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Carroll DM, Bittencourt L, Tessier KM, Usman A, Stepanov I, Hatsukami DK. Menthol and filter ventilation in cigarettes: prevalence estimates and relationships with harm perception and smoking exposure. Tob Control 2024:tc-2023-058495. [PMID: 38658056 DOI: 10.1136/tc-2023-058495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 04/15/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION Menthol and filter ventilation (FV) contribute to cigarette appeal. This observational study examines the US prevalence of menthol versus non-menthol cigarette use by FV and how harm perceptions, cigarettes per day and biomarkers of exposure vary. METHODS Population Assessment of Tobacco and Health Study (2013-2014) was merged with FV levels of cigarettes and restricted to daily smoking adults who had a usual cigarette variety and did not regularly use other tobacco (N=1614). Weighted descriptive statistics identified the prevalence of menthol and non-menthol use by low (0.02%-10.04%), moderate (10.05%-23.40%), high (23.41%-28.12%) and very high FV (28.13%-61.10%). Weighted linear regression was used to examine differences in outcomes by menthol/FV adjusted for potential confounders. RESULTS The prevalence of a usual brand that was non-menthol, low FV was the lowest at 2.91%. Using non-menthol cigarettes with high and very high FV (≥23.4%) vs low FV (≤10.04%) was associated with a greater likeliness of misperceiving one's cigarette variety to be less harmful than other varieties (p values<0.05). Total nicotine equivalent, biomarker for nicotine exposure, was elevated (p values<0.05) among three non-menthol groups (low, moderate and very high FV) compared with two menthol groups (moderate, very high FV). CONCLUSION The well-documented harm misperception linked to higher FV is more apparent in those using non-menthol than menthol cigarettes. Increased exposures were observed among some non-menthol cigarette users compared with some menthol cigarette users. These results should by no means delay a menthol ban but rather motivate concerted public health efforts to accompany the menthol ban to maximise smoking cessation.
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Affiliation(s)
- Dana Mowls Carroll
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lorna Bittencourt
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Katelyn M Tessier
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ayaantuu Usman
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Irina Stepanov
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Dorothy K Hatsukami
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
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Young WJ, Kennedy M, Wackowski OA, Mitarotondo A, Assan MA, Scalia D, Stepanov I, Steinberg MB, Heckman CJ. Measurement of cigarette relighting: A common but understudied behavior. Drug Alcohol Depend 2024; 257:111257. [PMID: 38493565 DOI: 10.1016/j.drugalcdep.2024.111257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/12/2024] [Accepted: 02/28/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVE Relighting, i.e., extinguishing, saving, and later relighting and smoking unfinished cigarettes, appears prevalent, may be associated with nicotine dependence and negative health outcomes, yet is poorly understood. We estimate the prevalence, frequency, correlates of, and reasons for, cigarette relighting. METHODS Survey respondents (n=676) were 18-45-year-old US-based Amazon Mechanical Turk (MTurk) participants who smoked cigarettes every/some days. Items assessed frequency of and reasons for relighting. Reported smoking sessions per day were compared to calculations based on reported cigarettes per day (CPD) and relighting frequency. RESULTS Seventy-two percent of those who smoked reported relighting cigarettes. Reasons included not having time to finish (77%), not feeling like finishing (75%), saving money or avoiding wasting (70%), and making cigarettes last longer (59%). Nearly half (44%) relight to cut down and 34% to reduce harm. Hispanic (OR=1.73, CI:1.03-2.91) and non-Hispanic Black respondents (OR= 2.23, CI:1.20-4.10) had higher odds of relighting than others, as did those who smoke within 30minutes of waking (OR=2.45, CI:1.33-4.52) or wake up at night to smoke (OR=2.40, CI:1.68-3.44) (all ps <0.05). Respondents demonstrated low consistency in reporting the number of times they smoke (first-lit and relit) compared to calculations based on CPD and relighting frequency. CONCLUSIONS Relighting is associated with race, ethnicity, nicotine dependence, and is often done to save money, cut down smoking, and reduce harm. Among those who relight, "smoking session" frequency seemed to be underestimated. Single item smoking frequency measures may not be ideal for individuals who smoke and relight.
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Affiliation(s)
- William J Young
- Rutgers Institute for Nicotine & Tobacco Studies, Rutgers Biomedical and Health Sciences, 303 George Street Suite 500, New Brunswick, NJ 08901, USA.
| | - Michelle Kennedy
- Rutgers Institute for Nicotine & Tobacco Studies, Rutgers Biomedical and Health Sciences, 303 George Street Suite 500, New Brunswick, NJ 08901, USA.
| | - Olivia A Wackowski
- Rutgers Institute for Nicotine & Tobacco Studies, Rutgers Biomedical and Health Sciences, 303 George Street Suite 500, New Brunswick, NJ 08901, USA; Department of Health Behavior, Society and Policy, Rutgers School of Public Health, 683 Hoes Lane W, Piscataway, NJ 08854, USA.
| | - Anna Mitarotondo
- Cancer Prevention and Control Program, Cancer Institute of New Jersey, Rutgers University, 120 Albany Street, New Brunswick, NJ 08901, USA.
| | - Maame Araba Assan
- Cancer Prevention and Control Program, Cancer Institute of New Jersey, Rutgers University, 120 Albany Street, New Brunswick, NJ 08901, USA.
| | - Daniel Scalia
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ 08901, USA.
| | - Irina Stepanov
- Division of Environmental Health Sciences, University of Minnesota Twin Cities, 2231 6th St SE, Minneapolis, MN 55455USA.
| | - Michael B Steinberg
- Rutgers Institute for Nicotine & Tobacco Studies, Rutgers Biomedical and Health Sciences, 303 George Street Suite 500, New Brunswick, NJ 08901, USA; Department of Medicine, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ 08901, USA.
| | - Carolyn J Heckman
- Cancer Prevention and Control Program, Cancer Institute of New Jersey, Rutgers University, 120 Albany Street, New Brunswick, NJ 08901, USA.
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El-Hellani A, Adeniji A, Erythropel HC, Wang Q, Lamb T, Mikheev VB, Rahman I, Stepanov I, Strongin RM, Wagener TL, Brinkman MC. Comparison of emissions across tobacco products: A slippery slope in tobacco control. Tob Induc Dis 2024; 22:TID-22-57. [PMID: 38560551 PMCID: PMC10980913 DOI: 10.18332/tid/183797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 02/07/2024] [Accepted: 02/10/2024] [Indexed: 04/04/2024] Open
Abstract
In this narrative review, we highlight the challenges of comparing emissions from different tobacco products under controlled laboratory settings (using smoking/vaping machines). We focus on tobacco products that generate inhalable smoke or aerosol, such as cigarettes, cigars, hookah, electronic cigarettes, and heated tobacco products. We discuss challenges associated with sample generation including variability of smoking/vaping machines, lack of standardized adaptors that connect smoking/vaping machines to different tobacco products, puffing protocols that are not representative of actual use, and sample generation session length (minutes or number of puffs) that depends on product characteristics. We also discuss the challenges of physically characterizing and trapping emissions from products with different aerosol characteristics. Challenges to analytical method development are also covered, highlighting matrix effects, order of magnitude differences in analyte levels, and the necessity of tailored quality control/quality assurance measures. The review highlights two approaches in selecting emissions to monitor across products, one focusing on toxicants that were detected and quantified with optimized methods for combustible cigarettes, and the other looking for product-specific toxicants using non-targeted analysis. The challenges of data reporting and statistical analysis that allow meaningful comparison across products are also discussed. We end the review by highlighting that even if the technical challenges are overcome, emission comparison may obscure the absolute exposure from novel products if we only focus on relative exposure compared to combustible products.
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Affiliation(s)
- Ahmad El-Hellani
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, United States
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, United States
| | - Ayomipo Adeniji
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, United States
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, United States
| | - Hanno C. Erythropel
- Department of Chemical and Environmental Engineering, School of Engineering & Applied Science, Yale University, New Haven, United States
- Yale Center for the Study of Tobacco Product Use and Addiction (YCSTP), Department of Psychiatry, Yale School of Medicine, New Haven, United States
| | - Qixin Wang
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, United States
| | - Thomas Lamb
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, United States
| | - Vladimir B. Mikheev
- Battelle Public Health Center for Tobacco Research, Battelle Memorial Institute, Columbus, United States
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, United States
| | - Irina Stepanov
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota Twin Cities, Minneapolis, United States
- Masonic Cancer Center, University of Minnesota Twin Cities, Minneapolis, United States
| | - Robert M. Strongin
- Department of Chemistry, Portland State University, Portland, United States
| | - Theodore L. Wagener
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, United States
- Department of Internal Medicine, The Ohio State University, Columbus, United States
| | - Marielle C. Brinkman
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, United States
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, United States
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Gomez F, Ayo-Yusuf O, Yershova K, Jain V, Alcheva A, Hatsukami DK, Parascandola M, Stepanov I. Heterogeneity of Harmful Constituent Profiles in Smokeless Tobacco Products from Five African Countries. Chem Res Toxicol 2023; 36:1901-1911. [PMID: 38051542 DOI: 10.1021/acs.chemrestox.3c00181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Addictive, toxic, and carcinogenic constituents present in smokeless tobacco (SLT) products are responsible for the harmful effects associated with SLT use. There are limited data on levels of such constituents in SLT products used in Africa, a region with high prevalence of SLT use and the associated morbidity and mortality. Manufactured and custom-made SLT products were purchased from five African countries (South Africa, Uganda, Mauritania, Nigeria, and Zambia) using a standard approach for sample collection, labeling, and storage. Moisture content, pH, total and unprotonated (biologically available) nicotine, five tobacco-specific N-nitrosamines (TSNA), 10 polycyclic aromatic hydrocarbons (PAH), five metals and metalloids (As, Cd, Cr, Ni, and Pb), nitrate, and nitrite were analyzed. A total of 54 samples representing 15 varieties of manufactured SLT products and 13 varieties of custom-made SLT products were purchased and analyzed. In all samples, the total nicotine ranged from 1.6 to 20.5 mg/g product and unprotonated nicotine accounted for 5.3-99.6% of the total nicotine content. The sum of all five TSNA ranged from 1.6 to 100 μg/g product, with significant within-country variations observed across both the manufactured and custom-made varieties. Significant variations were also found for PAH, metals and metalloids, nitrates, and nitrites. This is the most comprehensive report on the chemical profiling of products from African countries. This is also the first study illustrating the variability of harmful constituents within the same types and brands of African SLT. Our findings emphasize the need for consumer education and interventions to reduce SLT use in Africa. The data reported here can be useful to regulators in considering measures to prevent the occurrence of high levels of known toxicants and carcinogens in manufactured products.
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Affiliation(s)
- Francisco Gomez
- Masonic Cancer Center, University of Minnesota, CCRB 2-140, 2231 Sixth Street SE, Minneapolis, Minnesota 55455, United States
| | - Olalekan Ayo-Yusuf
- Africa Centre for Tobacco Industry Monitoring and Policy Research (ATIM), School of Health Systems and Public Health, University of Pretoria, Hatfield 0028, South Africa
| | - Katrina Yershova
- Masonic Cancer Center, University of Minnesota, CCRB 2-140, 2231 Sixth Street SE, Minneapolis, Minnesota 55455, United States
| | - Vipin Jain
- Masonic Cancer Center, University of Minnesota, CCRB 2-140, 2231 Sixth Street SE, Minneapolis, Minnesota 55455, United States
| | - Aleksandra Alcheva
- Masonic Cancer Center, University of Minnesota, CCRB 2-140, 2231 Sixth Street SE, Minneapolis, Minnesota 55455, United States
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Dorothy K Hatsukami
- Masonic Cancer Center, University of Minnesota, CCRB 2-140, 2231 Sixth Street SE, Minneapolis, Minnesota 55455, United States
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota 55454, United States
- Institute for Global Cancer Prevention Research, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Mark Parascandola
- Center for Global Health, National Cancer Institute, Bethesda, Maryland 20892, United States
| | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, CCRB 2-140, 2231 Sixth Street SE, Minneapolis, Minnesota 55455, United States
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota 55455, United States
- Institute for Global Cancer Prevention Research, University of Minnesota, Minneapolis, Minnesota 55455, United States
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Ongena J, Castano-Bardawil D, Crombé K, Kazakov Y, Schweer B, Stepanov I, Van Schoor M, Vervier M, Krämer-Flecken A, Neubauer O, Nicolai D, Satheeswaran G, Offermanns G, Hollfeld K, Benndorf A, Dinklage A, Hartmann D, Kallmeyer J, Wolf R, TEC. Physics design, construction and commissioning of the ICRH system for the stellarator Wendelstein 7-X. Fusion Engineering and Design 2023. [DOI: 10.1016/j.fusengdes.2023.113627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
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Cummings KM, Roberson A, Carroll DM, Stepanov I, Hatsukami D, Rees VW, O’Connor RJ. Illusion of filtration: Evidence from tobacco industry documents. Tob Induc Dis 2023; 21:85. [PMID: 37360043 PMCID: PMC10288540 DOI: 10.18332/tid/166093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/05/2023] [Accepted: 05/11/2023] [Indexed: 06/28/2023] Open
Abstract
INTRODUCTION We compared the design features of popular filtered and non-filtered cigarettes sold in the United States between 1960 and 1990, to assess the relationship between cigarette filter and tobacco weight. METHODS We analyzed data on the design features of six popular filtered and three non-filtered cigarette brands sold in the US including the weight of tobacco used provided in the Cigarette Information Reports produced by Philip Morris Tobacco Company between 1960 and 1990. We also collected information on other design features such as stick length and circumference, the percentage of reconstituted tobacco in the blend, among other product parameters. We used joinpoint regression to test for trends in outcome variables for each brand assessed between 1960 and 1990. RESULTS In all years, filtered cigarettes had less tobacco by weight compared to non-filtered cigarettes. The lower average weight of tobacco found in filtered cigarettes appears to be due to a combination of factors including stick and filter length, and the amount of reconstituted tobacco in the blend. The average percentages of total alkaloids and expanded tobacco increased over time but were similar between filtered and non-filtered brands. CONCLUSIONS While various design features of popular filtered and non-filtered brands changed between 1960 and 1990, the observed reduction in tobacco weight among filtered brands was perhaps the most salient in terms of disease risk. Less tobacco in a filtered cigarette calls into question the presumed exclusive role of cigarette filter tips in the reduced health risks of filtered versus non-filtered cigarette smoking.
