Exposure to Toxicants Associated With Use and Transitions Between Cigarettes, e-Cigarettes, and No Tobacco.
Exposure to Toxicants Associated With Use and Transitions Between Cigarettes, e-Cigarettes, and No Tobacco.
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与香烟，电子烟和无烟草之间使用和过渡相关的有毒物质的暴露。
DOI：
10.1001/jamanetworkopen.2021.47891
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发表时间：
2022-02-01
影响因子：
13.8
通讯作者：
Khan AS
中科院分区：
文献类型：
--
作者：
Dai H;Benowitz NL;Achutan C;Farazi PA;Degarege A;Khan AS
当使用者在卷烟、电子烟、双重使用和不使用之间转换时，接触烟草相关有毒物质是否会发生变化？在这项大规模的纵向队列研究中，从香烟或双重使用到电子烟或不使用的转变与减少接触有毒物质有关。从只使用香烟到同时使用香烟和电子烟，与尿液中有毒生物标志物水平的降低无关。这些发现可为监管战略和公共卫生政策提供信息，以指导烟草使用者转向减少危害的过渡模式。本队列研究考察了在香烟、电子烟、双重使用和不使用之间过渡的成年烟草使用者在基线和1年随访期间尿液生物标志物的变化。在烟草使用者中，电子烟和卷烟之间的转换很常见，但关于转换烟草产品的健康后果的经验证据很少。研究在电子烟和香烟之间切换的成年烟草使用者在基线和1年随访期间尿液生物标志物的变化。本队列研究使用的数据来自烟草与健康研究人群评估的第1期（基线，2013年9月至2014年12月）和第2期（1年随访，2014年10月至2015年10月）。我们分析了自愿提供2波生物标本的美国成年人的概率样本子集。参与者在基线时被分为3个相互排斥的组：纯吸烟者、纯电子烟使用者和双重使用者。数据分析于2021年进行。有害和潜在有害的成分包括尼古丁代谢物、烟草特异性亚硝胺（TSNAs，包括4-（甲基亚硝胺）-1-（3-吡啶基）-1-丁醇[NNAL]）、金属、多环芳烃（PAHs）和挥发性有机化合物（VOCs）。使用多变量回归模型检查了55种尿暴露于有害和潜在有害成分的生物标志物（BOEs）的参与者内部变化。在3211名参与者（55.6%的女性、68.3%的白人、13.2%的黑人和11.8%的西班牙裔）的基线中，21.9%的纯香烟使用者、42.8%的纯电子烟使用者和62.1%的双烟使用者在随访时改变了产品使用（所有百分比都是加权的）。当使用者从纯卷烟过渡到纯电子烟使用时，尿中tsna、PAHs和VOCs浓度显著降低，NNAL降低92%，从平均168.4 pg/mg肌酐（95% CI, 102.3-277.1 pg/mg肌酐）降至12.9 pg/mg肌酐（95% CI, 6.4-25.7 pg/mg肌酐，P < 0.001）。当双用户过渡到专门使用电子烟时，类似的BOEs面板下降；NNAL水平下降96%，从平均143.4 pg/mg肌酐（95% CI, 86.7-237.0 pg/mg肌酐）降至6.3 pg/mg肌酐（95% CI, 3.5-11.4 pg/mg肌酐，P < .001）。尼古丁代谢物、tsna、PAHs和VOCs在基线纯电子烟使用者过渡到纯电子烟使用者或双烟使用者时显著增加。从完全使用香烟到双重使用香烟的转变与BOEs的显著减少无关。这项国家队列研究提供了从独家卷烟使用或双重使用过渡到独家电子烟使用相关的潜在危害降低的证据。电子烟倾向于通过双重使用来补充香烟，而不是在人群层面上戒烟。有必要在人群水平上持续监测BOE，评估产品过渡导致的BOE变化，并确定不良健康结果。
Does exposure to tobacco-related toxicants change when users transition between cigarette, e-cigarette, dual use, and no use? In this large-scale, longitudinal cohort study, transitions from cigarettes or dual use to e-cigarettes or no use were associated with reduced exposure to toxicants. Switching from exclusive cigarette use to dual use of cigarettes and e-cigarettes was not associated with a decrease in levels of toxicant biomarkers in urine. These findings may inform regulatory strategies and public health policies to guide tobacco users toward harm reduction transition patterns. This cohort study examines changes in urinary biomarkers between baseline and 1-year follow-up among adult tobacco users transitioning among cigarettes, e-cigarettes, dual use, and no use. Transitions between e-cigarettes and cigarettes are common among tobacco users, but empirical evidence on the health outcomes of switching tobacco products is scarce. To examine changes in urinary biomarkers between baseline and 1-year follow-up among adult tobacco users switching between e-cigarettes and cigarettes. This cohort study used data from wave 1 (baseline, September 2013 to December 2014) and wave 2 (1-year follow-up, October 2014 to October 2015) of the Population