuchâtel, CH-2000, Switzerland
| | - Catherine Acquadro
- Patient-Centered Sciences, Mapi, an ICON plc Company, Lyon, 69003, France
| | - Esther F. Afolalu
- PMI R&D, Philip Morris Products S.A., Neuchâtel, CH-2000, Switzerland
| | - Erica Spies
- PMI R&D, Philip Morris Products S.A., Neuchâtel, CH-2000, Switzerland
| | - Thomas Salzberger
- Institute for Statistics and Mathematics, Institute for Marketing Management, Vienna University of Economics and Business, Vienna, 1020, Austria
| | - Linda Abetz-Webb
- Patient-Centered Outcomes Assessments Ltd, Macclesfield, Cheshire, SK10 5LQ, UK
| | - Stefan Cano
- Modus Outcomes, Letchworth Garden City, SG6 4ET, UK
| | - Benoit Arnould
- Patient-Centered Sciences, Mapi, an ICON plc Company, Lyon, 69003, France
| | - Nelly Mainy
- PMI R&D, Philip Morris Products S.A., Neuchâtel, CH-2000, Switzerland
| | - Jed Rose
- Rose Research Center, Raleigh, NC, 27617, USA
| | - Rolf Weitkunat
- PMI R&D, Philip Morris Products S.A., Neuchâtel, CH-2000, Switzerland
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20
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Belushkin M, Esposito M, Jaccard G, Jeannet C, Korneliou A, Tafin Djoko D. Role of testing standards in smoke-free product assessments. Regul Toxicol Pharmacol 2018; 98:1-8. [DOI: 10.1016/j.yrtph.2018.06.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 06/28/2018] [Accepted: 06/30/2018] [Indexed: 12/22/2022]
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21
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Ansari SM, Lama N, Blanc N, Bosilkovska M, Donelli A, Picavet P, Baker G, Haziza C, Lüdicke F. Evaluation of Biological and Functional Changes in Healthy Smokers Switching to the Tobacco Heating System 2.2 Versus Continued Tobacco Smoking: Protocol for a Randomized, Controlled, Multicenter Study. JMIR Res Protoc 2018; 7:e11294. [PMID: 30143474 PMCID: PMC6128954 DOI: 10.2196/11294] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 07/25/2018] [Accepted: 07/25/2018] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Tobacco harm reduction, substituting less harmful tobacco products for combustible cigarettes, is a complementary approach for smokers who would otherwise continue to smoke. The Philip Morris International (PMI) Tobacco Heating System (THS) 2.2 is a novel tobacco product with the potential to reduce the risk of harm in smokers compared to continued smoking of combustible cigarettes. It heats tobacco electrically in a controlled manner, never allowing the temperature to exceed 350°C, thereby preventing the combustion process from taking place and producing substantially lower levels of toxicants while providing nicotine, taste, ritual, and a sensory experience that closely parallels combustible cigarettes. Previous clinical studies have demonstrated reduced exposure to the toxicants (approaching the levels observed after quitting) for smokers who switched to THS 2.2, for three months. For adult smokers who would otherwise continue smoking combustible cigarettes, switching to THS 2.2 may represent an alternative way to reduce the risk of tobacco-related diseases. OBJECTIVE This study aimed to further substantiate the harm reduction potential of THS 2.2 by demonstrating favorable changes in a set of 8 coprimary endpoints, representative of pathomechanistic pathways (ie, inflammation, oxidative stress, lipid metabolism, respiratory function, and genotoxicity), linked to smoking-related diseases, in smokers switching from combustible cigarettes to THS 2.2. METHODS This study was a randomized, controlled, two-arm parallel group, multicenter ambulatory US study conducted in healthy adult smokers switching from combustible cigarettes to THS 2.2 compared with smokers continuing to smoke combustible cigarettes for six months. Subjects had a smoking history of at least ten years and did not intend to quit within the next six months. RESULTS Enrollment started in March 2015 and the trial was completed in September 2016. In total, 984 subjects were randomized (combustible cigarettes, n=483; THS 2.2, n=477), and 803 completed the study. The results are expected to be available in a subsequent publication in 2019. CONCLUSIONS In this paper, we describe the rationale and design for this clinical study that focused on the evaluation of THS 2.2's potential to reduce the risk of smoking-related diseases compared with that of combustible cigarettes. This study will provide insights regarding favorable changes in biological and functional endpoints informed by effects known to be seen upon smoking cessation. TRIAL REGISTRATION ClinicalTrials.gov NCT02396381; http://clinicaltrials.gov/ct2/show/NCT02396381 (Archived by WebCite at http://www.webcitation.org/71PCRdagP). REGISTERED REPORT IDENTIFIER RR1-10.2196/11294.