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Affiliation(s)
- K. Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, United States
| | - Avery Roberson
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, United States
| | - Dana M. Carroll
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, United States
| | - Irina Stepanov
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, United States
| | - Dorothy Hatsukami
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, United States
| | - Vaughan W. Rees
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, United States
| | - Richard J. O’Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, United States
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Cigan SS, Murphy SE, Stram DO, Hecht SS, Le Marchand L, Stepanov I, Park SL. Association of Urinary Biomarkers of Smoking-Related Toxicants with Lung Cancer Incidence in Smokers: The Multiethnic Cohort Study. Cancer Epidemiol Biomarkers Prev 2023; 32:306-314. [PMID: 36350738 PMCID: PMC9992134 DOI: 10.1158/1055-9965.epi-22-0569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/09/2022] [Accepted: 11/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While cigarette smoking is the leading cause of lung cancer, the majority of smokers do not develop the disease over their lifetime. The inter-individual differences in risk among smokers may in part be due to variations in exposure to smoking-related toxicants. METHODS Using data from a subcohort of 2,309 current smokers at the time of urine collection from the Multiethnic Cohort Study, we prospectively evaluated the association of ten urinary biomarkers of smoking-related toxicants [total nicotine equivalents (TNE), a ratio of total trans-3'-hydroxycotinine (3-HCOT)/cotinine (a phenotypic measure of CYP2A6 enzymatic activity), 4-(methylnitrosamino)-1-3-(pyridyl)-1-butanol (NNAL), S-phenylmercapturic acid (SPMA), 3-hydroxypropyl mercapturic acid (3-HPMA), phenanthrene tetraol (PheT), 3-hydroxyphenanthrene (PheOH), the ratio of PheT/PheOH, cadmium (Cd), and (Z)-7-(1R,2R,3R,5S)-3,5-dihydroxy-2-[(E,3S)-3-hydroxyoct-1-enyl]cyclopenyl]hept-5-enoic acid (8-iso-PGF2α)] with lung cancer risk (n = 140 incident lung cancer cases over an average of 13.4 years of follow-up). Lung cancer risk was estimated using Cox proportional hazards models. RESULTS After adjusting for decade of birth, sex, race/ethnicity, body mass index, self-reported pack-years, creatinine, and urinary TNE (a biomarker of internal smoking dose), a one SD increase in log total 3-HCOT/cotinine (HR, 1.33; 95% CI, 1.06-1.66), 3-HPMA (HR, 1.41; 95% CI, 1.07-1.85), and Cd (HR, 1.45; 95% CI, 1.18-1.79) were each associated with increased lung cancer risk. CONCLUSIONS Our study demonstrates that urinary total 3-HCOT/cotinine, 3-HPMA, and Cd are positively associated with lung cancer risk. These findings warrant replication and consideration as potential biomarkers for smoking-related lung cancer risk. IMPACT These biomarkers may provide additional information on lung cancer risk that is not captured by self-reported smoking history or TNE. See related commentary by Etemadi et al., p. 289.
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Affiliation(s)
- Shannon S. Cigan
- Department of Pediatrics, Division of Epidemiology and Clinical Research, University of Minnesota, Minneapolis, MN 55455, United States of America
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis MN 55455, United States of America
| | - Sharon E. Murphy
- Masonic Cancer Center, University of Minnesota, Minneapolis MN 55455, United States of America
| | - Daniel O. Stram
- Department of Preventive Medicine, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, United States of America
| | - Stephen S. Hecht
- Masonic Cancer Center, University of Minnesota, Minneapolis MN 55455, United States of America
| | - Loïc Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI 96813, United States of America
| | - Irina Stepanov
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis MN 55455, United States of America
- Masonic Cancer Center, University of Minnesota, Minneapolis MN 55455, United States of America
| | - Sungshim L. Park
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI 96813, United States of America
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Freitas-Lemos R, Tegge AN, Athamneh LN, Yeh YH, Craft WH, Stein JS, Smith TT, Stepanov I, Rees VW, Cummings KM, O'Connor RJ, Shields PG, Hatsukami DK, Bickel WK. Is perception reality? Associations among "light" cigarettes and number of cigarettes smoked per day. Drug Alcohol Depend 2023; 244:109709. [PMID: 36642000 PMCID: PMC10081565 DOI: 10.1016/j.drugalcdep.2022.109709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/10/2022] [Accepted: 11/10/2022] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Cigarette filter ventilation and light descriptors are associated with lowered perceptions of risk and smoking more cigarettes per day (CPD). This study examined the relationship between usual cigarette ventilation, perception, and CPD. METHODS A crowdsourced sample (N = 995) of individuals who smoke higher-ventilated (=>20% ventilation) or lower-ventilated (=<10% ventilation) cigarettes identified their usual cigarette as "light" or "full flavor", and reported their average CPD. RESULTS We found: 1) no association between ventilation status and perception of light versus full flavor (AUC=0.58), with the inaccurate perception being more prevalent in younger individuals (p = 0.041) and those who smoke L&M (73%, p < 0.001) and Camel (61%, p = 0.006) brands; and 2) perception, but not ventilation of usual cigarette, was significantly associated with CPD (p = 0.006), with individuals who perceived their cigarettes as light reporting an average of 13% more cigarettes per day (2.6 CPD), compared to those who perceived their cigarette as full flavor. CONCLUSIONS Perceptions of light versus full-flavor, but not ventilation status, predicted CPD. These findings may inform anti-smoking health communication strategies and smoking cessation interventions. IMPLICATIONS Tobacco control policies should eradicate the perception of cigarettes as light or full-flavored. Future research investigating the associations between cigarette filter ventilation and smoking behavior should consider the confounding effects that may lie in an individual's perceptions of their cigarettes.
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Affiliation(s)
| | - Allison N Tegge
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA; Department of Statistics, Virginia Tech, Blacksburg, VA, USA
| | - Liqa N Athamneh
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | - Yu-Hua Yeh
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | - William H Craft
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | - Jeffrey S Stein
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | - Tracy T Smith
- Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Irina Stepanov
- Division of Environmental Health Sciences, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Vaughan W Rees
- Department of Social and Behavioral Sciences, Harvard University T H Chan School of Public Health, Boston, MA, USA
| | - K Michael Cummings
- Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Peter G Shields
- James Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Dorothy K Hatsukami
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Warren K Bickel
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA.
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Imyanitov E, Bakayeva E, Romanko A, Stepanov I, Sultanova L, Khamgokov Z, Bolieva M, Epkhiev A, Chakhkieva M, Khabriev I, Murachuev M, Sokolenko A. 2P Spectrum of BRCA1, BRCA1, ATM and PALB2 alleles in ovarian cancer patients from North Caucasus. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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10
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Harris AC, Muelken P, Alcheva A, Stepanov I, LeSage MG. Cigarette Smoke Extract, but Not Electronic Cigarette Aerosol Extract, Inhibits Monoamine Oxidase in vitro and Produces Greater Acute Aversive/Anhedonic Effects Than Nicotine Alone on Intracranial Self-Stimulation in Rats. Front Neurosci 2022; 16:868088. [PMID: 35712461 PMCID: PMC9196039 DOI: 10.3389/fnins.2022.868088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 04/25/2022] [Indexed: 12/14/2022] Open
Abstract
Conventional tobacco cigarettes appear to have greater abuse liability than non-combusted products such as electronic cigarettes (ECs) and nicotine replacement therapy (NRT). This may be due to the higher levels of behaviorally active non-nicotine constituents [e.g., monoamine oxidase (MAO) inhibitors such as β-carbolines] in cigarette smoke (CS) compared to non-combusted products. To evaluate this hypothesis, the current studies compared the relative abuse liability of CS and EC aerosol extracts containing nicotine and a range of non-nicotine constituents to that of nicotine alone (NRT analog) using intracranial self-stimulation (ICSS) in rats. Effects of formulations on brain MAO activity in vitro and ex vivo were also studied to evaluate the potential role of MAO inhibition in the ICSS study. CS extract contained higher levels of several behaviorally active non-nicotine constituents (e.g., the β-carbolines norharmane and harmane) than EC extract. Nicotine alone reduced ICSS thresholds at a moderate nicotine dose, suggesting a reinforcement-enhancing effect that may promote abuse liability, and elevated ICSS thresholds at a high nicotine dose, suggesting an aversive/anhedonic effect that may limit abuse liability. CS extract elevated ICSS thresholds to a greater degree than nicotine alone at high nicotine doses. Effects of EC extract on ICSS did not differ from those of nicotine alone. Finally, CS extract significantly inhibited MAO-A and MAO-B activity in vitro, whereas EC extract and nicotine alone did not. None of the formulations inhibited MAO measured ex vivo. These findings indicate greater acute aversive/anhedonic effects for CS extract compared to nicotine alone, suggesting lower abuse liability. Although confirmation of our findings using other dosing regimens, preclinical addiction models, and tobacco product extracts is needed, these findings suggest that the centrally-mediated effects of MAO inhibitors and other non-nicotine constituents may not account for the greater abuse liability of cigarettes compared to non-combusted products. Nonetheless, identifying the specific constituent(s) mediating the effects of CS extracts in this study could help clarify mechanisms mediating tobacco addiction and inform FDA product standards.
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Affiliation(s)
- Andrew C. Harris
- Hennepin Healthcare Research Institute, Minneapolis, MN, United States,Department of Medicine, University of Minnesota, Minneapolis, MN, United States,Department of Psychology, University of Minnesota, Minneapolis, MN, United States,*Correspondence: Andrew C. Harris,
| | - Peter Muelken
- Hennepin Healthcare Research Institute, Minneapolis, MN, United States
| | - Aleksandra Alcheva
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States
| | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States
| | - Mark G. LeSage
- Hennepin Healthcare Research Institute, Minneapolis, MN, United States,Department of Medicine, University of Minnesota, Minneapolis, MN, United States,Department of Psychology, University of Minnesota, Minneapolis, MN, United States
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11
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Nikam SS, Gurjar M, Singhavi H, Patil A, Singh A, Villalta P, Chaturvedi P, Khariwala SS, Gota V, Stepanov I. Simultaneous analysis of urinary total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol, N'-nitrosonornicotine, and cotinine by liquid chromatography-tandem mass-spectrometry. Sci Rep 2021; 11:20007. [PMID: 34625573 PMCID: PMC8501032 DOI: 10.1038/s41598-021-99259-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 09/14/2021] [Indexed: 11/11/2022] Open
Abstract
Biomarkers of exposure to harmful tobacco constituents are key tools for identifying individuals at risk and developing interventions and tobacco control measures. However, tobacco biomarker studies are scarce in many parts of the world with high prevalence of tobacco use. Our goal was to establish a robust method for simultaneous analysis of urinary total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), N'-nitrosonornicotine (NNN), and cotinine at the Advanced Centre for Treatment, Research and Education in Cancer (ACTREC) in Mumbai, India. These biomarkers are validated measures of exposure to the carcinogenic tobacco nitrosamines 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and NNN and the addictive alkaloid nicotine, respectively. The established method is characterized by excellent accuracy, linearity, and precision, and was successfully applied to the analysis of 15 smokeless tobacco (SLT) users and 15 non-users of tobacco recruited in Mumbai. This is the first report of establishment of such procedure in a laboratory in India, which offers the first in-country capacity for research on tobacco carcinogenesis in Indian SLT users.
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Affiliation(s)
- Sampada S Nikam
- Department of Clinical Pharmacology, Advanced Centre for Training, Research and Education in Cancer (ACTREC), Mumbai, India
- Homi Bhabha National Institute, Mumbai, India
| | - Murari Gurjar
- Department of Clinical Pharmacology, Advanced Centre for Training, Research and Education in Cancer (ACTREC), Mumbai, India
| | | | - Anand Patil
- Department of Clinical Pharmacology, Advanced Centre for Training, Research and Education in Cancer (ACTREC), Mumbai, India
| | | | - Peter Villalta
- Masonic Cancer Center, University of Minnesota, 2231 6th Street SE, Minneapolis, MN, 55455, USA
| | - Pankaj Chaturvedi
- Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute, Mumbai, India
| | - Samir S Khariwala
- Department of Otolaryngology, Head and Neck Surgery, Medical School, University of Minnesota, Minneapolis, USA
| | - Vikram Gota
- Department of Clinical Pharmacology, Advanced Centre for Training, Research and Education in Cancer (ACTREC), Mumbai, India.
- Homi Bhabha National Institute, Mumbai, India.
| | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, 2231 6th Street SE, Minneapolis, MN, 55455, USA.
- Department of Otolaryngology, Head and Neck Surgery, Medical School, University of Minnesota, Minneapolis, USA.
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, USA.
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12
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Cigan S, Murphy S, Patel Y, Stram D, Le Marchand L, Hecht S, Stepanov I, Park S. FP12.03 Associations of Urinary Biomarkers of Tobacco Toxicants With Lung Cancer Incidence in Smokers: The Multiethnic Cohort Study. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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13
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Tackett AP, Wallace SW, Smith CE, Turner E, Fedele DA, Stepanov I, Lechner WV, Hale JJ, Wagener TL. Harm Perceptions of Tobacco/Nicotine Products and Child Exposure: Differences between Non-Users, Cigarette-Exclusive, and Electronic Cigarette-Exclusive Users. Tob Use Insights 2021; 14:1179173X21998362. [PMID: 33854392 PMCID: PMC8013926 DOI: 10.1177/1179173x21998362] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 02/04/2021] [Indexed: 12/17/2022] Open
Abstract
Objective This study examined caregiver perception of harm and child secondhand exposure to nicotine in a sample of e-cigarette-exclusive, cigarette-exclusive, and non-tobacco/nicotine users (non-users). Methods Cigarette-exclusive (n = 19), e-cigarette-exclusive (n = 12), and non-users (n = 20) and their children (N = 51, Mage = 10.47) completed self-report questionnaires about perceptions of harm, child secondhand exposure, and provided urine to assess child nicotine exposure (cotinine). ANOVAs examined differences between caregiver use status on tobacco harm perceptions and child cotinine levels. Independent samples t-test compared differences in caregiver-reported child secondhand exposure in the home and car. Results All 3 caregiver groups rated cigarettes as highly harmful (P = .14), but e-cigarette users rated all 3 types of e-cigarette products (Cartridge-based: P < .001; Tank: P < .001; Box Mod: P < .001) as less harmful than cigarette users and non-users. Caregivers from the e-cigarette user group reported greater child secondhand exposure than caregivers using cigarettes (past 7-day in-home exposure (P = .03); past 7-day exposure in-home + in-car exposure (P = .02); in-home exposure by caregivers and other people exposure (P = .02)). Children from the cigarette user group had significantly higher levels of cotinine (M = 16.6, SD = 21.7) compared to children from the Non-User group (M = .43, SD = .95; P = .001), but no significant difference when compared to children from the E-Cigarette User group (M = 6.5, SD = 13.5). Discussion In this sample, caregivers who used e-cigarettes perceived them as less harmful, reported using them more frequently at home and in the car, even when their children were present, compared to cigarette users. As a result, children appear to be exposed to nicotine at levels similar to children living with cigarette users. Future caregiver prevention and intervention efforts should target education around the potential harms of secondhand e-cigarette aerosol to children.
