Tobacco Product Use Patterns, and Nicotine and Tobacco-Specific Nitrosamine Exposure: NHANES 1999–2012

Choi, Kelvin; Sabado, Melanie; El‐Toukhy, Sherine; Vogtmann, Emily; Freedman, Neal D.; Hatsukami, Dorothy K.

doi:10.1158/1055-9965.epi-17-0338

Cited by 25 publications

(12 citation statements)

References 15 publications

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“…Nonetheless, the results raise some concerns about uptake of MRTPs given that susceptibility is a risk factor for tobacco use behaviour. 41 This is concerning given the detrimental health effects of multiple (vs single) tobacco product use 42 and those of any tobacco use compared with non-use. 43 Among current tobacco users, MRTP marketing claims might encourage multiple tobacco product use.…”

Section: Discussionmentioning

confidence: 99%

Impact of modified risk tobacco product claims on beliefs of US adults and adolescents

El‐Toukhy

Baig²,

Jeong³

et al. 2018

Tob Control

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ObjectiveUnder US law, tobacco product marketing may claim lower exposure to chemicals, or lower risk of health harms, only if these claims do not mislead the public. We sought to examine the impact of such marketing claims about potential modified risk tobacco products (MRTPs).MethodsParticipants were national samples of 4797 adults and 969 adolescent US smokers and non-smokers. We provided information about a potential MRTP (heated tobacco product, electronic cigarette or snus). Experiment 1 stated that the MRTP was as harmful as cigarettes or less harmful (lower risk claim). Experiment 2 stated that the MRTP exposed users to a similar quantity of harmful chemicals as cigarettes or to fewer chemicals (lower exposure claim).ResultsClaiming lower risk led to lower perceived quantity of chemicals and lower perceived risk among adults and adolescents (all p<0.05, Experiment 1). Among adults, this claim led to higher susceptibility to using the MRTP (p<0.05). Claiming lower exposure led to lower perceived chemical quantity and lower perceived risk (all p<0.05), but had no effect on use susceptibility (Experiment 2). Participants thought that snus exposed users to more chemicals and was less safe to use than heated tobacco products or electronic cigarette MRTPs (Experiments 1 and 2).DiscussionRisk and exposure claims acted similarly on MRTP beliefs. Lower exposure claims misled the public to perceive lower perceived risk even though no lower risk claim was explicitly made, which is impermissible under US law.

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Section: Discussionmentioning

confidence: 99%

Impact of modified risk tobacco product claims on beliefs of US adults and adolescents

El‐Toukhy

Baig²,

Jeong³

et al. 2018

Tob Control

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“…The toxic constituents of smoke from combusted tobacco have been widely described and well characterized. 14–16 , 33–37 Other HPHCs are categorized as tobacco-specific nitrosamines, carbonyls, volatile organic compounds, polyaromatic hydrocarbons, and carbon monoxide. Select HPHCs have been identified by the FDA through published notice and guidance in accordance with Section 904 of the Food, Drug and Cosmetic Act.…”

Section: Discussionmentioning

confidence: 99%

Five-Day Changes in Biomarkers of Exposure Among Adult Smokers After Completely Switching From Combustible Cigarettes to a Nicotine-Salt Pod System

Jay¹,

Pfaunmiller

Huang³

et al. 2019

Nicotine &Amp; Tobacco Research

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Introduction This study examined changes in biomarkers of exposure (BoE) after 5 days of nicotine-salt pod system (NSPS) use, compared with continuation of usual-cigarette smoking and cigarette abstinence, among adult combustible cigarette smokers. Aims and Methods A randomized, open-label, parallel-cohort, confinement study of healthy adult smokers, naive to NSPS use, was conducted. Participants (N = 90) were randomized to six cohorts (n = 15 each): exclusive ad libitum use of NSPS (four flavors: Virginia Tobacco, Mint, Mango, Creme), continuation of usual-brand cigarette smoking, or cigarette abstinence. Total nicotine equivalents and BoE (NNN, NNAL, 3-HPMA, MHBMA, S-PMA, HMPMA, CEMA, 1-OHP, and COHb) were measured. Results Eight non-nicotine BoEs, measured in urine, were reduced by an aggregate of 85.0% in the pooled NSPS cohort; increased by 14.4% in the cigarette cohort (p < .001 for pooled NSPS vs. cigarette); and reduced by 85.3% in the abstinence cohort (p > .05; 99.6% relative reduction between pooled NSPS vs. abstinence). Similar changes in individual BoEs were also observed (p < .001 for each BoE between pooled NSPS vs. cigarettes; and abstinence vs. pooled NSPS; p > .05 for each BoE between pooled NSPS vs. abstinence). Blood COHb decreased by 71.8% in the pooled NSPS cohort and 69.1% in the abstinence cohort (p > .05) and increased by 13.3% in the cigarette cohort (p < .001). Mean total urine nicotine equivalents increased in the pooled NSPS and cigarette cohorts by 9% and 26%, respectively, and did not significantly differ (p > .05). Conclusion Complete switching from cigarettes to NSPS produced significant reductions in key non-nicotine BoEs associated with cigarette smoking. Implications The results of this study concorded with evidence that complete switching from combustible cigarettes to tobacco and nontobacco-flavored vapor products may reduce exposure to key carcinogens and other toxicants known to be associated with tobacco-related diseases. Future research is needed to assess the long-term health effects of NSPS use. These results should not be interpreted to mean that the use of NSPS is without any risk, particularly for nonusers of tobacco products.

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“…Dual use of tobacco products is also on the rise ( 21 , 22 ). The most recent surveillance data show that 3.7% (9 million) of adults ( 11 ), 11% (1.7 million) of high school students, and 2% (270,000) of middle school students ( 13 ) use two or more tobacco products.…”

Section: Tobacco Product Use and Nicotine Addictionmentioning

confidence: 99%

Current advances in research in treatment and recovery: Nicotine addiction

2019

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The health harms of combusted tobacco use are undeniable. With market and regulatory pressures to reduce the harms of nicotine delivery by combustion, the tobacco product landscape has diversified to include smokeless, heated, and electronic nicotine vaping products. Products of tobacco combustion are the main cause of smokinginduced disease, and nicotine addiction sustains tobacco use. An understanding of the biology and clinical features of nicotine addiction and the conditioning of behavior that occurs via stimuli paired with frequent nicotine dosing, as with a smoked cigarette, is important for informing pharmacologic and behavioral treatment targets. We review current advances in research on nicotine addiction treatment and recovery, with a focus on conventional combustible cigarette use. Our review covers evidence-based methods to treat smoking in adults and policy approaches to prevent nicotine product initiation in youth. In closing, we discuss emerging areas of evidence and consider new directions for advancing the field.

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Tobacco Product Use Patterns, and Nicotine and Tobacco-Specific Nitrosamine Exposure: NHANES 1999–2012

Cited by 25 publications

References 15 publications

Impact of modified risk tobacco product claims on beliefs of US adults and adolescents

Impact of modified risk tobacco product claims on beliefs of US adults and adolescents

Five-Day Changes in Biomarkers of Exposure Among Adult Smokers After Completely Switching From Combustible Cigarettes to a Nicotine-Salt Pod System

Current advances in research in treatment and recovery: Nicotine addiction

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