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Affiliation(s)
- S Michael Ansari
- Philip Morris International Research & Development, Neuchâtel, Switzerland
| | - Nicola Lama
- Philip Morris International Research & Development, Neuchâtel, Switzerland
| | - Nicolas Blanc
- Philip Morris International Research & Development, Neuchâtel, Switzerland
| | - Marija Bosilkovska
- Philip Morris International Research & Development, Neuchâtel, Switzerland
| | - Andrea Donelli
- Philip Morris International Research & Development, Neuchâtel, Switzerland
| | - Patrick Picavet
- Philip Morris International Research & Development, Neuchâtel, Switzerland
| | - Gizelle Baker
- Philip Morris International Research & Development, Neuchâtel, Switzerland
| | - Christelle Haziza
- Philip Morris International Research & Development, Neuchâtel, Switzerland
| | - Frank Lüdicke
- Philip Morris International Research & Development, Neuchâtel, Switzerland
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LeSage MG, Smethells JR, Harris AC. Status and Future Directions of Preclinical Behavioral Pharmacology in Tobacco Regulatory Science. ACTA ACUST UNITED AC 2018; 18:252-274. [PMID: 30214916 DOI: 10.1037/bar0000113] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Behavioral pharmacology is a branch of the experimental analysis of behavior that has had great influence in drug addiction research and policy. This paper provides an overview of recent behavioral pharmacology research in the field of tobacco regulatory science, which provides the scientific foundation for the Food and Drug Administration Center for Tobacco Products (FDA CTP) to set tobacco control policies. The rationale and aims of tobacco regulatory science are provided, including the types of preclinical operant behavioral models it deems important for assessing the abuse liability of tobacco products and their constituents. We then review literature relevant to key regulatory actions being considered by the FDA CTP, including regulations over nicotine and menthol content of cigarettes, and conclude with suggesting some directions for future research. The current era of tobacco regulatory science provides great opportunities for behavioral pharmacologists to address the leading cause of preventable death and disease worldwide.
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Affiliation(s)
- Mark G LeSage
- Department of Medicine, Minneapolis Medical Research Foundation
- Departments of Medicine, University of Minnesota
- Department of Psychology, University of Minnesota
| | - John R Smethells
- Department of Medicine, Minneapolis Medical Research Foundation
- Departments of Medicine, University of Minnesota
| | - Andrew C Harris
- Department of Medicine, Minneapolis Medical Research Foundation
- Departments of Medicine, University of Minnesota
- Department of Psychology, University of Minnesota
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Iskandar AR, Martin F, Leroy P, Schlage WK, Mathis C, Titz B, Kondylis A, Schneider T, Vuillaume G, Sewer A, Guedj E, Trivedi K, Elamin A, Frentzel S, Ivanov NV, Peitsch MC, Hoeng J. Comparative biological impacts of an aerosol from carbon-heated tobacco and smoke from cigarettes on human respiratory epithelial cultures: A systems toxicology assessment. Food Chem Toxicol 2018; 115:109-126. [PMID: 29501877 DOI: 10.1016/j.fct.2018.02.063] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 02/27/2018] [Indexed: 02/02/2023]
Abstract
The biological impact of an aerosol of a potential modified-risk tobacco product, carbon heated tobacco product 1.2 (CHTP1.2), was comprehensively assessed for the first time in vitro using human small airway and nasal epithelial models following a systems toxicology approach. The potentially reduced effects of CHTP1.2 aerosol exposure were benchmarked against those of 3R4F cigarette smoke at similar nicotine concentrations. Experimental repetitions were conducted for which new batches of small airway and nasal cultures were exposed to CHTP1.2 aerosol or 3R4F smoke for 28 minutes. The biological impacts were determined based on a collection of endpoints including morphology, cytotoxicity, proinflammatory mediator profiles, cytochrome P450 1A1/1B1 activity, global mRNA and microRNA changes and proteome profiles. Alterations in mRNA expression were detected in cultures exposed to CHTP1.2 aerosol, without noticeable morphological changes and cytotoxicity, and minimal impact on proinflammatory mediator and proteome profiles. The changes linked to CHTP1.2 aerosol exposure, when observed, were transient. However, the impact of 3R4F smoke exposure persisted long post-exposure and greater than CHTP1.2 aerosol. Morphological changes were observed only in cultures exposed to 3R4F smoke. The lower biological effects of CHTP1.2 aerosol than 3R4F smoke exposure were observed similarly in both small airway and nasal epithelial cultures.