Assessment of Tobacco and Health Study. A subset of the probability sample of US adults who voluntarily provided biospecimens at 2 waves was analyzed. Participants were divided into 3 mutually exclusive groups at baseline: exclusive cigarette smokers, exclusive e-cigarette users, and dual users. Data analysis was performed in 2021. Harmful and potentially harmful constituents included nicotine metabolites, tobacco-specific nitrosamines (TSNAs; including 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol [NNAL]), metals, polycyclic aromatic hydrocarbons (PAHs), and volatile organic compounds (VOCs). Within-participant changes in 55 urinary biomarkers of exposure (BOEs) to harmful and potentially harmful constituents were examined using multivariable regression models. Among 3211 participants (55.6% women, 68.3% White, 13.2% Black, and 11.8% Hispanic) at baseline, 21.9% of exclusive cigarette users, 42.8% of exclusive e-cigarette users, and 62.1% of dual users changed product use at follow-up (all percentages are weighted). There was a significant reduction in urine concentrations of TSNAs, PAHs, and VOCs when users transitioned from exclusive cigarette to exclusive e-cigarette use, with a 92% decrease in NNAL, from a mean of 168.4 pg/mg creatinine (95% CI, 102.3-277.1 pg/mg creatinine) to 12.9 pg/mg creatinine (95% CI, 6.4-25.7 pg/mg creatinine; P < .001). A similar panel of BOEs decreased when dual users transitioned to exclusive e-cigarette use; NNAL levels decreased by 96%, from a mean of 143.4 pg/mg creatinine (95% CI, 86.7-237.0 pg/mg creatinine) to 6.3 pg/mg creatinine (95% CI, 3.5-11.4 pg/mg creatinine; P < .001). Nicotine metabolites, TSNAs, PAHs, and VOCs significantly increased when baseline exclusive e-cigarette users transitioned to exclusive cigarette use or dual use. Switching from exclusive cigarette use to dual use was not associated with significant decreases in BOEs. This national cohort study provides evidence on the potential harm reduction associated with transitioning from exclusive cigarette use or dual use to exclusive e-cigarette use. e-Cigarettes tend to supplement cigarettes through dual use instead of cessation at the population level. Continuous monitoring of BOE at the population level and assessment of BOE change by product transition are warranted, as well as defined adverse health outcomes.
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DOI：
10.1158/1055-9965.epi-16-0675
发表时间：
2017-03
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Chang CM;Edwards SH;Arab A;Del Valle-Pinero AY;Yang L;Hatsukami DK
通讯作者：
Hatsukami DK
影响因子：
39.2
作者：
Mirbolouk, Mohammadhassan;Charkhchi, Paniz;Blaha, Michael J.
通讯作者：
Blaha, Michael J.
DOI：
10.1093/ntr/ntaa180
发表时间：
2020-12-15
期刊：
Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
影响因子：
--
作者：
Dai H;Khan AS
通讯作者：
Khan AS
影响因子：
4.7
作者：
HECHT, SS;HOFFMANN, D
通讯作者：
HOFFMANN, D
影响因子：
5.2
作者：
Goniewicz ML;Boykan R;Messina CR;Eliscu A;Tolentino J
通讯作者：
Tolentino J