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Affiliation(s)
- Alayna P Tackett
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Los Angeles, USA
| | | | | | - Elise Turner
- Department of Clinical & Health Psychology, University of Florida, Gainesville, USA
| | - David A Fedele
- Department of Clinical & Health Psychology, University of Florida, Gainesville, USA
| | - Irina Stepanov
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, USA
| | | | - Jessica J Hale
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, USA.,Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, USA
| | - Theodore L Wagener
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, USA.,Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, USA
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14
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Loken B, Borgida E, Wang T, Madzelan MK, Williams AL, Hatsukami D, Stepanov I. Can the Public Be Educated About Constituents in Smokeless Tobacco? A Three-Wave Randomized Controlled Trial. Nicotine Tob Res 2021; 23:161-170. [PMID: 32010948 PMCID: PMC7789948 DOI: 10.1093/ntr/ntz241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 12/19/2019] [Indexed: 11/12/2022]
Abstract
INTRODUCTION The U.S. Food and Drug Administration (FDA) is required by law to inform the public about levels of harmful and potentially harmful tobacco constituents in a format that is "understandable and not misleading to a lay person." Our study addresses a critical gap in research on communicating such information for smokeless tobacco (SLT) products. METHODS The design included random assignment to one of the experimental (online interactive) conditions differing in presentation format or a control condition (receiving no information). Experimental respondents viewed information on levels and health risks of 5 harmful constituents in up to 79 products. Outcome measures included knowledge of health risks of constituents, perception of constituent variability in SLT products, disease risk ratings, self-reported SLT use, and side-by-side product comparisons. The sample of 333 SLT users, 535 cigarette smokers, and 663 nontobacco users participated at baseline, time of intervention, and 6 weeks postintervention. RESULTS Presentation formats showed few systematic differences so were combined in analyses. Experimental condition respondents increased their knowledge about constituent health effects and their perceptions of constituent variability in SLT products, from baseline to postintervention, and relative to the control condition. Changes in respondents' ratings of disease risk and their estimates of constituent exposure from specific products were observed, but not in self-reported SLT use. CONCLUSIONS Interactive online graphic and numeric presentation formats can be efficient in increasing people's knowledge of health effects and perceived variation of constituents in SLT products. Further research on longer-term behavioral assessment, and usefulness of this approach for regulatory agencies, is needed. IMPLICATIONS Research on communicating the information about harmful constituents in SLT products to lay persons is critically lacking. This study proposes novel formats for effective communication about the levels and the health effects of SLT constituents to multiple user groups. The lack of misperceptions among study participants that some tobacco products are safe suggests that such formats can potentially be used for public display of SLT constituent data by the FDA and regulatory agencies in other countries.
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Affiliation(s)
- Barbara Loken
- Department of Marketing, Carlson School of Management, University of Minnesota, Minneapolis, MN
| | - Eugene Borgida
- Department of Psychology, University of Minnesota, Minneapolis, MN
| | - Tzushuo Wang
- Department of Marketing, Carlson School of Management, University of Minnesota, Minneapolis, MN
| | - Molly K Madzelan
- Department of Psychology, University of Minnesota, Minneapolis, MN
| | - Allison L Williams
- Department of Psychology, University of Minnesota, Minneapolis, MN
- Department of Psychology, Happify, New York, NY
| | - Dorothy Hatsukami
- Department of Psychiatry, School of Medicine, University of Minnesota, Minneapolis, MN
| | - Irina Stepanov
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN
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15
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Carroll DM, Cigan S, Ikuemonisan J, Hammonds T, Stepanov I, St. Helen G, Benowitz N, Hatsukami DK. Relationships Between Race, Gender, and Spot Urine Levels of Biomarkers of Tobacco Exposure Vary Based on How Creatinine Is Handled in Analyses. Nicotine Tob Res 2020; 22:2109-2113. [PMID: 32598452 PMCID: PMC7593361 DOI: 10.1093/ntr/ntaa117] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 06/23/2020] [Indexed: 12/22/2022]
Abstract
INTRODUCTION We illustrate the differential impact of common analysis approaches to handling urinary creatinine, a measure for urine dilution, on relationships between race, gender, and biomarkers of exposure measured in spot urine. METHODS In smokers, spot urine levels of total nicotine equivalents (TNE, sum of total nicotine, total cotinine, and total 3'-hydroxycotinine) and total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) overall and per cigarette were examined. Relationships between race (African Americans [AA] n = 373, Whites n = 758) or gender (males n = 629, females n = 502) and TNE or NNAL were examined using the following approaches to handling creatinine: (1) unadjusted/unstandardized; (2) standardization; (3) adjustment as a covariate. Significance was considered at p < .05. RESULTS Creatinine was higher in AA versus Whites (1.19 vs. 0.96 mg/mL; p < .0001) and in males versus females (1.21 vs. 0.84 mg/mL; p < .0001). Independent of how creatinine was handled, TNE was lower among AA than Whites (TNE ratios AA vs. Whites: 0.67-0.84; p's < .05). Unadjusted TNE per cigarette was higher among AA versus Whites (ratio 1.12; p = .0411); however, the relationship flipped with standardization (ratio 0.90; p = .0360) and adjustment (ratio 0.95; p = .3165). Regarding gender, unadjusted TNE was higher among males versus females (ratio 1.13; p = .0063), but the relationship flipped with standardization (ratio 0.79; p < .0001) or adjustment (ratio 0.89; p = .0018). Unadjusted TNE per cigarette did not differ across gender (ratio 0.98; p = .6591), but lower levels were found in males versus females with standardization (ratio 0.68; p < .0001) and adjustment (ratio 0.74; p < .0001). NNAL displayed similar patterns. CONCLUSIONS Relationships between race, gender, and spot urine levels of biomarkers of exposure can vary greatly based on how creatinine is handled in analyses. IMPLICATIONS Lack of appropriate methods can lead to discrepancies across reports on variability of urinary biomarkers by race and gender. We recommend that for any analyses of biomarkers of exposure measure in spot urine samples across race, gender, or other population subgroups that differ in urinary creatinine levels, sensitivity analyses comparing the different methods for handling urinary creatinine should be conducted. If methods result in discrepant findings, this should be clearly noted and discussed.
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Affiliation(s)
- Dana M Carroll
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Shannon Cigan
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN
| | | | - Taylor Hammonds
- Graduate Program in Regulatory Sciences and Interdisciplinary Biomedical Sciences, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Irina Stepanov
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Gideon St. Helen
- Clinical Pharmacology Research Program, Division of Cardiology, Department of Medicine, University of California, San Francisco, CA
| | - Neal Benowitz
- Clinical Pharmacology Research Program, Division of Cardiology, Department of Medicine, University of California, San Francisco, CA
| | - Dorothy K Hatsukami
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN
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16
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Carroll DM, Stepanov I, O'Connor R, Luo X, Cummings KM, Rees VW, Bickel WK, Berman ML, Ashley DL, Bansal-Travers M, Shields PG, Hatsukami DK. Impact of Cigarette Filter Ventilation on U.S. Smokers' Perceptions and Biomarkers of Exposure and Potential Harm. Cancer Epidemiol Biomarkers Prev 2020; 30:38-44. [PMID: 33093163 DOI: 10.1158/1055-9965.epi-20-0852] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/24/2020] [Accepted: 10/14/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Relationships between cigarette filter ventilation levels, biomarkers of exposure (BOE) and potential harm (BOPH), and harm perceptions were examined. METHODS Filter ventilation levels in cigarette brands were merged with Wave 1 (2013-2014) Population Assessment of Tobacco Use and Health study. Data were restricted to smokers who reported a usual brand and not regular users of other tobacco products. BOEs included nicotine, tobacco-specific nitrosamines, volatile organic compounds (VOC), and polycyclic aromatic hydrocarbons. BOPHs measured inflammation and oxidative stress. Perceived harm was assessed as self-reported risk of one's usual brand compared with other brands. RESULTS Filter ventilation ranged from 0.2% to 61.1% (n = 1,503). Adjusted relationships between filter ventilation and BOE or BOPH were nonsignificant except for VOC N-acetyl-S-(phenyl)-L-cysteine (PHMA) and high-sensitivity C-reactive protein (hsCRP). In pairwise comparisons, PHMA was higher in quartile (Q) 4 (4.23 vs. 3.36 pmol/mg; P = 0.0103) and Q3 (4.48 vs. 3.36 pmol/mg; P = 0.0038) versus Q1 of filter ventilation and hsCRP comparisons were nonsignificant. Adjusted odds of perceiving one's own brand as less harmful was 26.87 (95% confidence interval: 4.31-167.66), 12.55 (3.01-52.32), and 19.18 (3.87-95.02) times higher in the Q2, Q3, and Q4 of filter ventilation compared with Q1 (P = 0.0037). CONCLUSIONS Filter ventilation was not associated with BOE or BOPH, yet smokers of higher ventilated cigarettes perceived their brand as less harmful than other brands compared with smokers of lower ventilated cigarettes. IMPACT Research to understand the impact of this misperception is needed, and remedial strategies, potentially including a ban on filter ventilation, are recommended.
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Affiliation(s)
- Dana M Carroll
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
| | - Irina Stepanov
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Richard O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Xianghua Luo
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - K Michael Cummings
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Vaughan W Rees
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Warren K Bickel
- Fralin Biomedical Research Institute of Virginia Tech, Roanoke, Virginia
| | - Micah L Berman
- College of Public Health and Moritz College of Law, The Ohio State University, Columbus, Ohio
| | - David L Ashley
- Department of Population Health Sciences, Georgia State University, Atlanta, Georgia
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Peter G Shields
- Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, Ohio
| | - Dorothy K Hatsukami
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota
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17
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Peterson LA, Balbo S, Fujioka N, Hatsukami DK, Hecht SS, Murphy SE, Stepanov I, Tretyakova NY, Turesky RJ, Villalta PW. Applying Tobacco, Environmental, and Dietary-Related Biomarkers to Understand Cancer Etiology and Evaluate Prevention Strategies. Cancer Epidemiol Biomarkers Prev 2020; 29:1904-1919. [PMID: 32051197 PMCID: PMC7423750 DOI: 10.1158/1055-9965.epi-19-1356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/18/2019] [Accepted: 01/27/2020] [Indexed: 01/20/2023] Open
Abstract
Many human cancers are caused by environmental and lifestyle factors. Biomarkers of exposure and risk developed by our team have provided critical data on internal exposure to toxic and genotoxic chemicals and their connection to cancer in humans. This review highlights our research using biomarkers to identify key factors influencing cancer risk as well as their application to assess the effectiveness of exposure intervention and chemoprevention protocols. The use of these biomarkers to understand individual susceptibility to the harmful effects of tobacco products is a powerful example of the value of this type of research and has provided key data confirming the link between tobacco smoke exposure and cancer risk. Furthermore, this information has led to policy changes that have reduced tobacco use and consequently, the tobacco-related cancer burden. Recent technological advances in mass spectrometry led to the ability to detect DNA damage in human tissues as well as the development of adductomic approaches. These new methods allowed for the detection of DNA adducts in tissues from patients with cancer, providing key evidence that exposure to carcinogens leads to DNA damage in the target tissue. These advances will provide valuable insights into the etiologic causes of cancer that are not tobacco-related.See all articles in this CEBP Focus section, "Environmental Carcinogenesis: Pathways to Prevention."
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Affiliation(s)
- Lisa A Peterson
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota.
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Silvia Balbo
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Naomi Fujioka
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, Minnesota
| | - Dorothy K Hatsukami
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | - Stephen S Hecht
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | - Sharon E Murphy
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
- Department of Biochemistry, Molecular Biology and Biophysics, University of Minnesota, Minneapolis, Minnesota
| | - Irina Stepanov
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Natalia Y Tretyakova
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
- Department of Medicinal Chemistry, University of Minnesota, Minneapolis, Minnesota
| | - Robert J Turesky
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
- Department of Medicinal Chemistry, University of Minnesota, Minneapolis, Minnesota
| | - Peter W Villalta
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
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18
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Meier E, Vandrey R, Rubin N, Pacek LR, Jensen JA, Donny EC, Hecht SS, Carmella SG, Murphy SE, Luo X, Stepanov I, Ikuemonisan J, Severson H, Al’absi M, Hatsukami DK. Cigarette Smokers Versus Cousers of Cannabis and Cigarettes: Exposure to Toxicants. Nicotine Tob Res 2020; 22:1383-1389. [PMID: 31616939 PMCID: PMC7366295 DOI: 10.1093/ntr/ntz199] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 10/11/2019] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Cannabis and tobacco couse is common and could expose users to higher levels of toxicants. No studies have examined biomarkers of toxicant exposure in cousers of cannabis and cigarettes, compared with cigarette smokers (CS). AIMS AND METHODS Adult daily CS were recruited from 10 US sites for a study of reduced nicotine cigarettes. In this analysis of baseline data, participants were categorized as either cousers of cannabis and tobacco (cousers; N = 167; urine positive for 11-nor-9-carboxy-Δ 9-tetrahydrocannnabinol and self-reported cannabis use ≥1×/week), or CS (N = 911; negative urine and no self-reported cannabis use). Participants who did not meet either definition (N = 172) were excluded. Self-reported tobacco and cannabis use and tobacco and/or combustion-related biomarkers of exposure were compared between groups. RESULTS Compared to CS, cousers were younger (couser Mage = 38.96, SD = 13.01; CS Mage = 47.22, SD = 12.72; p < .001) and more likely to be male (cousers = 67.7%, CS = 51.9%, p < .001). There were no group differences in self-reported cigarettes/day, total nicotine equivalents, or breath carbon monoxide, but cousers had greater use of non-cigarette tobacco products. Compared to CS, cousers had higher concentrations of 3-hydroxypropylmercapturic acid, 2-cyanoethylmercapturic acid, S-phenylmercapturic acid, 3-hydroxy-1-methylpropylmercapturic acid (ps < .05), and phenanthrene tetraol (p < .001). No biomarkers were affected by number of cannabis use days/week or days since last cannabis use during baseline (ps > .05). CONCLUSIONS Cousers had higher concentrations of biomarkers of exposure than CS, but similar number of cigarettes per day and nicotine exposure. Additional studies are needed to determine whether cannabis and/or alternative tobacco products are driving the increased toxicant exposure. IMPLICATIONS Cousers of cannabis and tobacco appear to be exposed to greater levels of harmful chemicals (ie, volatile organic compounds and polycyclic aromatic hydrocarbons), but similar levels of nicotine as CS. It is unclear if the higher levels of toxicant exposure in cousers are due to cannabis use or the increased use of alternative tobacco products compared with CS. It is important for studies examining biomarkers of exposure among CS to account for cannabis use as it may have a significant impact on outcomes. Additionally, further research is needed examining exposure to harmful chemicals among cannabis users.