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Affiliation(s)
- Anita R Iskandar
- PMI R&D, Philip Morris Products S.A., Part of Philip Morris International group of companies, Quai Jeanrenaud 5, CH-2000 Neuchâtel, Switzerland.
| | - Florian Martin
- PMI R&D, Philip Morris Products S.A., Part of Philip Morris International group of companies, Quai Jeanrenaud 5, CH-2000 Neuchâtel, Switzerland
| | - Patrice Leroy
- PMI R&D, Philip Morris Products S.A., Part of Philip Morris International group of companies, Quai Jeanrenaud 5, CH-2000 Neuchâtel, Switzerland
| | - Walter K Schlage
- PMI R&D, Philip Morris Products S.A., Part of Philip Morris International group of companies, Quai Jeanrenaud 5, CH-2000 Neuchâtel, Switzerland
| | - Carole Mathis
- PMI R&D, Philip Morris Products S.A., Part of Philip Morris International group of companies, Quai Jeanrenaud 5, CH-2000 Neuchâtel, Switzerland
| | - Bjorn Titz
- PMI R&D, Philip Morris Products S.A., Part of Philip Morris International group of companies, Quai Jeanrenaud 5, CH-2000 Neuchâtel, Switzerland
| | - Athanasios Kondylis
- PMI R&D, Philip Morris Products S.A., Part of Philip Morris International group of companies, Quai Jeanrenaud 5, CH-2000 Neuchâtel, Switzerland
| | - Thomas Schneider
- PMI R&D, Philip Morris Products S.A., Part of Philip Morris International group of companies, Quai Jeanrenaud 5, CH-2000 Neuchâtel, Switzerland
| | - Grégory Vuillaume
- PMI R&D, Philip Morris Products S.A., Part of Philip Morris International group of companies, Quai Jeanrenaud 5, CH-2000 Neuchâtel, Switzerland
| | - Alain Sewer
- PMI R&D, Philip Morris Products S.A., Part of Philip Morris International group of companies, Quai Jeanrenaud 5, CH-2000 Neuchâtel, Switzerland
| | - Emmanuel Guedj
- PMI R&D, Philip Morris Products S.A., Part of Philip Morris International group of companies, Quai Jeanrenaud 5, CH-2000 Neuchâtel, Switzerland
| | - Keyur Trivedi
- PMI R&D, Philip Morris Products S.A., Part of Philip Morris International group of companies, Quai Jeanrenaud 5, CH-2000 Neuchâtel, Switzerland
| | - Ashraf Elamin
- PMI R&D, Philip Morris Products S.A., Part of Philip Morris International group of companies, Quai Jeanrenaud 5, CH-2000 Neuchâtel, Switzerland
| | - Stefan Frentzel
- PMI R&D, Philip Morris Products S.A., Part of Philip Morris International group of companies, Quai Jeanrenaud 5, CH-2000 Neuchâtel, Switzerland
| | - Nikolai V Ivanov
- PMI R&D, Philip Morris Products S.A., Part of Philip Morris International group of companies, Quai Jeanrenaud 5, CH-2000 Neuchâtel, Switzerland
| | - Manuel C Peitsch
- PMI R&D, Philip Morris Products S.A., Part of Philip Morris International group of companies, Quai Jeanrenaud 5, CH-2000 Neuchâtel, Switzerland
| | - Julia Hoeng
- PMI R&D, Philip Morris Products S.A., Part of Philip Morris International group of companies, Quai Jeanrenaud 5, CH-2000 Neuchâtel, Switzerland
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Smethells JR, Harris AC, Burroughs D, Hursh SR, LeSage MG. Substitutability of nicotine alone and an electronic cigarette liquid using a concurrent choice assay in rats: A behavioral economic analysis. Drug Alcohol Depend 2018; 185:58-66. [PMID: 29427916 PMCID: PMC5889753 DOI: 10.1016/j.drugalcdep.2017.12.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 12/06/2017] [Accepted: 12/11/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND For the Food and Drug Administration to effectively regulate tobacco products, the contribution of non-nicotine tobacco constituents to the abuse liability of tobacco must be well understood. Our previous work compared the abuse liability of electronic cigarette refill liquids (EC liquids) and nicotine (Nic) alone when each was available in isolation and found no difference in abuse liability (i.e., demand elasticity). Another, and potentially more sensitive measure, would be to examine abuse liability in a choice context, which also provides a better model of the tobacco marketplace. METHODS Demand elasticity for Nic alone and an EC liquid were measured when only one formulation was available (alone-price demand) and when both formulations were concurrently available (own-price demand), allowing an assessment of the degree to which each formulation served as a substitute (cross-price demand) when available at a low fixed-price. RESULTS Own-price demand for both formulations were more elastic compared to alone-price demand, indicating that availability of a substitute increased demand elasticity. During concurrent access, consumption of the fixed-price formulation increased as the unit-price of the other formulation increased. The rate of increase was similar between formulations, indicating that they served as symmetrical substitutes. CONCLUSION The cross-price model reliably quantified the substitutability of both nicotine formulations and indicated that the direct CNS effects of non-nicotine constituents in EC liquid did not alter its abuse liability compared to Nic. These data highlight the sensitivity of this model and its potential utility for examining the relative abuse liability and substitutability of tobacco products.
