Nicotine, Carcinogen, and Toxin Exposure in Long-Term E-Cigarette and Nicotine Replacement Therapy Users: A Cross-sectional Study.
Nicotine, Carcinogen, and Toxin Exposure in Long-Term E-Cigarette and Nicotine Replacement Therapy Users: A Cross-sectional Study.
复制标题
DOI：
10.7326/m16-1107
复制
发表时间：
2017-03-21
影响因子：
39.2
通讯作者：
West R
中科院分区：
文献类型：
--
作者：
Shahab L;Goniewicz ML;Blount BC;Brown J;McNeill A;Alwis KU;Feng J;Wang L;West R
鉴于电子烟（EC）普及率的快速增长以及与此相关的纵向健康相关数据的缺乏，迫切需要评估长期使用EC的潜在风险。比较仅吸烟者、长期使用EC或使用尼古丁替代疗法（NRT;一种已知安全性的产品）的吸烟者和戒烟者对尼古丁、烟草相关致癌物和有毒物质的暴露。横断面研究。英国.有目的地招募了5个组：（1）仅使用氯吡格雷的患者，（2）长期（≥6个月）仅使用EC或（3）仅使用NRT的既往吸烟者，以及（4）长期双重氯吡格雷-EC或（5）双重氯吡格雷-NRT患者（每组N=36-37，总N=181）。评估了社会人口统计学和吸烟特征;参与者提供了尿液和唾液样本，分析了尼古丁，烟草特有的亚硝胺（TSNAs）和挥发性有机化合物（VOCs）的生物标志物。在控制混杂因素后，尼古丁摄入的唾液或尿液生物标志物没有明显的组间差异。与仅使用氯硝西泮、双氯硝西泮-EC或氯硝西泮-NRT的使用者相比，仅使用EC和仅使用NRT的使用者的TSNA（包括致癌代谢物4-（甲基亚硝胺）-1-（3-吡啶基）-1-丁醇，NNAL）和VOC（包括有毒物质丙烯醛、丙烯酰胺、丙烯腈、1，3-丁二烯、环氧乙烷的代谢物）代谢物水平显著较低。仅使用EC的用户的NNAL水平显著低于所有其他组。仅吸烟者、双氯硝西泮-NRT和氯硝西泮-EC使用者的TSNA和VOC代谢物水平基本相似。自选样本横断面设计。长期仅使用EC或仅使用NRT的戒烟者可能达到与仅使用尼古丁的吸烟者大致相似的尼古丁摄入量，但结果不同。长期仅使用NRT和EC，但不与香烟双重使用，与仅吸烟的致癌物和有毒物水平大幅降低有关。英国癌症研究（C27061/A16929）。
Given the rapid increase in e-cigarette (EC) popularity and paucity of longitudinal health-related data associated with this, there is an urgent need to assess the potential risks of long-term EC use. To compare exposure to nicotine, tobacco-related carcinogens and toxicants among cigarette-only smokers, and smokers and ex-smokers with long-term EC use or with use of nicotine replacement therapy (NRT; a product with known safety profile). Cross-sectional study. United Kingdom. Five groups were purposively recruited: (1) cigarette-only users, (2) ex-smokers with long-term (≥6 months) EC-only or (3) NRT-only use, and (4) long-term dual cigarette-EC or (5) dual cigarette-NRT users (N=36-37 per group, total N=181). Socio-demographic and smoking characteristics were assessed; participants provided urine and saliva samples, analysed for biomarkers of nicotine, tobacco-specific nitrosamines (TSNAs) and volatile organic compounds (VOCs). After controlling for confounders, there were no clear group differences in salivary or urinary biomarkers of nicotine intake. EC-only and NRT-only users had significantly lower metabolite levels for TSNAs (including the carcinogenic metabolite 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol, NNAL) and for VOCs (including metabolites of the toxicants acrolein, acrylamide, acrylonitrile, 1,3-butadiene, ethylene oxide) compared with cigarette-only, dual cigarette-EC or cigarette-NRT users. EC-only users had significantly lower NNAL levels than all other groups. Cigarette-only, dual cigarette-NRT and cigarette-EC users had largely similar levels of TSNA and VOC metabolites. Cross-sectional design with self-selected sample. Ex-smokers with long-term EC-only or NRT-only use may achieve approximately similar nicotine intake to cigarette-only smokers but results were variable. Long-term NRT-only and EC-only use, but not dual use with cigarettes, is associated with substantially reduced levels of measured carcinogens and toxicants relative to cigarette-only smoking. Cancer Research UK (C27061/A16929).