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Affiliation(s)
- Ellen Meier
- Department of Psychology, University of Wisconsin—Stevens Point, Stevens Point, WI
| | - Ryan Vandrey
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - Nathan Rubin
- University of Minnesota Masonic Cancer Center, Minneapolis, MN
| | - Lauren R Pacek
- Department of Psychiatry, Duke University School of Medicine, Durham, NC
| | - Joni A Jensen
- University of Minnesota, Tobacco Research Programs, Minneapolis, MN
| | - Eric C Donny
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC
| | - Stephen S Hecht
- University of Minnesota Masonic Cancer Center, Minneapolis, MN
| | | | - Sharon E Murphy
- University of Minnesota Masonic Cancer Center, Minneapolis, MN
| | - Xianghua Luo
- University of Minnesota Masonic Cancer Center, Minneapolis, MN
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN 55414
| | - Irina Stepanov
- University of Minnesota Masonic Cancer Center, Minneapolis, MN
- University of Minnesota, Tobacco Research Programs, Minneapolis, MN
| | | | | | - Mustafa Al’absi
- Department of Family Medicine and BioBehavioral Health, University of Minnesota Medical School, Duluth, MN
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19
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Ma B, Villalta PW, Hochalter JB, Stepanov I, Hecht SS. Methyl DNA phosphate adduct formation in lung tumor tissue and adjacent normal tissue of lung cancer patients. Carcinogenesis 2020; 40:1387-1394. [PMID: 30873516 DOI: 10.1093/carcin/bgz053] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 02/25/2019] [Accepted: 03/08/2019] [Indexed: 11/14/2022] Open
Abstract
The formation of methyl DNA adducts is a critical step in carcinogenesis initiated by the exposure to methylating carcinogens. Methyl DNA phosphate adducts, formed by methylation of the oxygen atoms of the DNA phosphate backbone, have been detected in animals treated with methylating carcinogens. However, detection of these adducts in human tissues has not been reported. We developed an ultrasensitive liquid chromatography-nanoelectrospray ionization-high resolution tandem mass spectrometry method for detecting methyl DNA phosphate adducts. Using 50 μg of human lung DNA, a limit of quantitation of two adducts/1010 nucleobases was achieved. Twenty-two structurally unique methyl DNA phosphate adducts were detected in human lung DNA. The adduct levels were measured in both tumor and adjacent normal tissues from 30 patients with lung cancer, including 13 current smokers and 17 current non-smokers, as confirmed by measurements of urinary cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol. Levels of total methyl DNA phosphate adducts in normal lung tissues were higher in smokers than non-smokers, with an average of 13 and 8 adducts/109 nucleobases, respectively. Methyl DNA phosphate adducts were also detected in lung tissues from untreated rats with steady-state levels of 5-7 adducts/109 nucleobases over a period of 70 weeks. This is the first study to report the detection of methyl DNA phosphate adducts in human lung tissues. The results provide new insights toward using these DNA adducts as potential biomarkers to study human exposure to environmental methylating carcinogens.
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Affiliation(s)
- Bin Ma
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Peter W Villalta
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | | | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Stephen S Hecht
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
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20
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Dator R, Villalta PW, Thomson N, Jensen J, Hatsukami DK, Stepanov I, Warth B, Balbo S. Metabolomics Profiles of Smokers from Two Ethnic Groups with Differing Lung Cancer Risk. Chem Res Toxicol 2020; 33:2087-2098. [PMID: 32293874 PMCID: PMC7434657 DOI: 10.1021/acs.chemrestox.0c00064] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
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African
American (AA) smokers are at a higher risk of developing
lung cancer compared to whites. The variations in the metabolism of
nicotine and tobacco-derived carcinogens in these groups were reported
previously with the levels of nicotine metabolites and carcinogen-derived
metabolites measured using targeted approaches. While useful, these
targeted strategies are not able to detect global metabolic changes
for use in predicting the detrimental effects of tobacco use and ultimately
lung cancer susceptibility among smokers. To address this limitation,
we have performed global untargeted metabolomics profiling in urine
of AA and white smokers to characterize the pattern of metabolites,
identify differentially regulated pathways, and correlate these profiles
with the observed variations in lung cancer risk between these two
populations. Urine samples from AA (n = 30) and white
(n = 30) smokers were used for metabolomics analysis
acquired in both positive and negative electrospray ionization modes.
LC-MS data were uploaded onto the cloud-based XCMS online (http://xcmsonline.scripps.edu) platform for retention time correction, alignment, feature detection,
annotation, statistical analysis, data visualization, and automated
systems biology pathway analysis. The latter identified global differences
in the metabolic pathways in the two groups including the metabolism
of carbohydrates, amino acids, nucleotides, fatty acids, and nicotine.
Significant differences in the nicotine degradation pathway (cotinine
glucuronidation) in the two groups were observed and confirmed using
a targeted LC-MS/MS approach. These results are consistent with previous
studies demonstrating AA smokers with lower glucuronidation capacity
compared to whites. Furthermore, the d-glucuronate degradation
pathway was found to be significantly different between the two populations,
with lower amounts of the putative metabolites detected in AA compared
to whites. We hypothesize that the differential regulation of the d-glucuronate degradation pathway is a consequence of the variations
in the glucuronidation capacity observed in the two groups. Other
pathways including the metabolism of amino acids, nucleic acids, and
fatty acids were also identified, however, the biological relevance
and implications of these differences across ethnic groups need further
investigation. Overall, the applied metabolomics approach revealed
global differences in the metabolic networks and endogenous metabolites
in AA and whites, which could be used and validated as a new potential
panel of biomarkers that could be used to predict lung cancer susceptibility
among smokers in population-based studies.
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Affiliation(s)
- Romel Dator
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Peter W Villalta
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Nicole Thomson
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | | | - Dorothy K Hatsukami
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Benedikt Warth
- Department of Food Chemistry and Toxicology, Faculty of Chemistry, University of Vienna, Währingerstraβe 38, 1090 Vienna, Austria.,Scripps Center for Metabolomics, The Scripps Research Institute, La Jolla, California 92037, United States
| | - Silvia Balbo
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota 55455, United States
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21
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Meier E, Lindgren BR, Anderson A, Reisinger SA, Norton KJ, Jensen J, Strayer L, Dick L, Tang MK, Chen M, Carmella SG, Hecht SS, Murphy SE, Yang J, Stepanov I, O'Connor RJ, Shields PG, Hatsukami DK. A Randomized Clinical Trial of Snus Examining the Effect of Complete Versus Partial Cigarette Substitution on Smoking-Related Behaviors, and Biomarkers of Exposure. Nicotine Tob Res 2020; 22:473-481. [PMID: 31321423 DOI: 10.1093/ntr/ntz055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 04/05/2019] [Indexed: 12/27/2022]
Abstract
INTRODUCTION This 8-week multisite, randomized controlled trial of snus examined the differential effects of instructions on (1) snus use, (2) smoking and smoking-related measures, and (3) exposure to tobacco-related constituents. METHOD US adult daily cigarette smokers (n = 150; 43.3% female; Medianage = 43.5) were recruited from Minneapolis, Minnesota; Columbus and Coshocton, Ohio; and Buffalo, New York. Following a 1-week sampling phase of snus, participants who used at least 7 pouches were randomized to either (1) partial substitution (PS; "use snus as you like with your cigarettes"), (2) complete substitution (CS; "avoid cigarettes"), or (3) usual brand cigarettes (UB). Analyses included between-group analyses (eg, PS vs. CS) using Wilcoxon rank sum test of cigarettes per day and snus pouches per day, and a linear mixed model (biomarkers). RESULTS Compared to the PS and UB groups, smokers assigned to CS reported greater reductions in cigarettes per day (ps < .001), using more snus pouches per day (p = .02), and more smoke-free days (CS median = 14.5, PS and UB medians = 0, p < .001). In addition, results demonstrated reductions in carbon monoxide (p < .001), total nicotine equivalents (p = .02), and four out of five measured volatile organic compounds (ps < .01) over time among the CS group. Exposure to N'-nitrosonornicotine increased by trial end only among the PS group (p < .04). Phenanthrene tetraol increased among all groups by trial end (p = .02) with no difference between groups. CONCLUSIONS Instructions to completely switch from cigarettes to snus resulted in the greatest reduction in cigarettes and exposure to harmful constituents. IMPLICATIONS Directly instructing smokers to switch completely to snus, rather than using ad libitum (with no instructions to avoid cigarettes), is necessary for reductions in smoking and subsequent exposure to harmful constituents.
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Affiliation(s)
- Ellen Meier
- Department of Psychology, University of Wisconsin-Stevens Point, WI
| | - Bruce R Lindgren
- Masonic Comprehensive Cancer Center, University of Minnesota, Minneapolis, MN
| | - Amanda Anderson
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
| | | | | | - Joni Jensen
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
| | - Lori Strayer
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
| | - Laura Dick
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
| | - Mei-Kuen Tang
- Masonic Comprehensive Cancer Center, University of Minnesota, Minneapolis, MN
| | - Menglan Chen
- Masonic Comprehensive Cancer Center, University of Minnesota, Minneapolis, MN
| | - Steven G Carmella
- Masonic Comprehensive Cancer Center, University of Minnesota, Minneapolis, MN
| | - Stephen S Hecht
- Masonic Comprehensive Cancer Center, University of Minnesota, Minneapolis, MN.,Department of Psychiatry, University of Minnesota, Minneapolis, MN
| | - Sharon E Murphy
- Masonic Comprehensive Cancer Center, University of Minnesota, Minneapolis, MN.,Department of Psychiatry, University of Minnesota, Minneapolis, MN
| | - Jing Yang
- Masonic Comprehensive Cancer Center, University of Minnesota, Minneapolis, MN
| | - Irina Stepanov
- Masonic Comprehensive Cancer Center, University of Minnesota, Minneapolis, MN.,Department of Psychiatry, University of Minnesota, Minneapolis, MN
| | | | | | - Dorothy K Hatsukami
- Masonic Comprehensive Cancer Center, University of Minnesota, Minneapolis, MN.,Department of Psychiatry, University of Minnesota, Minneapolis, MN
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22
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Sharma AK, DeBusk WT, Stepanov I, Gomez A, Khariwala SS. Oral Microbiome Profiling in Smokers with and without Head and Neck Cancer Reveals Variations Between Health and Disease. Cancer Prev Res (Phila) 2020; 13:463-474. [PMID: 32071121 DOI: 10.1158/1940-6207.capr-19-0459] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 01/08/2020] [Accepted: 02/14/2020] [Indexed: 11/16/2022]
Abstract
While smoking is inextricably linked to oral/head and neck cancer (HNSCC), only a small fraction of smokers develop HNSCC. Thus, we have sought to identify other factors, which may influence the development of HNSCC in smokers including microbiology. To determine microbial associations with HNSCC among tobacco users, we characterized oral microbiome composition in smokers with and without HNSCC. 16S rRNA MiSeq sequencing was used to examine the oral mucosa microbiome of 27 smokers with (cases) and 24 without HNSCC (controls). In addition, we correlated previously reported levels of DNA damage with the microbiome data. Smokers with HNSCC showed lower microbiome richness compared with controls (q = 0.012). Beta-diversity analyses, assessed as UniFrac (weighted and unweighted) and Bray-Curtis distances, showed significant differences in oral mucosal microbiome signatures between cases and controls (r 2 = 0.03; P = 0.03) and higher interindividual microbiome heterogeneity in the former (q ≤ 0.01). Higher relative abundance of Stenotrophomonas and Comamonadaceae and predicted bacterial pathways mainly involved in xenobiotic and amine degradation were found in cases compared with controls. The latter, in contrast, exhibited higher abundance of common oral commensals and predicted sugar degradation pathways. Finally, levels of DNA damage in the oral cavity were correlated with the microbiome profiles above. Oral microbiome traits differ in smokers with and without HNSCC, potentially informing the risk of eventual HNSCC and shedding light into possible microbially mediated mechanisms of disease. These findings present data that may be useful in screening efforts for HNSCC among smokers who are unable to quit.
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Affiliation(s)
- Ashok Kumar Sharma
- Department of Animal Science and Microbial and Plant Genomics Institute, University of Minnesota, Minneapolis, Minnesota
| | - William T DeBusk
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Irina Stepanov
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Andres Gomez
- Department of Animal Science and Microbial and Plant Genomics Institute, University of Minnesota, Minneapolis, Minnesota.
| | - Samir S Khariwala
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota.
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23
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Abstract
The oral cavity is usually the first part of a consumer's body exposed to the constituents of tobacco products or their emissions. Consequently, the oral cavity is a frequent site for carcinogenic, microbial, immunologic, and clinical effects of tobacco use. This article summarizes 5 presentations on various aspects of oral health affected by combusted or noncombusted tobacco products from a recent conference, "Oral Health Effects of Tobacco Products: Science and Regulatory Policy," sponsored by the American Association for Dental Research and the Food and Drug Administration.