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Affiliation(s)
- John R Smethells
- Minneapolis Medical Research Foundation, 914 S. 8th Street, Minneapolis, MN, United States.
| | - Andrew C Harris
- Minneapolis Medical Research Foundation, 914 S. 8th Street, Minneapolis, MN, United States; Department of Medicine, University of Minnesota Medical School, 420 Delaware Street, SE, Minneapolis, MN, United States; Department of Psychology, University of Minnesota, 75 E. River Road, Minneapolis, MN, United States
| | - Danielle Burroughs
- Minneapolis Medical Research Foundation, 914 S. 8th Street, Minneapolis, MN, United States
| | - Steven R Hursh
- Institutes for Behavior Resources, Inc., 2104 Maryland Avenue, Baltimore, MD, United States; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD, United States
| | - Mark G LeSage
- Minneapolis Medical Research Foundation, 914 S. 8th Street, Minneapolis, MN, United States; Department of Medicine, University of Minnesota Medical School, 420 Delaware Street, SE, Minneapolis, MN, United States; Department of Psychology, University of Minnesota, 75 E. River Road, Minneapolis, MN, United States
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25
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Proctor C. Assessment of tobacco heating product THP1.0. Part 1: Series introduction. Regul Toxicol Pharmacol 2018; 93:1-3. [PMID: 28989081 DOI: 10.1016/j.yrtph.2017.09.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 08/14/2017] [Accepted: 09/10/2017] [Indexed: 01/01/2023]
Abstract
We have recently developed a Tobacco Heating Product (THP) comprising an electrical heating device, commercially known as Glo™, and consumable tobacco rods, commercially known as Kent Neostiks™. We refer to this system as THP1.0; Bright tobacco-flavoured variant THP1.0(T), or THP1.0(M) Menthol-flavoured variant. In this issue, we present a series of seven pre-clinical studies conducted on THP1.0,covering the following aspects of its design, development, safety and toxicological assessment, and a paper on placing THPs on an emissions continuum.
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26
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Assessment of tobacco heating product THP1.0. Part 9: The placement of a range of next-generation products on an emissions continuum relative to cigarettes via pre-clinical assessment studies. Regul Toxicol Pharmacol 2018; 93:92-104. [DOI: 10.1016/j.yrtph.2017.10.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 09/29/2017] [Accepted: 10/02/2017] [Indexed: 11/18/2022]
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27
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Peitsch MC, Polosa R, Proctor C, Hassler T, Gaca M, Hill E, Hoeng J, Hayes AW. Next-generation tobacco and nicotine products. TOXICOLOGY RESEARCH AND APPLICATION 2018. [DOI: 10.1177/2397847318773701] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A framework for the assessment of novel next-generation tobacco and nicotine products with the potential to reduce health risks compared with cigarettes should integrate scientific studies incorporating nonclinical, clinical, and population studies approaches. These products should have lower emissions and exhibit reduced biological effects compared with those of cigarettes, ideally approaching those of smoking cessation. The products should also be acceptable cigarette alternatives for current smokers, while not appealing to nonsmokers or former smokers. Validating harm reduction and promoting regulatory acceptance of the assessment methods require a collaborative approach by industry, independent reviewers, the public health community, and regulatory agencies. This article summarizes the science and approaches applied and considered to substantiate tobacco harm reduction in the light of regulatory requirements, presented at the 53rd Congress of the European Societies of Toxicology, 2017.
