Urinary biomarkers for secondhand smoke and heated tobacco products exposure

Research progress and prospect on the safety of heated tobacco products

In recent years, Heated tobacco products (HTP) have gradually entered the market and become more and more popular with consumers because of their low risk (compared with traditional cigarette). With the increasing popularity and proportion of HTP in the international market, people pay more and more attention to the safety evaluation of HTP, but there is still a lack of systematic review of HTP safety research. In this review, the harmful components of HTP, multi-organ functional programming effects (including respiratory system, cardiovascular system, etc.), and mechanism of the effect generation (including oxidative stress, inflammatory response, etc.) were systematically reviewed, the safety effects of HTP and traditional cigarettes were compared in detail, and the shortcomings and future research directions in the field of HTP safety were discussed. In summary, this review conforms to the general trend of contemporary "tobacco and health", helps people to understand and evaluate HTP more systematically, and provides a strong theoretical support and literature basis for the tobacco industry to carry out HTP risk assessment and exposure improvement.

Simultaneous Measurement and Distribution Analysis of Urinary Nicotine, Cotinine, Trans-3'-Hydroxycotinine, Nornicotine, Anabasine, and Total Nicotine Equivalents in a Large Korean Population

Measurement of multiple nicotine metabolites and total nicotine equivalents (TNE) might be a more reliable strategy for tobacco exposure verification than measuring single urinary cotinine alone. We simultaneously measured nicotine, cotinine, 3-OH cotinine, nornicotine, and anabasine using 19,874 urine samples collected from the Korean National Health and Nutrition Examination Survey. Of all samples, 18.6% were positive for cotinine, 17.4% for nicotine, 17.3% for nornicotine, 17.6% for 3-OH cotinine, and 13.2% for anabasine. Of the cotinine negative samples, less than 0.3% were positive for all nicotine metabolites, but not for anabasine (5.7%). The agreement of the classification of smoking status by cotinine combined with nicotine metabolites was 0.982-0.994 (Cohen's kappa). TNE3 (the molar sum of urinary nicotine, cotinine, and 3-OH cotinine) was most strongly correlated with cotinine compared to the other nicotine metabolites; however, anabasine was less strongly correlated with other biomarkers. Among anabasine-positive samples, 30% were negative for nicotine or its metabolites, and 25% were undetectable. Our study shows that the single measurement of urinary cotinine is simple and has a comparable classification of smoking status to differentiate between current smokers and non-smokers relative to the measurement of multiple nicotine metabolites. However, measurement of multiple nicotine metabolites and TNE3 could be useful for monitoring exposure to low-level or secondhand smoke exposure and for determining individual differences in nicotine metabolism. Geometric or cultural factors should be considered for the differentiation of tobacco use from patients with nicotine replacement therapy by anabasine.

Quality of life and sleep disorders in Tehran Employees Cohort (TEC); Association with secondhand smoking and wealth index

PURPOSE

Second-hand smoke is recognized as a major indoor pollutant. Evidences indicated that Second-hand smoke exposure can influence on not only physical health, but also mental well-being. As the correlation of secondhand smoke exposure with sleep quality and quality of life has not yet been clarified sufficiently, the purpose of this study was to evaluate the association between Second-hand smoke exposure, with sleep quality and quality of life after adjusting for active smoking and other relevant confounders.

METHODS

The participants of this study were 1790 staff in Tehran University of Medical Sciences with different jobs employed in various academic departments (clinical, research, services, educational and technical ones). They participated voluntarily in this research project and completed the informed consent form between 2018 and 2019. A translated questionnaire of Global Adult Tobacco Survey was used to gather information about smoke exposure. When to evaluate the quality of life, the WHOQOL-BREF tool was applied. All statistical analyses were executed using STATA V14 software.

RESULTS

High rate of smoking and also exposure to second-hand smoke significantly increased sleep disorder and reduced the quality of life. In other words, smokers or those who are exposed to second-hand smoke suffer from sleep disturbances and had a poorer physical, psychological, and environmental quality of life. Additionally, the results of multivariate regression analysis demonstrated that the secondhand-smoke group had 1.38 times higher rate of sleep disorder in comparison with non-smokers, that was statistically significant. The women had 2.68 times higher odds of having sleep disorder compared to men. (95 % CI: 2.20 to 3.27). On the other hand, mean score of psychological domain of quality of life in secondhand-smoke group was lower with the size of difference as 0.66 than that in non-smokers, and the difference was statistically significant (p = 0.001).

CONCLUSIONS

Both active smoking and exposure to second hand smoke have a negative impact on sleep quality and quality of life.