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Affiliation(s)
- S L Tomar
- College of Dentistry, University of Florida, Gainesville, FL, USA
| | - S S Hecht
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - I Jaspers
- School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - R L Gregory
- School of Dentistry, Indiana University, Indianapolis, IN, USA
| | - I Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
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24
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Harris AC, Muelken P, Swain Y, Palumbo M, Jain V, Goniewicz ML, Stepanov I, LeSage MG. Non-nicotine constituents in e-cigarette aerosol extract attenuate nicotine's aversive effects in adolescent rats. Drug Alcohol Depend 2019; 203:51-60. [PMID: 31404849 PMCID: PMC6941564 DOI: 10.1016/j.drugalcdep.2019.05.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 05/17/2019] [Accepted: 05/20/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Development of preclinical methodology for evaluating the abuse liability of electronic cigarettes (ECs) in adolescents is urgently needed to inform FDA regulation of these products. We previously reported reduced aversive effects of EC liquids containing nicotine and a range of non-nicotine constituents (e.g., propylene glycol, minor tobacco alkaloids) compared to nicotine alone in adult rats as measured using intracranial self-stimulation. The goal of this study was to compare the aversive effects of nicotine alone and EC aerosol extracts in adolescent rats as measured using conditioned taste aversion (CTA), which can be conducted during the brief adolescent period. METHODS AND RESULTS In Experiment 1, nicotine alone (1.0 or 1.5 mg/kg, s.c.) produced significant CTA in adolescent rats in a two-bottle procedure, thereby establishing a model to study the effects of EC extracts. At a nicotine dose of 1.0 mg/kg, CTA to Vuse Menthol EC extract, but not Aroma E-Juice EC extract, was attenuated compared to nicotine alone during repeated two-bottle CTA tests (Experiment 2a). At a nicotine dose of 0.5 mg/kg, CTA to Vuse Menthol EC extract did not differ from nicotine alone during the first two-bottle CTA test but extinguished more rapidly across repeated two-bottle tests (Experiment 2b). CONCLUSIONS Non-nicotine constituents in Vuse Menthol EC extracts attenuated CTA in a two-bottle procedure in adolescents. This model may be useful for anticipating the abuse liability of ECs in adolescents and for modeling FDA-mandated changes in product standards for nicotine or other constituents in ECs.
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Affiliation(s)
- Andrew C. Harris
- Department of Medicine, Hennepin Healthcare Research Institute, Minneapolis, MN, USA,Department of Medicine, University of Minnesota, Minneapolis, MN, USA,Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Peter Muelken
- Department of Medicine, Hennepin Healthcare Research Institute, Minneapolis, MN, USA
| | - Yayi Swain
- Department of Medicine, Hennepin Healthcare Research Institute, Minneapolis, MN, USA,Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Mary Palumbo
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Vipin Jain
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Maciej L. Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Mark G. LeSage
- Department of Medicine, Hennepin Healthcare Research Institute, Minneapolis, MN, USA,Department of Medicine, University of Minnesota, Minneapolis, MN, USA,Department of Psychology, University of Minnesota, Minneapolis, MN, USA
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25
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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26
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Khariwala SS, Hatsukami DK, Stepanov I, Rubin N, Nelson HH. Patterns of Tobacco Cessation Attempts and Symptoms Experienced Among Smokers With Head and Neck Squamous Cell Carcinoma. JAMA Otolaryngol Head Neck Surg 2019; 144:477-482. [PMID: 29800964 DOI: 10.1001/jamaoto.2018.0249] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Among smokers with head and neck squamous cell carcinoma (HNSCC), there is ample evidence regarding the benefits of smoking cessation prior to treatment. Prior data indicates that increased attempts at cessation result in higher likelihood of cessation after diagnosis but the prediagnostic patterns of smoking cessation attempts among those smokers developing HNSCC has not been characterized. Data of this kind may direct cessation efforts toward increased efficacy. Objective To determine the frequency and character of tobacco cessation attempts and symptoms experienced prior to development of HNSCC, as well as to determine the correlation of these symptoms with number of cessation attempts and maximum quit days. Design, Setting, and Participants Cross-sectional study including 123 active smokers with HNSCC recruited from a tertiary medical center at an academic institution from February 2014 to May 2017. Exposures All included patients were active cigarette smokers prior to developing HNSCC. Main Outcomes and Measures Patients provided data indicating intensity of smoking, duration, number of cessation attempts, maximum number of days during which they successfully ceased smoking, and symptoms during cessation attempts. Principal component analysis was used to identify clustering of symptoms. Results In total, 123 patients were identified (97 men, 23 women, and 3 unspecified) from February 2014 to May 2017 as active smokers (mean [SD] age, 59.4 [9.0] years; median [interquartile range] age, 58.5 [54.8-66.0] years); patients had oral (n = 39 [32%]), oropharyngeal (n = 44 [36%]), laryngeal (n = 32 [26%]) or hypopharyngeal (n = 7 [6%]) tumors. Overall, 108 patients (88%) had made at least 1 prior attempt at cessation, and the mean number of lifetime cessation attempts was 6.6. Symptoms of cravings, restlessness, irritability, and anxiety were reported most frequently. Symptoms were clustered into 2 component groups: component group 1 (C1; increased appetite, cravings, depression) and component group 2 (C2; restlessness, irritability, insomnia, anxiety, and difficulty concentrating). Component group 2 correlated with quit attempts (Spearman correlation, 0.268 [95% CI, 0.07 to 0.45]), and C1 and C2 were not correlated with maximum quit days. Cessation attempts and maximum quit days positively correlated with each other. Conclusions and Relevance Our analysis shows that symptoms during cessation attempts tend to cluster and that most patients made 1 or more cessation attempts. Many patients successfully ceased before restarting. Our data suggest that patients experiencing C2 symptoms make more quit attempts; C1 symptoms may be more difficult to overcome because they are associated with fewer quit attempts. Future work will address whether amelioration of these symptoms may help smoking cessation among smokers with HNSCC.
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Affiliation(s)
- Samir S Khariwala
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis.,Masonic Cancer Center, University of Minnesota, Minneapolis
| | - Dorothy K Hatsukami
- Masonic Cancer Center, University of Minnesota, Minneapolis.,Department of Psychiatry, University of Minnesota, Minneapolis
| | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis.,Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis
| | - Nathan Rubin
- Masonic Cancer Center, University of Minnesota, Minneapolis.,Department of Biostatistics, University of Minnesota, Minneapolis
| | - Heather H Nelson
- Masonic Cancer Center, University of Minnesota, Minneapolis.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis
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27
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Luo K, Stepanov I, Hecht SS. Chemical biomarkers of exposure and early damage from potentially carcinogenic airborne pollutants. ACTA ACUST UNITED AC 2019. [DOI: 10.21037/ace.2019.08.01] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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28
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Amente S, Di Palo G, Scala G, Castrignanò T, Gorini F, Cocozza S, Moresano A, Pucci P, Ma B, Stepanov I, Lania L, Pelicci PG, Dellino GI, Majello B. Genome-wide mapping of 8-oxo-7,8-dihydro-2'-deoxyguanosine reveals accumulation of oxidatively-generated damage at DNA replication origins within transcribed long genes of mammalian cells. Nucleic Acids Res 2019; 47:221-236. [PMID: 30462294 PMCID: PMC6326803 DOI: 10.1093/nar/gky1152] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 10/30/2018] [Indexed: 01/16/2023] Open
Abstract
8-Oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodG) is one of the major DNA modifications and a potent pre-mutagenic lesion prone to mispair with 2′-deoxyadenosine (dA). Several thousand residues of 8-oxodG are constitutively generated in the genome of mammalian cells, but their genomic distribution has not yet been fully characterized. Here, by using OxiDIP-Seq, a highly sensitive methodology that uses immuno-precipitation with efficient anti–8-oxodG antibodies combined with high-throughput sequencing, we report the genome-wide distribution of 8-oxodG in human non-tumorigenic epithelial breast cells (MCF10A), and mouse embryonic fibroblasts (MEFs). OxiDIP-Seq revealed sites of 8-oxodG accumulation overlapping with γH2AX ChIP-Seq signals within the gene body of transcribed long genes, particularly at the DNA replication origins contained therein. We propose that the presence of persistent single-stranded DNA, as a consequence of transcription-replication clashes at these sites, determines local vulnerability to DNA oxidation and/or its slow repair. This oxidatively-generated damage, likely in combination with other kinds of lesion, might contribute to the formation of DNA double strand breaks and activation of DNA damage response.
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Affiliation(s)
- Stefano Amente
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples 'Federico II', Naples, Italy
| | - Giacomo Di Palo
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples 'Federico II', Naples, Italy
| | - Giovanni Scala
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples 'Federico II', Naples, Italy
| | | | - Francesca Gorini
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples 'Federico II', Naples, Italy
| | - Sergio Cocozza
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples 'Federico II', Naples, Italy
| | - Angela Moresano
- Department of Chemical Sciences, University of Naples 'Federico II', Naples, Italy
| | - Piero Pucci
- Department of Chemical Sciences, University of Naples 'Federico II', Naples, Italy.,CEINGE Biotecnologie Avanzate, Naples, Italy
| | - Bin Ma
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Luigi Lania
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples 'Federico II', Naples, Italy
| | - Pier Giuseppe Pelicci
- Department of Experimental Oncology, European Institute of Oncology, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milano, Milan, Italy
| | - Gaetano Ivan Dellino
- Department of Experimental Oncology, European Institute of Oncology, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milano, Milan, Italy
| | - Barbara Majello
- Department of Biology, University of Naples 'Federico II', Naples, Italy
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29
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Jain V, Alcheva A, Huang D, Caruso R, Jain A, Lay M, O'Connor R, Stepanov I. Comprehensive Chemical Characterization of Natural American Spirit Cigarettes. TOB REGUL SCI 2019; 5:381-399. [PMID: 33907702 PMCID: PMC8075288 DOI: 10.18001/trs.5.4.8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Marketing of the Natural American Spirit (NAS) cigarettes implies reduced risk of toxic exposures. We aimed to provide a comprehensive chemical characterization of these cigarettes. METHODS We analyzed 13 varieties of NAS for a range of tobacco- and combustion-derived constituents. Cigarettes were smoked by 2 standard regimens and analyzed using our routine analytical procedures. We also analyzed tobacco filler and physical cigarette characteristics. RESULTS Under intense smoking conditions, nicotine in smoke of NAS cigarettes averaged 3.3(±0.7) mg/cigarette, compared to 2.4(±0.4) in other brands. The levels of carcinogenic nitrosamines NNN and NNK varied extensively across NAS varieties, their sum ranging from 71 to 443 ng/cigarette. Levels of volatile toxicants were generally similar to, or higher than those found in other commercial US cigarettes. CONCLUSIONS High nicotine content suggests that NAS cigarettes may be more addictive than many other brands. Similarly low TSNA levels were measured in some NAS varieties, independent of whether or not they were labeled as organic. Levels of other toxicants were similar to other brands. Consumer education and additional regulatory measures are needed to address the misperceptions that NAS cigarettes are safer than other commercial cigarette brands.
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Affiliation(s)
- Vipin Jain
- Vipin Jain, Research Associate, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Aleksandra Alcheva, Graduate Student, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN. Darlene Huang, Senior Associate, O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC. Rosalie Caruso, Senior Research Associate, Tobacco Research Laboratory, Roswell Park Comprehensive Cancer Center, Buffalo, NY. Anshu Jain, Research Scientist, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Mula Lay, Student Intern, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Richard O'Connor, Professor, Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY. Irina Stepanov, Associate Professor, Masonic Cancer Center and Division of Environmental Health Sciences, University of Minnesota, Minneapolis, MN
| | - Aleksandra Alcheva
- Vipin Jain, Research Associate, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Aleksandra Alcheva, Graduate Student, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN. Darlene Huang, Senior Associate, O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC. Rosalie Caruso, Senior Research Associate, Tobacco Research Laboratory, Roswell Park Comprehensive Cancer Center, Buffalo, NY. Anshu Jain, Research Scientist, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Mula Lay, Student Intern, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Richard O'Connor, Professor, Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY. Irina Stepanov, Associate Professor, Masonic Cancer Center and Division of Environmental Health Sciences, University of Minnesota, Minneapolis, MN
| | - Darlene Huang
- Vipin Jain, Research Associate, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Aleksandra Alcheva, Graduate Student, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN. Darlene Huang, Senior Associate, O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC. Rosalie Caruso, Senior Research Associate, Tobacco Research Laboratory, Roswell Park Comprehensive Cancer Center, Buffalo, NY. Anshu Jain, Research Scientist, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Mula Lay, Student Intern, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Richard O'Connor, Professor, Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY. Irina Stepanov, Associate Professor, Masonic Cancer Center and Division of Environmental Health Sciences, University of Minnesota, Minneapolis, MN
| | - Rosalie Caruso
- Vipin Jain, Research Associate, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Aleksandra Alcheva, Graduate Student, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN. Darlene Huang, Senior Associate, O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC. Rosalie Caruso, Senior Research Associate, Tobacco Research Laboratory, Roswell Park Comprehensive Cancer Center, Buffalo, NY. Anshu Jain, Research Scientist, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Mula Lay, Student Intern, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Richard O'Connor, Professor, Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY. Irina Stepanov, Associate Professor, Masonic Cancer Center and Division of Environmental Health Sciences, University of Minnesota, Minneapolis, MN
| | - Anshu Jain
- Vipin Jain, Research Associate, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Aleksandra Alcheva, Graduate Student, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN. Darlene Huang, Senior Associate, O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC. Rosalie Caruso, Senior Research Associate, Tobacco Research Laboratory, Roswell Park Comprehensive Cancer Center, Buffalo, NY. Anshu Jain, Research Scientist, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Mula Lay, Student Intern, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Richard O'Connor, Professor, Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY. Irina Stepanov, Associate Professor, Masonic Cancer Center and Division of Environmental Health Sciences, University of Minnesota, Minneapolis, MN
| | - Mula Lay
- Vipin Jain, Research Associate, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Aleksandra Alcheva, Graduate Student, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN. Darlene Huang, Senior Associate, O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC. Rosalie Caruso, Senior Research Associate, Tobacco Research Laboratory, Roswell Park Comprehensive Cancer Center, Buffalo, NY. Anshu Jain, Research Scientist, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Mula Lay, Student Intern, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Richard O'Connor, Professor, Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY. Irina Stepanov, Associate Professor, Masonic Cancer Center and Division of Environmental Health Sciences, University of Minnesota, Minneapolis, MN
| | - Richard O'Connor
- Vipin Jain, Research Associate, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Aleksandra Alcheva, Graduate Student, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN. Darlene Huang, Senior Associate, O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC. Rosalie Caruso, Senior Research Associate, Tobacco Research Laboratory, Roswell Park Comprehensive Cancer Center, Buffalo, NY. Anshu Jain, Research Scientist, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Mula Lay, Student Intern, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Richard O'Connor, Professor, Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY. Irina Stepanov, Associate Professor, Masonic Cancer Center and Division of Environmental Health Sciences, University of Minnesota, Minneapolis, MN
| | - Irina Stepanov
- Vipin Jain, Research Associate, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Aleksandra Alcheva, Graduate Student, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN. Darlene Huang, Senior Associate, O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC. Rosalie Caruso, Senior Research Associate, Tobacco Research Laboratory, Roswell Park Comprehensive Cancer Center, Buffalo, NY. Anshu Jain, Research Scientist, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Mula Lay, Student Intern, Masonic Cancer Center, University of Minnesota, Minneapolis, MN. Richard O'Connor, Professor, Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY. Irina Stepanov, Associate Professor, Masonic Cancer Center and Division of Environmental Health Sciences, University of Minnesota, Minneapolis, MN
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Carroll DM, Allenzara A, Jensen J, Stepanov I, Hecht S, Murphy S, Luo X, Donny E, Hatsukami DK. Biomarkers of Exposure and Potential Harm among Natural American Spirit Smokers. TOB REGUL SCI 2019; 5:339-351. [PMID: 33457467 PMCID: PMC7810336 DOI: 10.18001/trs.5.4.4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES We compared biomarkers of exposure and potential harm in smokers of American Spirit (AS) to smokers of Marlboro, Newport, Camel, and Pall Mall. METHODS We conducted secondary analysis on: (1) data from a randomized clinical trial (RCT); and (2) the Population Assessment of Tobacco Use and Health (PATH) Study. Biomarkers analyzed included: total nicotine equivalents (TNE); 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol and its glucuronides (total NNAL); N'-nitrosonornicotine and its N-glucuronide (total NNN);3-hydroxypropylmercapturic acid(3-HPMA); 2-hydroxypropylmercapturic acid (2-HPMA), 3-hydroxy-1 methylpropylmercapturic acid (HMPMA); S-phenylmercapturic acid(SPMA); 2-cyanoethylmercapturic acid (CEMA); phenanthrene tetraol(PheT);1-hydroxypyrene (1-HOP);8-iso-PGF2α; white blood count(WBC); prostaglandin E metabolite(PGEM); and high sensitivity C-reactive protein(hsCRP). RESULTS AS smokers did not differ in TNE but had higher TNE per cigarette compared to other brands. Total NNAL, total NNN, CEMA, and 3-HPMA were lower in AS smokers. All other biomarkers were no different in AS smokers compared to all or the majority of the other brands. CONCLUSIONS Levels of total NNAL, total NNN, acrylonitrile, and acrolein were reduced in AS smokers; however, it is not known whether reductions in exposure to these toxicants contribute to reduced harm. Higher TNE per cigarette smoked in AS smokers suggests a greater addictive potential compared to other brands. Regulatory action to ensure that consumers are not misled about the risks of the AS brand are recommended.