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Affiliation(s)
- Manuel C Peitsch
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Riccardo Polosa
- Dipartimento di Medicina Clinica e Sperimentale, University of Catania, Catania, Italy
| | - Christopher Proctor
- British American Tobacco (Investments) Ltd., Group Research and Development, Southampton, UK
| | - Thord Hassler
- Swedish Match, European Division, Gothenburg, Sweden
| | - Marianna Gaca
- British American Tobacco (Investments) Ltd., Group Research and Development, Southampton, UK
| | - Erin Hill
- Institute for In Vitro Sciences, Inc., Gaithersburg, MD, USA
| | - Julia Hoeng
- Philip Morris International R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - A Wallace Hayes
- Institute of Integrated Toxicology, Michigan State University, East Lansing, MI, USA
- College of Public Health, University of South Florida, Tampa, FL, USA
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Murphy J, Gaca M, Lowe F, Minet E, Breheny D, Prasad K, Camacho O, Fearon IM, Liu C, Wright C, McAdam K, Proctor C. Assessing modified risk tobacco and nicotine products: Description of the scientific framework and assessment of a closed modular electronic cigarette. Regul Toxicol Pharmacol 2017; 90:342-357. [PMID: 28954704 DOI: 10.1016/j.yrtph.2017.09.008] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 07/05/2017] [Accepted: 09/05/2017] [Indexed: 12/12/2022]
Abstract
Cigarette smoking causes many human diseases including cardiovascular disease, lung disease and cancer. Novel tobacco products with reduced yields of toxicants compared to cigarettes, such as tobacco-heating products, snus and electronic cigarettes, hold great potential for reducing the harms associated with tobacco use. In the UK several public health agencies have advocated a potential role for novel products in tobacco harm reduction. Public Health England has stated that "The current best estimate is that e-cigarettes are around 95% less harmful than smoking" and the Royal College of Physicians has urged public health to "Promote e-cigarettes widely as substitute for smoking". Health related claims on novel products such as 'reduced exposure' and 'reduced risk' should be substantiated using a weight of evidence approach based on a comprehensive scientific assessment. The US FDA, has provided draft guidance outlining a framework to assess novel products as Modified Risk Tobacco Products (MRTP). Based on this, we now propose a framework comprising pre-clinical, clinical, and population studies to assess the risk profile of novel tobacco products. Additionally, the utility of this framework is assessed through the pre-clinical and part of the clinical comparison of a commercial e-cigarette (Vype ePen) with a scientific reference cigarette (3R4F) and the results of these studies suggest that ePen has the potential to be a reduced risk product.
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Affiliation(s)
- James Murphy
- British American Tobacco, R&D Centre, Southampton, SO15 8TL, United Kingdom.
| | - Marianna Gaca
- British American Tobacco, R&D Centre, Southampton, SO15 8TL, United Kingdom
| | - Frazer Lowe
- British American Tobacco, R&D Centre, Southampton, SO15 8TL, United Kingdom
| | - Emmanuel Minet
- British American Tobacco, R&D Centre, Southampton, SO15 8TL, United Kingdom
| | - Damien Breheny
- British American Tobacco, R&D Centre, Southampton, SO15 8TL, United Kingdom
| | - Krishna Prasad
- British American Tobacco, R&D Centre, Southampton, SO15 8TL, United Kingdom
| | - Oscar Camacho
- British American Tobacco, R&D Centre, Southampton, SO15 8TL, United Kingdom
| | - Ian M Fearon
- British American Tobacco, R&D Centre, Southampton, SO15 8TL, United Kingdom
| | - Chuan Liu
- British American Tobacco, R&D Centre, Southampton, SO15 8TL, United Kingdom
| | - Christopher Wright
- British American Tobacco, R&D Centre, Southampton, SO15 8TL, United Kingdom
| | - Kevin McAdam
- British American Tobacco, R&D Centre, Southampton, SO15 8TL, United Kingdom
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29
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Shields PG, Berman M, Brasky TM, Freudenheim JL, Mathe E, McElroy JP, Song MA, Wewers MD. A Review of Pulmonary Toxicity of Electronic Cigarettes in the Context of Smoking: A Focus on Inflammation. Cancer Epidemiol Biomarkers Prev 2017; 26:1175-1191. [PMID: 28642230 PMCID: PMC5614602 DOI: 10.1158/1055-9965.epi-17-0358] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 05/22/2017] [Accepted: 05/24/2017] [Indexed: 12/30/2022] Open
Abstract
The use of electronic cigarettes (e-cigs) is increasing rapidly, but their effects on lung toxicity are largely unknown. Smoking is a well-established cause of lung cancer and respiratory disease, in part through inflammation. It is plausible that e-cig use might affect similar inflammatory pathways. E-cigs are used by some smokers as an aid for quitting or smoking reduction, and by never smokers (e.g., adolescents and young adults). The relative effects for impacting disease risk may differ for these groups. Cell culture and experimental animal data indicate that e-cigs have the potential for inducing inflammation, albeit much less than smoking. Human studies show that e-cig use in smokers is associated with substantial reductions in blood or urinary biomarkers of tobacco toxicants when completely switching and somewhat for dual use. However, the extent to which these biomarkers are surrogates for potential lung toxicity remains unclear. The FDA now has regulatory authority over e-cigs and can regulate product and e-liquid design features, such as nicotine content and delivery, voltage, e-liquid formulations, and flavors. All of these factors may impact pulmonary toxicity. This review summarizes current data on pulmonary inflammation related to both smoking and e-cig use, with a focus on human lung biomarkers. Cancer Epidemiol Biomarkers Prev; 26(8); 1175-91. ©2017 AACR.
