Comparison of Nicotine and Toxicant Exposure in Users of Electronic Cigarettes and Combustible Cigarettes
Comparison of Nicotine and Toxicant Exposure in Users of Electronic Cigarettes and Combustible Cigarettes
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DOI：
10.1001/jamanetworkopen.2018.5937
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发表时间：
2018-12-01
影响因子：
13.8
通讯作者：
Hyland, Andrew J.
中科院分区：
文献类型：
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作者：
Goniewicz, Maciej L.;Smith, Danielle M.;Hyland, Andrew J.
电子烟（e-cigarettes）的使用正在增加。电子烟使用者暴露于已知烟草相关毒物的措施将告知个体产品使用者潜在的健康风险。为了估计电子烟使用者中烟草相关毒物的浓度，并将这些生物标志物浓度与可燃香烟使用者、双重使用者和从不吸烟者中观察到的浓度进行比较。2013-2014年在美国进行了纵向队列研究。在2016年11月4日至2017年10月5日期间，对烟草与健康研究人口评估收集的烟草相关毒物暴露生物标志物进行了横断面分析。参与者包括提供尿液样本和烟草使用数据的成年人暴露主要暴露是烟草使用，包括目前的纯电子烟使用者（n = 247），目前的纯香烟吸烟者（n = 247），（n = 2411），这两种产品的用户（双重使用者）（n = 792）与从不吸烟者相比（n = 1655）.主要结果和测量测量来自5个主要类别的烟草产品成分的50个单独生物标志物的几何平均浓度：尼古丁、烟草特有的亚硝胺（TSNAs）、金属、多环芳烃（PAHs）和挥发性有机化合物（VOCs）。结果在5105名参与者中，大多数年龄在35至54岁之间（加权百分比，38%; 95% CI，35%-40%）、女性（60%; 95% CI，59%-62%）和非西班牙裔白色人（61%; 95% CI，58%-64%）。与纯电子烟使用者相比，从不使用电子烟的人暴露于尼古丁、TSNA、某些金属（如镉和铅）和某些VOC（包括丙烯腈）的生物标志物浓度显著降低19%至81%。与纯吸烟者相比，纯电子烟使用者暴露的生物标志物浓度显著降低10%至98%，包括TSNA，PAH，大多数VOC和尼古丁;金属和3种VOC的浓度相当。单独吸烟者的几种生物标志物浓度比双重吸烟者低10%至36%。双用户之间的香烟使用频率呈正相关尼古丁和有毒物质exposure.CONCLUSIONS AND RELEVANCE独家使用电子烟似乎会导致可测量的暴露于已知的烟草相关的有毒物质，一般在较低的水平比吸烟。双重使用者中的毒物暴露最大，可燃香烟使用频率与烟草毒物浓度呈正相关。这些发现提供了证据，表明与单独使用电子烟相比，单独使用燃烧的烟草卷烟或与电子烟结合使用与更高浓度的潜在有害烟草成分相关。
IMPORTANCE Use of electronic cigarettes (e-cigarettes) is increasing. Measures of exposure to known tobacco-related toxicants among e-cigarette users will inform potential health risks to individual product users.OBJECTIVES To estimate concentrations of tobacco-related toxicants among e-cigarette users and compare these biomarker concentrations with those observed in combustible cigarette users, dual users, and never tobacco users.DESIGN, SETTING, AND PARTICIPANTS A population-based, longitudinal cohort study was conducted in the United States in 2013-2014. Cross-sectional analysis was performed between November 4, 2016, and October 5, 2017, of biomarkers of exposure to tobacco-related toxicants collected by the Population Assessment of Tobacco and Health Study. Participants included adults who provided a urine sample and data on tobacco use (N = 5105).EXPOSURES The primary exposure was tobacco use, including current exclusive e-cigarette users (n = 247), current exclusive cigarette smokers (n = 2411), and users of both products (dual users) (n = 792) compared with never tobacco users (n = 1655).MAIN OUTCOMES AND MEASURES Geometric mean concentrations of 50 individual biomarkers from 5 major classes of tobacco product constituents were measured: nicotine, tobacco-specific nitrosamines (TSNAs), metals, polycyclic aromatic hydrocarbons (PAHs), and volatile organic compounds (VOCs).RESULTS Of the 5105 participants, most were aged 35 to 54 years (weighted percentage, 38%; 95% CI, 35%-40%), women (60%; 95% CI, 59%-62%), and non-Hispanic white (61%; 95% CI, 58%-64%). Compared with exclusive e-cigarette users, never users had 19% to 81% significantly lower concentrations of biomarkers of exposure to nicotine, TSNAs, some metals (eg, cadmium and lead), and some VOCs (including acrylonitrile). Exclusive e-cigarette users showed 10% to 98% significantly lower concentrations of biomarkers of exposure, including TSNAs, PAHs, most VOCs, and nicotine, compared with exclusive cigarette smokers; concentrations were comparable for metals and 3 VOCs. Exclusive cigarette users showed 10% to 36% lower concentrations of several biomarkers than dual users. Frequency of cigarette use among dual users was positively correlated with nicotine and toxicant exposure.CONCLUSIONS AND RELEVANCE Exclusive use of e-cigarettes appears to result in measurable exposure to known tobacco-related toxicants, generally at lower levels than cigarette smoking. Toxicant exposure is greatest among dual users, and frequency of combustible cigarette use is positively correlated with tobacco toxicant concentration. These findings provide evidence that using combusted tobacco cigarettes alone or in combination with e-cigarettes is associated with higher concentrations of potentially harmful tobacco constituents in comparison with using e-cigarettes alone.