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Affiliation(s)
- Dana M Carroll
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Astia Allenzara
- Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Joni Jensen
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Stephen Hecht
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Sharon Murphy
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Xianghua Luo
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Eric Donny
- Wake Forest School of Medicine, Winston-Salem, NC
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Affiliation(s)
- Irina Stepanov
- Masonic Cancer Center and Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Alistair Woodward
- Department of Epidemiology and Biostatistics, University of Auckland, Auckland, New Zealand
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Ma B, Stepanov I, Hecht SS. Recent Studies on DNA Adducts Resulting from Human Exposure to Tobacco Smoke. Toxics 2019; 7:E16. [PMID: 30893918 PMCID: PMC6468371 DOI: 10.3390/toxics7010016] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 03/09/2019] [Accepted: 03/13/2019] [Indexed: 12/22/2022]
Abstract
DNA adducts are believed to play a central role in the induction of cancer in cigarette smokers and are proposed as being potential biomarkers of cancer risk. We have summarized research conducted since 2012 on DNA adduct formation in smokers. A variety of DNA adducts derived from various classes of carcinogens, including aromatic amines, polycyclic aromatic hydrocarbons, tobacco-specific nitrosamines, alkylating agents, aldehydes, volatile carcinogens, as well as oxidative damage have been reported. The results are discussed with particular attention to the analytical methods used in those studies. Mass spectrometry-based methods that have higher selectivity and specificity compared to 32P-postlabeling or immunochemical approaches are preferred. Multiple DNA adducts specific to tobacco constituents have also been characterized for the first time in vitro or detected in vivo since 2012, and descriptions of those adducts are included. We also discuss common issues related to measuring DNA adducts in humans, including the development and validation of analytical methods and prevention of artifact formation.
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Affiliation(s)
- Bin Ma
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Stephen S Hecht
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA.
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33
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Khariwala SS, Rubin N, Stepanov I, Nollen N, Ahluwalia JS, Nelson HH, Hatsukami DK. "Cold turkey" or pharmacotherapy: Examination of tobacco cessation methods tried among smokers prior to developing head and neck cancer. Head Neck 2019; 41:2332-2339. [PMID: 30770605 DOI: 10.1002/hed.25708] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 01/09/2019] [Accepted: 01/29/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Tobacco cessation methods employed by patients with head and neck cancer (HNSCC) are previously unstudied and have the potential to inform choice of cessation method and necessary abstinence support. METHODS A total of 130 current smokers with HNSCC were queried regarding prior unsuccessful tobacco cessation techniques, product used (cold turkey, varenicline, and nicotine patch/gum), and maximum time abstained from smoking. RESULTS One hundred six smokers retrospectively reported using one of the four main quit methods. Unassisted cessation ("cold turkey") was the most commonly used method (P < .001). A multiple ordinal logistic general estimating equation analysis revealed that cold turkey had increased odds [5.2 (95% confidence interval [CI]: 2.2, 11.8) and 4.3 (95% CI: 1.5, 12.9)] of achieving a longer quit duration than the nicotine patch or varenicline, respectively. CONCLUSIONS Among smokers developing HNSCC, previous cessation attempts were most commonly unassisted. This method was associated with longest abstinence periods. These data suggest insufficient support and education regarding behavioral and pharmacologic cessation therapies.
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Affiliation(s)
- Samir S Khariwala
- Department of Otolaryngology - Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota.,Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Nathan Rubin
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.,Department of Biostatistics, University of Minnesota, Minneapolis, Minnesota
| | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.,Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Nicole Nollen
- Department of Preventive Medicine and Public Health, University of Kansas, Kansas City, Kansas
| | - Jasjit S Ahluwalia
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence
| | - Heather H Nelson
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Dorothy K Hatsukami
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.,Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
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34
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Gupta PC, Ray CS, Papke RL, Stepanov I, Khariwala SS, Chaturvedi P, Gupte HA, Pednekar MS. Perspectives on areca nut with some global implications: Symposium report. Translational Research in Oral Oncology 2018. [DOI: 10.1177/2057178x18814068] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Areca nut and products made from the nut, evaluated by the International Agency for Research on Cancer as carcinogenic to humans since 2004, are being increasingly used in India and South East Asia and exported to many countries. There is thus an urgent need to identify best control policies and research gaps. On 1 February 2018, a group of experts shared their latest knowledge and perspectives on areca nut at Healis-Seksaria Institute for Public Health in Navi Mumbai, Maharashtra, India. By itself, areca nut has been implicated in oral and oesophageal cancer. Areca nut users are also at high risk of oral submucous fibrosis, a debilitating and potentially malignant condition. Users may also suffer adverse health outcomes due to smokeless tobacco, commonly mixed with areca nut. The use of areca nut commonly begins in childhood and often proceeds to use with tobacco. Gutka, a widely consumed, industrially made areca nut product containing tobacco, has been banned in all states and union territories of India, but it is still widely available. Areca nuts contain arecoline, an alkaloid that stimulates various brain receptors, promoting physical dependence. Areca nut alkaloids have also been implicated in carcinogenesis. Other chemicals, introduced during cultivation and processing of areca nuts, contribute to oral submucous fibrosis and cancer. The wide variety of products, different storage conditions and lack of regulation can lead to significant variation in the content of toxicants, carcinogens and alkaloids, making the psychological and physical dependence issues even more challenging. Regulation of product contents is needed as a part of control measures to supplement product bans.
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Affiliation(s)
- Prakash C. Gupta
- Healis Sekhsaria Institute for Public Health, Navi Mumbai, Maharashtra, India
| | - Cecily S. Ray
- Healis Sekhsaria Institute for Public Health, Navi Mumbai, Maharashtra, India
| | - Roger L. Papke
- University of Florida College of Medicine, Gainesville, FL, USA
| | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Samir S. Khariwala
- Division of Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA
| | | | | | - Mangesh S. Pednekar
- Healis Sekhsaria Institute for Public Health, Navi Mumbai, Maharashtra, India
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35
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Cigan SS, McGovern PM, Choudhary K, Miller NC, Georgieff M, Rao R, Stepanov I. Toenail manganese as a potential biomarker for in utero and early childhood exposure studies. Sci Rep 2018; 8:17034. [PMID: 30451873 PMCID: PMC6242873 DOI: 10.1038/s41598-018-35112-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 10/26/2018] [Indexed: 12/31/2022] Open
Abstract
Elevated in utero and early childhood exposure to manganese may have adverse effects on neurodevelopment. We conducted preliminary analyses to evaluate toenails as a matrix for investigating manganese exposure in infants. Infant and maternal toenail and hair samples were collected from 25 infants (7 months old) and their mothers. A subset of mothers was recruited in the third trimester of pregnancy and some also provided pre-natal toenail, hair, and blood samples, cord blood, and additional post-natal samples. Collected samples were analyzed by inductively coupled plasma mass-spectrometry. Toenail manganese levels in infants ranged from below the limit of detection (LOD) to 2.80 µg/g. Only 1 toenail sample and 4 hair samples contained levels of manganese below LOD. Associations between infant and maternal biomarkers were not statistically significant. Analysis of multiple post-natal toenail samples from a single infant-mother pair showed an increase in the infant’s toenail manganese and a decrease in maternal toenail manganese over the first year of the infant’s life. Overall, our findings suggest that toenails may serve as a valuable biological matrix for measuring manganese exposure in newborns and infants; however, additional studies are needed to determine the impact of the timing of toenail sample collection on its utility in assessing early life exposure and health outcomes.
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Affiliation(s)
- Shannon S Cigan
- School of Public Health, Division of Environmental Health Sciences, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Patricia M McGovern
- School of Public Health, Division of Environmental Health Sciences, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Kriti Choudhary
- School of Public Health, Division of Environmental Health Sciences, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Neely C Miller
- School of Public Health, Division of Environmental Health Sciences, University of Minnesota, Minneapolis, MN, 55455, USA.,Medical School and Department of Pediatrics, Division of Neonatology, University of Minnesota, Minneapolis, MN, 55454, USA.,Center for Neurobehavioral Development, University of Minnesota, Minneapolis, MN, 55414, USA
| | - Michael Georgieff
- Medical School and Department of Pediatrics, Division of Neonatology, University of Minnesota, Minneapolis, MN, 55454, USA.,Center for Neurobehavioral Development, University of Minnesota, Minneapolis, MN, 55414, USA
| | - Raghavendra Rao
- Medical School and Department of Pediatrics, Division of Neonatology, University of Minnesota, Minneapolis, MN, 55454, USA
| | - Irina Stepanov
- School of Public Health, Division of Environmental Health Sciences, University of Minnesota, Minneapolis, MN, 55455, USA. .,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA.
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36
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Singhavi H, Ahluwalia JS, Stepanov I, Gupta PC, Gota V, Chaturvedi P, Khariwala SS. Tobacco carcinogen research to aid understanding of cancer risk and influence policy. Laryngoscope Investig Otolaryngol 2018; 3:372-376. [PMID: 30450409 PMCID: PMC6209619 DOI: 10.1002/lio2.204] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 07/03/2018] [Indexed: 12/11/2022] Open
Abstract
Education regarding the health effects associated with tobacco use has made important progress worldwide over the last few decades. Still, tobacco remains a significant cause of cancer and other diseases. As a result, significant worldwide morbidity and mortality is still attributable to tobacco use in modern times. Research into tobacco products, the carcinogens they contain, and how users metabolize them is an important benefit to the advancement of research aimed at reducing harm associated with tobacco use. This review summarizes the use of this type of research to study tobacco users’ risk of developing cancer, especially head and neck cancer. In addition, we discuss the use of tobacco research to provide support for increasing levels of federal regulation of tobacco products. Level of Evidence 4.
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Affiliation(s)
| | - Jasjit S Ahluwalia
- The School of Public Health Brown University Providence Rhode Island U.S.A
| | | | - Prakash C Gupta
- Healis-Sekhsaria Institute for Public Health Minneapolis Minnesota U.S.A
| | | | | | - Samir S Khariwala
- Department of Otolaryngology-Head and Neck Surgery University of Minnesota Minneapolis Minnesota U.S.A
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Abstract
The popularity of e-cigarettes is growing exponentially. Yet, the health risks associated with their use remain unclear, mainly due to the fact that they are not "one product", but a combination of ever-evolving designs, flavors, brands, and modes of use. Research needs to better understand how these variables affect toxicity.
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Affiliation(s)
- Silvia Balbo
- Masonic Cancer Center , University of Minnesota , 2231 Sixth St. SE , Minneapolis , Minnesota 55455 , United States
| | - Irina Stepanov
- Masonic Cancer Center , University of Minnesota , 2231 Sixth St. SE , Minneapolis , Minnesota 55455 , United States
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38
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Murphy SE, Park SL, Balbo S, Haiman CA, Hatsukami DK, Patel Y, Peterson LA, Stepanov I, Stram DO, Tretyakova N, Hecht SS, Le Marchand L. Tobacco biomarkers and genetic/epigenetic analysis to investigate ethnic/racial differences in lung cancer risk among smokers. NPJ Precis Oncol 2018; 2:17. [PMID: 30155522 PMCID: PMC6105591 DOI: 10.1038/s41698-018-0057-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 06/08/2018] [Accepted: 06/13/2018] [Indexed: 12/31/2022] Open
Abstract
The Multiethnic Cohort Study has demonstrated that African Americans and Native Hawaiians have a higher risk for lung cancer due to cigarette smoking than Whites while Latinos and Japanese Americans have a lower risk. These findings are consistent with other epidemiologic studies in the literature. In this review, we summarize tobacco carcinogen and toxicant biomarker studies and genetic analyses which partially explain these differences. As determined by measurement of total nicotine equivalents in urine, which account for about 85% of the nicotine dose, African Americans take up greater amounts of nicotine than Whites per cigarette while Japanese Americans take up less. There are corresponding differences in the uptake of tobacco smoke carcinogens such as tobacco-specific nitrosamines, polycyclic aromatic hydrocarbons, 1,3-butadiene, and other toxic volatiles. The lower nicotine uptake of Japanese Americans is clearly linked to the preponderance of low activity forms of the primary nicotine metabolizing enzyme CYP2A6 in this ethnic group, leading to more unchanged nicotine in the body and thus lower smoking intensity. But the relatively high risk of Native Hawaiians and the low risk of Latino smokers for lung cancer are not explained by these factors. The possible role of epigenetics in modifying lung cancer risk among smokers is also discussed here. The results of these published studies may lead to a better understanding of susceptibility factors for lung cancer in cigarette smokers thus potentially identifying biomarkers that can detect those individuals at highest risk so that preventive approaches can be initiated at an early stage of the lung cancer development process.