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Affiliation(s)
- Peter G Shields
- Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, and College of Medicine, Columbus, Ohio.
| | - Micah Berman
- Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, and College of Public Health, Ohio
| | - Theodore M Brasky
- Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, and College of Medicine, Columbus, Ohio
| | - Jo L Freudenheim
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York
| | - Ewy Mathe
- Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio
| | - Joseph P McElroy
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio
| | - Min-Ae Song
- Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, and College of Medicine, Columbus, Ohio
| | - Mark D Wewers
- Department of Internal Medicine, The Ohio State University, Columbus, Ohio
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Breheny D, Adamson J, Azzopardi D, Baxter A, Bishop E, Carr T, Crooks I, Hewitt K, Jaunky T, Larard S, Lowe F, Oke O, Taylor M, Santopietro S, Thorne D, Zainuddin B, Gaça M, Liu C, Murphy J, Proctor C. A novel hybrid tobacco product that delivers a tobacco flavour note with vapour aerosol (Part 2): In vitro biological assessment and comparison with different tobacco-heating products. Food Chem Toxicol 2017; 106:533-546. [PMID: 28595930 DOI: 10.1016/j.fct.2017.05.023] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 04/05/2017] [Accepted: 05/11/2017] [Indexed: 01/10/2023]
Abstract
This study assessed the toxicological and biological responses of aerosols from a novel hybrid tobacco product. Toxicological responses from the hybrid tobacco product were compared to those from a commercially available Tobacco Heating Product (c-THP), a prototype THP (p-THP) and a 3R4F reference cigarette, using in vitro test methods which were outlined as part of a framework to substantiate the risk reduction potential of novel tobacco and nicotine products. Exposure matrices used included total particulate matter (TPM), whole aerosol (WA), and aqueous aerosol extracts (AqE) obtained after machine-puffing the test products under the Health Canada Intense smoking regime. Levels of carbonyls and nicotine in these matrices were measured to understand the aerosol dosimetry of the products. The hybrid tobacco product tested negative across the in vitro assays including mutagenicity, genotoxicity, cytotoxicity, tumour promotion, oxidative stress and endothelial dysfunction. All the THPs tested demonstrated significantly reduced responses in these in vitro assays when compared to 3R4F. The findings suggest these products have the potential for reduced health risks. Further pre-clinical and clinical assessments are required to substantiate the risk reduction of these novel products at individual and population levels.
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Affiliation(s)
- Damien Breheny
- Research and Development, British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire SO15 8TL, UK.
| | - Jason Adamson
- Research and Development, British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire SO15 8TL, UK
| | - David Azzopardi
- Research and Development, British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire SO15 8TL, UK
| | - Andrew Baxter
- Research and Development, British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire SO15 8TL, UK
| | - Emma Bishop
- Research and Development, British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire SO15 8TL, UK
| | - Tony Carr
- Research and Development, British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire SO15 8TL, UK
| | - Ian Crooks
- Research and Development, British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire SO15 8TL, UK
| | - Katherine Hewitt
- Research and Development, British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire SO15 8TL, UK
| | - Tomasz Jaunky
- Research and Development, British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire SO15 8TL, UK
| | - Sophie Larard
- Research and Development, British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire SO15 8TL, UK
| | - Frazer Lowe
- Research and Development, British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire SO15 8TL, UK
| | - Oluwatobiloba Oke
- Research and Development, British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire SO15 8TL, UK
| | - Mark Taylor
- Research and Development, British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire SO15 8TL, UK
| | - Simone Santopietro
- Research and Development, British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire SO15 8TL, UK
| | - David Thorne
- Research and Development, British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire SO15 8TL, UK
| | - Benjamin Zainuddin
- Research and Development, British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire SO15 8TL, UK
| | - Marianna Gaça
- Research and Development, British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire SO15 8TL, UK
| | - Chuan Liu
- Research and Development, British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire SO15 8TL, UK
| | - James Murphy
- Research and Development, British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire SO15 8TL, UK