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Affiliation(s)
- Sharon E. Murphy
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455 USA
| | - Sungshim Lani Park
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90089 USA
| | - Silvia Balbo
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455 USA
| | - Christopher A. Haiman
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90089 USA
| | | | - Yesha Patel
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90089 USA
| | - Lisa A. Peterson
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455 USA
| | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455 USA
| | - Daniel O. Stram
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90089 USA
| | - Natalia Tretyakova
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455 USA
| | - Stephen S. Hecht
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455 USA
| | - Loïc Le Marchand
- Cancer Research Center of Hawaii, University of Hawaii, Honolulu, HI 96813 USA
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Bustamante G, Ma B, Yakovlev G, Yershova K, Le CT, Jensen J, Hatsukami D, Stepanov I. Presence of the Carcinogen N'-Nitrosonornicotine in Saliva of E-cigarette Users. Chem Res Toxicol 2018; 31:731-738. [PMID: 30019582 PMCID: PMC8556657 DOI: 10.1021/acs.chemrestox.8b00089] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Many harmful constituents are present in e-cigarettes at much lower levels than in cigarette smoke, and the results of analysis of urinary biomarkers in e-cigarette users are consistent with these findings. However, understanding the health effects of chronic exposures to e-cigarette aerosols may require thinking beyond these comparisons. In this study, we investigated the endogenous formation of the tobacco-specific oral and esophageal carcinogen N'-nitrosonornicotine (NNN) in e-cigarette users. Salivary NNN, nornicotine, and nicotine as well as urinary tobacco biomarkers, including total NNN, were analyzed in 20 e-cigarette users, 20 smokers, and 19 nonsmokers. Nornicotine and NNN levels in e-cigarettes used by the study participants were also analyzed. The mean of NNN in saliva of e-cigarette users was 14.6 (±23.1) pg/mL, ranging from nonquantifiable (below the limit of quantitation, LOQ) to 76.0 pg/mL. In smokers, salivary NNN ranged from below LOQ to 739 pg/mL, with 80% of smokers having salivary NNN in the range of levels found in e-cigarette users. Consistent with a previous report, very low levels of urinary total NNN were present in only 5 out of 20 e-cigarette users (ranging from 0.001 to 0.01 pmol/mL urine). Only trace levels of NNN were found in e-cigarette liquids. Together, our findings demonstrate that NNN is formed endogenously in e-cigarette users. While the overall exposure to NNN in e-cigarette users is dramatically lower than in smokers, the known carcinogenic potency of NNN warrants further investigations into the potential consequences of its endogenous formation. Salivary NNN, rather than urinary total NNN, which accounts for only 1-3% of the NNN dose, should be used to monitor e-cigarette users' exposure to this carcinogen.
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Affiliation(s)
- Gabriela Bustamante
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota 55455, USA
- School of Medicine, Universidad San Francisco de Quito, Quito, 170157, Ecuador
| | - Bin Ma
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - Galina Yakovlev
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - Katrina Yershova
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - Chap T. Le
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - Joni Jensen
- Tobacco Research Programs, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - Dorothy Hatsukami
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota 55455, USA
- Tobacco Research Programs, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - Irina Stepanov
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota 55455, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota 55455, USA
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40
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Kelley DE, Boynton MH, Noar SM, Morgan JC, Mendel JR, Ribisl KM, Stepanov I, Nylander-French LA, Brewer NT. Effective Message Elements for Disclosures About Chemicals in Cigarette Smoke. Nicotine Tob Res 2018; 20:1047-1054. [PMID: 28521063 PMCID: PMC6093311 DOI: 10.1093/ntr/ntx109] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 05/12/2017] [Indexed: 11/13/2022]
Abstract
Introduction Cigarette smoke contains at least 93 chemicals or "constituents" that the Food and Drug Administration has identified as harmful and potentially harmful constituents to human health. Our study sought to identify which constituent disclosure message elements are most effective in discouraging people from smoking. Methods Three hundred eighty eight current smokers aged 18 and older completed an online survey in February 2015. We randomized participants to respond to one of two sets of 13 toxic products that contain cigarette constituents and 25 health effects associated with cigarette constituents. Results Products that elicited the most discouragement were those with lower chances of exposure (e.g., explosives), followed by products with possible exposure (e.g., rat poison), and products with a high likelihood of exposure (e.g., floor cleaner). Awareness of toxic products that constituents are found in (p < .001) and low exposure products (p < .001) were associated with higher discouragement. Health effects that people had heard are caused by cigarette smoke constituents elicited higher discouragement from smoking cigarettes (p < .001). Cancer was associated with higher discouragement relative to respiratory, cardiovascular, and reproductive health effects (all p < .001). Conclusions Cigarette smoke constituent messages may be more effective at discouraging smoking if they include information about carcinogenic health effects (e.g., mouth cancer and lung tumors) and low exposure toxic products (e.g., explosives and radioactive material) as message elements. Implications Our study identified health effects and toxic products, especially cancers and rarely encountered toxic products, that may discourage smoking when included in disclosure messages. By constructing messages that communicate the harms associated with tobacco use by contextualizing those harms in terms of specific constituents, tobacco education messaging efforts may be increasingly successful.
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Affiliation(s)
- Dannielle E Kelley
- School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Marcella H Boynton
- Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Seth M Noar
- School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jennifer C Morgan
- Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jennifer R Mendel
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Kurt M Ribisl
- Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Irina Stepanov
- Division of Environmental Health Sciences, Department of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Leena A Nylander-French
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Noel T Brewer
- Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Abstract
Behavioral economic methods allow experimental manipulation of price and examination of its effects on tobacco product purchasing. These methods may be used to examine tobacco product abuse liability and to prospectively model possible effects of price regulation. In the present study, we examined multiple measures of behavioral economic demand for cigarettes and e-liquid for use in a second-generation electronic cigarette (e-cigarette) in e-cigarette-naïve cigarette smokers. Twenty-five smokers received an e-cigarette (eGo ONE CT), sampled study e-liquid (24 mg/mL nicotine), and completed recurring sessions in which they used an experimental income to purchase real-world supplies of cigarettes and/or e-liquid. Participants also completed self-report measures of drug effects/liking. When products were available alone, we observed lower demand for e-liquid than for cigarettes. This effect was magnified when cigarettes and e-liquid were available concurrently. In additional assessments, e-liquid served as a partial substitute for cigarettes, but cigarettes did not serve as a substitute for e-liquid. Finally, participants rated e-liquid more poorly than cigarettes on several dimensions of drug effects/liking (any effects, liking, desire, and probability of continued use). We conclude that e-cigarette-naïve smokers value cigarettes more highly than e-liquid across multiple contexts and measurements. Nonetheless, participants still valued e-liquid positively and purchased it frequently, both as a substitute for cigarettes and independently of cigarettes. To understand the variables that influence transitions from exclusive smoking to either dual cigarette/e-cigarette use or exclusive e-cigarette use, future work should systematically examine the role of duration of e-liquid exposure. (PsycINFO Database Record
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Affiliation(s)
- Jeffrey S Stein
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute
| | - Mikhail N Koffarnus
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute
| | - Irina Stepanov
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota
| | | | - Warren K Bickel
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute
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Harris AC, Muelken P, Smethells JR, Yershova K, Stepanov I, Olson TT, Kellar KJ, LeSage MG. Effects of nicotine-containing and "nicotine-free" e-cigarette refill liquids on intracranial self-stimulation in rats. Drug Alcohol Depend 2018; 185:1-9. [PMID: 29413432 PMCID: PMC5889751 DOI: 10.1016/j.drugalcdep.2017.11.032] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 11/10/2017] [Accepted: 11/30/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Animal models are needed to inform FDA regulation of electronic cigarettes (ECs) because they avoid limitations associated with human studies. We previously reported that an EC refill liquid produced less aversive/anhedonic effects at a high nicotine dose than nicotine alone as measured by elevations in intracranial self-stimulation (ICSS) thresholds, which may reflect the presence of behaviorally active non-nicotine constituents (e.g., propylene glycol) in the EC liquids. The primary objective of this study was to assess the generality of our prior ICSS findings to two additional EC liquids. We also compared effects of "nicotine-free" varieties of these EC liquids on ICSS, as well as binding affinity and/or functional activity of nicotine alone, nicotine-containing EC liquids, and "nicotine-free" EC liquids at nicotinic acetylcholine receptors (nAChRs). METHODS AND RESULTS Nicotine alone and nicotine dose-equivalent concentrations of both nicotine-containing EC liquids produced similar lowering of ICSS thresholds at low to moderate nicotine doses, indicating similar reinforcement-enhancing effects. At high nicotine doses, nicotine alone elevated ICSS thresholds (a measure of anhedonia-like behavior) while the EC liquids did not. Nicotine-containing EC liquids did not differ from nicotine alone in terms of binding affinity or functional activity at nAChRs. "Nicotine-free" EC liquids did not affect ICSS, but bound with low affinity at some (e.g., α4ß2) nAChRs. CONCLUSIONS These findings suggest that non-nicotine constituents in these EC liquids do not contribute to their reinforcement-enhancing effects. However, they may attenuate nicotine's acute aversive/anhedonic and/or toxic effects, which may moderate the abuse liability and/or toxicity of ECs.
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Affiliation(s)
- Andrew C. Harris
- Department of Medicine, Minneapolis Medical Research Foundation, Minneapolis, MN, USA,Department of Medicine, University of Minnesota, Minneapolis, MN, USA,Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Peter Muelken
- Department of Medicine, Minneapolis Medical Research Foundation, Minneapolis, MN, USA
| | - John R. Smethells
- Department of Medicine, Minneapolis Medical Research Foundation, Minneapolis, MN, USA,Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Katrina Yershova
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Thao Tran Olson
- Department of Pharmacology and Physiology, Georgetown University School of Medicine, Washington, DC, USA
| | - Kenneth J. Kellar
- Department of Pharmacology and Physiology, Georgetown University School of Medicine, Washington, DC, USA
| | - Mark G. LeSage
- Department of Medicine, Minneapolis Medical Research Foundation, Minneapolis, MN, USA,Department of Medicine, University of Minnesota, Minneapolis, MN, USA,Department of Psychology, University of Minnesota, Minneapolis, MN, USA
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Murphy SE, vonWeymarn LB, Parenteau M, Stepanov I, Tiirikainen M, Le Marchand L, Park SL. Influence of UGT2B10 Genotype on Urinary Excretion of 4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanol- N-glucuronide by African American Smokers. Chem Res Toxicol 2018; 31:168-175. [PMID: 29460622 PMCID: PMC6058729 DOI: 10.1021/acs.chemrestox.7b00264] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
At similar smoking levels, African American's lung cancer risk is as much as twice that of whites. We hypothesized that racial/ethnic differences in UDP-glucuronosyltransferase (UGT)-catalyzed glucuronidation of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), a detoxication pathway for the tobacco-specific lung carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) may contribute to this variable risk. UGT2B10 catalyzes NNAL- N-glucuronidation, and a UGT2B10 splice variant is common among African Americans. Smokers from two independent studies were genotyped for this variant (rs116294140) and an Asp67Tyr variant (rs61750900), and urinary NNAL and NNAL-glucuronide concentrations were quantified. In the first, no significant differences in NNAL- N-glucuronidation between African Americans ( n = 257) and whites ( n = 354) or between homozygous carriers of UGT2B10 variants (genetic score 2) and noncarriers (score 0) were detected. However, total NNAL glucuronidation by score 2 compared to score 0 smokers was lower (68.9 vs 71.2%, p < 0.0001). For NNAL- N-glucuronide to be more precisely quantified in a second study, a sensitive high-resolution LC-MS/MS-based method, which separated NNAL, NNAL- O-glucuronide, and NNAL- N-glucuronide prior to analysis, was developed. In this study, the excretion of total NNAL (free plus glucuronides) by African American ( n = 52) and white ( n = 54) smokers was not different; however, total NNAL glucuronidation by African Americans (64.0%) was slightly less than by whites (68.3%, p = 0.05). The mean NNAL- N-glucuronidation by African Americans was much lower than for whites (14 vs 24.9%, p < 0.00001), but the NNAL- O-glucuronidation was greater (50.0 vs 43.3%, p = 0.013). UGT2B10 genotype influenced NNAL- N-glucuronidation; the geometric mean percentage N-glucuronidation was 22.5% for smokers with genetic score 0 ( n = 57) and 11.2% for score 2 ( n = 11). In summary, the high prevalence of a UGT2B10 splice variant among African Americans results in lower NNAL- N-glucuronidation but only a small decrease in total NNAL glucuronidation. Therefore, despite the significant contribution of UGT2B10 to NNAL- N-glucuronidation, the UGT2B10 genotype does not play a large role in NNAL detoxication. Any decrease in N-glucuronidation was accompanied by a parallel increase in O-glucuronidation.
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Affiliation(s)
- Sharon E. Murphy
- Department of Biochemistry Molecular Biology and Biophysics and Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455 USA
| | - Linda B. vonWeymarn
- Department of Biochemistry Molecular Biology and Biophysics and Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455 USA
| | - Marc Parenteau
- Department of Biochemistry Molecular Biology and Biophysics and Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455 USA
| | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455 USA
| | - Maarit Tiirikainen
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, 96813 USA
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, 96813 USA
| | - Sungshim L. Park
- Department of Preventive Medicine, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089 USA
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Ma B, Zarth AT, Carlson ES, Villalta PW, Upadhyaya P, Stepanov I, Hecht SS. Identification of more than 100 structurally unique DNA-phosphate adducts formed during rat lung carcinogenesis by the tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone. Carcinogenesis 2018; 39:232-241. [PMID: 29194532 PMCID: PMC5862267 DOI: 10.1093/carcin/bgx135] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 10/25/2017] [Accepted: 11/25/2017] [Indexed: 02/01/2023] Open
Abstract
The tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) is a powerful lung carcinogen in animal models and is considered a causative factor for lung cancer in people who use tobacco products. NNK undergoes metabolic activation-a critical step in its mechanism of carcinogenesis-to an intermediate which reacts with DNA to form pyridyloxobutyl DNA base and phosphate adducts. Another important metabolic pathway of NNK is its conversion to 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), which similarly forms pyridylhydroxybutyl DNA base adducts that have been characterized previously. In this study, we investigated the potential formation of pyridylhydroxybutyl DNA phosphate adducts. We report the characterization and quantitation of 107 structurally unique pyridylhydroxybutyl DNA phosphate adducts in the lungs of rats treated chronically with a carcinogenic dose of 5 ppm of NNK in their drinking water for up to 70 weeks, by using a novel liquid chromatography-nanoelectrospray ionization-high-resolution tandem mass spectrometry method. Our findings demonstrate that pyridylhydroxybutyl phosphate adducts account for 38-55 and 34-40% of all the measured pyridine-containing DNA adducts in rat lung and liver, respectively, upon treatment with NNK. Some of the pyridylhydroxybutyl DNA phosphate adducts persisted in both tissues for over 70 weeks, suggesting that they could be potential biomarkers of chronic exposure to NNK and NNAL. This study provides comprehensive characterization and relative quantitation of a panel of NNK/NNAL-derived DNA phosphate adducts, thus identifying NNK as the source of the most structurally diverse set of DNA adducts identified to date from any carcinogen.
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Affiliation(s)
- Bin Ma
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Adam T Zarth
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Erik S Carlson
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Peter W Villalta
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Pramod Upadhyaya
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Stephen S Hecht
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
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45
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Ma B, Zarth AT, Carlson ES, Villalta PW, Upadhyaya P, Stepanov I, Hecht SS. Methyl DNA Phosphate Adduct Formation in Rats Treated Chronically with 4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanone and Enantiomers of Its Metabolite 4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanol. Chem Res Toxicol 2018; 31:48-57. [PMID: 29131934 PMCID: PMC5770887 DOI: 10.1021/acs.chemrestox.7b00281] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Indexed: 11/29/2022]
Abstract
The tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) is a powerful lung carcinogen in animal models and is considered a causative factor for lung cancer in tobacco users. NNK is stereoselectively and reversibly metabolized to 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), which is also a lung carcinogen. Both NNK and NNAL undergo metabolic activation by α-hydroxylation on their methyl groups to form pyridyloxobutyl and pyridylhydroxybutyl DNA base and phosphate adducts, respectively. α-Hydroxylation also occurs on the α-methylene carbons of NNK and NNAL to produce methane diazohydroxide, which reacts with DNA to form methyl DNA base adducts. DNA adducts of NNK and NNAL are important in their mechanisms of carcinogenesis. In this study, we characterized and quantified methyl DNA phosphate adducts in the lung of rats treated with 5 ppm of NNK, (S)-NNAL, or (R)-NNAL in drinking water for 10, 30, 50, and 70 weeks, by using a novel liquid chromatography-nanoelectrospray ionization-high resolution tandem mass spectrometry method. A total of 23, 21, and 22 out of 32 possible methyl DNA phosphate adducts were detected in the lung tissues of rats treated with NNK, (S)-NNAL, and (R)-NNAL, respectively. Levels of the methyl DNA phosphate adducts were 2290-4510, 872-1120, and 763-1430 fmol/mg DNA, accounting for 15-38%, 8%, and 5-9% of the total measured DNA adducts in rats treated with NNK, (S)-NNAL, and (R)-NNAL, respectively. The methyl DNA phosphate adducts characterized in this study further enriched the diversity of DNA adducts formed by NNK and NNAL. These results provide important new data regarding NNK- and NNAL-derived DNA damage and new insights pertinent to future mechanistic and biomonitoring studies of NNK, NNAL, and other chemical methylating agents.
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Affiliation(s)
- Bin Ma
- Masonic Cancer Center, University of Minnesota, 2231 Sixth Street SE, 2-152 CCRB, Minneapolis, Minnesota 55455, United States
| | - Adam T. Zarth
- Masonic Cancer Center, University of Minnesota, 2231 Sixth Street SE, 2-152 CCRB, Minneapolis, Minnesota 55455, United States
| | - Erik S. Carlson
- Masonic Cancer Center, University of Minnesota, 2231 Sixth Street SE, 2-152 CCRB, Minneapolis, Minnesota 55455, United States
| | - Peter W. Villalta
- Masonic Cancer Center, University of Minnesota, 2231 Sixth Street SE, 2-152 CCRB, Minneapolis, Minnesota 55455, United States
| | - Pramod Upadhyaya
- Masonic Cancer Center, University of Minnesota, 2231 Sixth Street SE, 2-152 CCRB, Minneapolis, Minnesota 55455, United States
| | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, 2231 Sixth Street SE, 2-152 CCRB, Minneapolis, Minnesota 55455, United States
| | - Stephen S. Hecht
- Masonic Cancer Center, University of Minnesota, 2231 Sixth Street SE, 2-152 CCRB, Minneapolis, Minnesota 55455, United States
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46
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Ma B, Zarth AT, Carlson ES, Villalta PW, Stepanov I, Hecht SS. Pyridylhydroxybutyl and pyridyloxobutyl DNA phosphate adduct formation in rats treated chronically with enantiomers of the tobacco-specific nitrosamine metabolite 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol. Mutagenesis 2017; 32:561-570. [PMID: 29186507 PMCID: PMC5907908 DOI: 10.1093/mutage/gex031] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 10/17/2017] [Indexed: 01/24/2023] Open
Abstract
The tobacco-specific lung carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) is metabolically converted to 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) in a reaction which is both stereoselective and reversible. NNAL is also a lung carcinogen, with both (R)-NNAL and (S)-NNAL inducing a high incidence of lung tumours in rats. Both NNAL and NNK undergo metabolic activation to intermediates which react with DNA to form pyridylhydroxybutyl and pyridyloxobutyl DNA adducts, respectively. DNA adduct formation by NNAL and NNK is an important step in their mechanisms of carcinogenesis. In this study, we quantified both pyridylhydroxybutyl and pyridyloxobutyl DNA phosphate adducts in the lung of rats treated with 5 ppm of (R)-NNAL or (S)-NNAL in drinking water for 10, 30, 50 and 70 weeks. In (R)-NNAL-treated rats, the pyridylhydroxybutyl and pyridyloxobutyl phosphate adducts were 4530-6920 fmol/mg DNA and 46-175 fmol/mg DNA, accounting for 45-51% and 0.3-1% of the total measured DNA phosphate and base adducts, respectively. In (S)-NNAL-treated rats, the two types of phosphate adducts were 3480-4180 fmol/mg DNA and 1180-4650 fmol/mg DNA, accounting for 30-36% and 11-38% of the total adducts, respectively. Distinct patterns of adduct formation were observed, with higher levels of NNAL-derived pyridylhydroxybutyl phosphate adducts and lower levels of NNK-derived pyridyloxobutyl phosphate adducts in the (R)-NNAL treatment group than the (S)-NNAL group. The persistence and increase over time of certain pyridylhydroxybutyl phosphate adducts over the course of the study suggest that these adducts could be useful biomarkers of chronic exposure to NNAL and NNK. The results of this study provide important new information regarding DNA damage by NNAL and NNK, and contribute to understanding mechanisms of tobacco-related carcinogenesis.
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Affiliation(s)
- Bin Ma
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Adam T Zarth
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Erik S Carlson
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Peter W Villalta
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Stephen S Hecht
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
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Khariwala SS, Ma B, Ruszczak C, Carmella SG, Lindgren B, Hatsukami DK, Hecht SS, Stepanov I. High Level of Tobacco Carcinogen-Derived DNA Damage in Oral Cells Is an Independent Predictor of Oral/Head and Neck Cancer Risk in Smokers. Cancer Prev Res (Phila) 2017; 10:507-513. [PMID: 28679497 PMCID: PMC5712492 DOI: 10.1158/1940-6207.capr-17-0140] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 06/06/2017] [Accepted: 06/30/2017] [Indexed: 02/07/2023]
Abstract
Exposure to tobacco-specific nitrosamines (TSNA) and polycyclic aromatic hydrocarbons (PAH) is recognized to play an important role in the development of oral/head and neck squamous cell cancer (HNSCC). We recently reported higher levels of TSNA-associated DNA adducts in the oral cells of smokers with HNSCC as compared with cancer-free smokers. In this study, we further investigated the tobacco constituent exposures in the same smokers to better understand the potential causes for the elevated oral DNA damage in smokers with HNSCC. Subjects included cigarette smokers with HNSCC (cases, n = 30) and cancer-free smokers (controls, n = 35). At recruitment, tobacco/alcohol use questionnaires were completed, and urine and oral cell samples were obtained. Analysis of urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and N'-Nitrosonornicotine (NNN; TSNA biomarkers), 1-hydroxypyrene (1-HOP, a PAH), cotinine, 3'-hydroxycotinine, and the nicotine metabolite ratio (NMR) were performed. Cases and controls differed in mean age, male preponderance, and frequency of alcohol consumption (but not total alcoholic drinks). Univariate analysis revealed similar levels of NNN, 1-HOP, and cotinine between groups but, as reported previously, significantly higher DNA adduct formation in the cases. Multiple regression adjusting for potential confounders showed persistent significant difference in DNA adduct levels between cases and controls [ratio of geometric means, 20.0; 95% CI, 2.7-148.6). Our cohort of smokers with HNSCC demonstrates higher levels of TSNA-derived oral DNA damage in the setting of similar exposure to nicotine and tobacco carcinogens. Among smokers, DNA adduct formation may act as a predictor of eventual development of HNSCC that is independent of carcinogen exposure indicators. Cancer Prev Res; 10(9); 507-13. ©2017 AACRSee related editorial by Johnson and Bauman, p. 489.
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Affiliation(s)
- Samir S Khariwala
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota.
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Bin Ma
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Chris Ruszczak
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Steven G Carmella
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Bruce Lindgren
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | | | - Stephen S Hecht
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
- Environmental Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
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Morgan JC, Byron MJ, Baig SA, Stepanov I, Brewer NT. A response from Morgan, Byron, Baig, Stepanov and Brewer. J Behav Med 2017; 40:684. [PMID: 28612097 PMCID: PMC5538370 DOI: 10.1007/s10865-017-9865-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 05/29/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Jennifer C Morgan
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - M Justin Byron
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Sabeeh A Baig
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Irina Stepanov
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
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49
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Morgan JC, Byron MJ, Baig SA, Stepanov I, Brewer NT. How people think about the chemicals in cigarette smoke: a systematic review. J Behav Med 2017; 40:553-564. [PMID: 28224264 PMCID: PMC5501992 DOI: 10.1007/s10865-017-9823-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 01/04/2017] [Indexed: 11/24/2022]
Abstract
Laws and treaties compel countries to inform the public about harmful chemicals (constituents) in cigarette smoke. To encourage relevant research by behavioral scientists, we provide a primer on cigarette smoke toxicology and summarize research on how the public thinks about cigarette smoke chemicals. We systematically searched PubMed in July 2016 and reviewed citations from included articles. Four central findings emerged across 46 articles that met inclusion criteria. First, people were familiar with very few chemicals in cigarette smoke. Second, people knew little about cigarette additives, assumed harmful chemicals are added during manufacturing, and perceived cigarettes without additives to be less harmful. Third, people wanted more information about constituents. Finally, well-presented chemical information increased knowledge and awareness and may change behavior. This research area is in urgent need of behavioral science. Future research should investigate whether educating the public about these chemicals increases risk perceptions and quitting.
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Affiliation(s)
- Jennifer C Morgan
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 325 Rosenau Hall CB7440, Chapel Hill, NC, 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - M Justin Byron
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 325 Rosenau Hall CB7440, Chapel Hill, NC, 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Sabeeh A Baig
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 325 Rosenau Hall CB7440, Chapel Hill, NC, 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Irina Stepanov
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 325 Rosenau Hall CB7440, Chapel Hill, NC, 27599, USA.
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
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50
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Stepanov I, Gupta PC, Parascandola M, Yershova K, Jain V, Dhumal G, Hatsukami DK. Constituent Variations in Smokeless Tobacco Purchased in Mumbai, India. TOB REGUL SCI 2017; 3:305-314. [PMID: 34734108 PMCID: PMC8562702 DOI: 10.18001/trs.3.3.6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Worldwide, smokeless tobacco products vary greatly in their formulations and chemical composition. Understanding of toxic and carcinogenic constituent variations in such products can provide valuable insights for the development of effective tobacco control policies. In this study, we applied a standardized protocol to collect and analyze smokeless products sold in Mumbai, India. METHODS Tobacco products were purchased at three markets in Mumbai, using standardized protocol for sample collection, labeling, and storage. Moisture content, pH, total and unprotonated nicotine, and five tobacco-specific N-nitrosamines (TSNA) were analyzed by validated methods. RESULTS We purchased 39 samples representing eight varieties of manufactured and vendor-made smokeless tobacco products. Total nicotine ranged from 5.3 to 57.8 mg/g dry weight. Unprotonated nicotine content varied from 0.13% to 99.8% of total nicotine. Total TSNA content ranged from 0.17 to 81.0 μg/g dry weight. When expressed per wet weight of product, unprotonated nicotine varied more than 300-fold and TSNA content varied more than 650-fold across the products. Substantial vendor-to-vendor variations were also observed. CONCLUSIONS Our findings emphasize the critical need for systematic smokeless tobacco surveillance in India, to improve understanding of exposures and cancer risks in users of these products.
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Affiliation(s)
- Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Prakash C. Gupta
- Healis-Sekhsaria Institute for Public Health, Mumbai, Maharashtra, India
| | - Mark Parascandola
- Tobacco Control Research Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Katrina Yershova
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Vipin Jain
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Gauri Dhumal
- Healis-Sekhsaria Institute for Public Health, Mumbai, Maharashtra, India
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