| | - Christopher Proctor
- Research and Development, British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire SO15 8TL, UK
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31
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Song MA, Benowitz NL, Berman M, Brasky TM, Cummings KM, Hatsukami DK, Marian C, O'Connor R, Rees VW, Woroszylo C, Shields PG. Cigarette Filter Ventilation and its Relationship to Increasing Rates of Lung Adenocarcinoma. J Natl Cancer Inst 2017; 109:3836090. [PMID: 28525914 DOI: 10.1093/jnci/djx075] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 03/23/2017] [Indexed: 01/09/2023] Open
Abstract
The 2014 Surgeon General's Report on smoking and health concluded that changing cigarette designs have caused an increase in lung adenocarcinomas, implicating cigarette filter ventilation that lowers smoking machine tar yields. The Food and Drug Administration (FDA) now has the authority to regulate cigarette design if doing so would improve public health. To support a potential regulatory action, two weight-of-evidence reviews were applied for causally relating filter ventilation to lung adenocarcinoma. Published scientific literature (3284 citations) and internal tobacco company documents contributed to causation analysis evidence blocks and the identification of research gaps. Filter ventilation was adopted in the mid-1960s and was initially equated with making a cigarette safer. Since then, lung adenocarcinoma rates paradoxically increased relative to other lung cancer subtypes. Filter ventilation 1) alters tobacco combustion, increasing smoke toxicants; 2) allows for elasticity of use so that smokers inhale more smoke to maintain their nicotine intake; and 3) causes a false perception of lower health risk from "lighter" smoke. Seemingly not supportive of a causal relationship is that human exposure biomarker studies indicate no reduction in exposure, but these do not measure exposure in the lung or utilize known biomarkers of harm. Altered puffing and inhalation may make smoke available to lung cells prone to adenocarcinomas. The analysis strongly suggests that filter ventilation has contributed to the rise in lung adenocarcinomas among smokers. Thus, the FDA should consider regulating its use, up to and including a ban. Herein, we propose a research agenda to support such an effort.
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Affiliation(s)
- Min-Ae Song
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Neal L Benowitz
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Micah Berman
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Theodore M Brasky
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - K Michael Cummings
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Dorothy K Hatsukami
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Catalin Marian
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Richard O'Connor
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Vaughan W Rees
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Casper Woroszylo
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Peter G Shields
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
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Iskandar AR, Mathis C, Schlage WK, Frentzel S, Leroy P, Xiang Y, Sewer A, Majeed S, Ortega-Torres L, Johne S, Guedj E, Trivedi K, Kratzer G, Merg C, Elamin A, Martin F, Ivanov NV, Peitsch MC, Hoeng J. A systems toxicology approach for comparative assessment: Biological impact of an aerosol from a candidate modified-risk tobacco product and cigarette smoke on human organotypic bronchial epithelial cultures. Toxicol In Vitro 2017; 39:29-51. [PMID: 27865774 DOI: 10.1016/j.tiv.2016.11.009] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 11/11/2016] [Indexed: 11/24/2022]
Abstract
This study reports a comparative assessment of the biological impact of a heated tobacco aerosol from the tobacco heating system (THS) 2.2 and smoke from a combustible 3R4F cigarette. Human organotypic bronchial epithelial cultures were exposed to an aerosol from THS2.2 (a candidate modified-risk tobacco product) or 3R4F smoke at similar nicotine concentrations. A systems toxicology approach was applied to enable a comprehensive exposure impact assessment. Culture histology, cytotoxicity, secreted pro-inflammatory mediators, ciliary beating, and genome-wide mRNA/miRNA profiles were assessed at various time points post-exposure. Series of experimental repetitions were conducted to increase the robustness of the assessment. At similar nicotine concentrations, THS2.2 aerosol elicited lower cytotoxicity compared with 3R4F smoke. No morphological change was observed following exposure to THS2.2 aerosol, even at nicotine concentration three times that of 3R4F smoke. Lower levels of secreted mediators and fewer miRNA alterations were observed following exposure to THS2.2 aerosol than following 3R4F smoke. Based on the computational analysis of the gene expression changes, 3R4F (0.13 mg nicotine/L) elicited the highest biological impact (100%) in the context of Cell Fate, Cell Proliferation, Cell Stress, and Inflammatory Network Models at 4 h post-exposure. Whereas, the corresponding impact of THS2.2 (0.14 mg nicotine/L) was 7.6%.
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Affiliation(s)
- Anita R Iskandar
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland.
| | - Carole Mathis
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland.
| | - Walter K Schlage
- Biology Consultant, Max-Baermann-Str. 21, 51429, Bergisch Gladbach, Germany.
| | - Stefan Frentzel
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland.
| | - Patrice Leroy
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland.
| | - Yang Xiang
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland.
| | - Alain Sewer
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland.
| | - Shoaib Majeed
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland.
| | - Laura Ortega-Torres
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland.
| | - Stephanie Johne
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland.
| | - Emmanuel Guedj
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland.
| | - Keyur Trivedi
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland.
| | - Gilles Kratzer
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland.
| | - Celine Merg
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland.
| | - Ashraf Elamin
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland.
| | - Florian Martin
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland.
| | - Nikolai V Ivanov
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland.
| | - Manuel C Peitsch
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland.
| | - Julia Hoeng
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland.
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Hsu PC, Lan RS, Brasky TM, Marian C, Cheema AK, Ressom HW, Loffredo CA, Pickworth WB, Shields PG. Metabolomic profiles of current cigarette smokers. Mol Carcinog 2017; 56:594-606. [PMID: 27341184 PMCID: PMC5646689 DOI: 10.1002/mc.22519] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 05/09/2016] [Accepted: 06/22/2016] [Indexed: 01/07/2023]
Abstract
Smoking-related biomarkers for lung cancer and other diseases are needed to enhance early detection strategies and to provide a science base for tobacco product regulation. An untargeted metabolomics approach by ultra-performance liquid chromatography-quadrupole-time of flight mass spectrometry (UHPLC-Q-TOF MS) totaling 957 assays was used in a novel experimental design where 105 current smokers smoked two cigarettes 1 h apart. Blood was collected immediately before and after each cigarette allowing for within-subject replication. Dynamic changes of the metabolomic profiles from smokers' four blood samples were observed and biomarkers affected by cigarette smoking were identified. Thirty-one metabolites were definitively shown to be affected by acute effect of cigarette smoking, uniquely including menthol-glucuronide, the reduction of glutamate, oleamide, and 13 glycerophospholipids. This first time identification of a menthol metabolite in smokers' blood serves as proof-of-principle for using metabolomics to identify new tobacco-exposure biomarkers, and also provides new opportunities in studying menthol-containing tobacco products in humans. Gender and race differences also were observed. Network analysis revealed 12 molecules involved in cancer, notably inhibition of cAMP. These novel tobacco-related biomarkers provide new insights to the effects of smoking which may be important in carcinogenesis but not previously linked with tobacco-related diseases. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Ping-Ching Hsu
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio 43210
| | - Renny S. Lan
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio 43210
| | - Theodore M. Brasky
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio 43210
| | - Catalin Marian
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio 43210
- Biochemistry Department, “Victor Babes” University of Medicine and Pharmacy 300041 Timisoara, Romania
| | - Amrita K. Cheema
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington DC 20057
| | - Habtom W. Ressom
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington DC 20057
| | | | | | - Peter G. Shields
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio 43210
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Evaluation of the Tobacco Heating System 2.2. Part 1: Description of the system and the scientific assessment program. Regul Toxicol Pharmacol 2016; 81 Suppl 2:S17-S26. [DOI: 10.1016/j.yrtph.2016.07.006] [Citation(s) in RCA: 169] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 07/08/2016] [Indexed: 11/19/2022]
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Abstract
OBJECTIVE Preclinical abuse liability assessment is an essential component of tobacco regulatory science. The goal of this project was to evaluate the relative abuse liability of smokeless tobacco products in rats using aqueous extracts of those products. These extracts provide exposure to an extensive range of nicotine and non-nicotine tobacco constituents as occurs in humans. METHODS Rats were trained to self-administer either nicotine alone or extracts of Camel Snus or Kodiak smokeless tobacco at an equivalent nicotine unit dose. In Experiment 1, the relative reinforcing efficacy of these formulations was assessed in adults and adolescents using a progressive ratio schedule under limited-access conditions. In Experiment 2, relative reinforcing efficacy was assessed in adolescents under unlimited-access conditions using behavioral economic demand curve analysis. RESULTS The reinforcing efficacy of nicotine formulations was higher in adolescents than adults, but no difference was observed between formulations in either age group. Similarly, there was no difference in elasticity of demand between formulations in adolescents. CONCLUSIONS The present findings suggest that the abuse liability of these smokeless tobacco products is similar to nicotine alone, and that nicotine dose is the primary determinant of the reinforcing efficacy of systemic exposure to these products.
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