Cigarillo smoking: smoke toxicant content and user toxicant exposure and effects

描述（由申请人提供）：美国每年有超过 400,000 人因心血管疾病、癌症和其他健康问题而死亡。这种发病率和死亡率很大程度上归因于吸烟者吸入的有毒物质，如致癌物质、一氧化碳 (CO) 和产生依赖性的药物尼古丁。吸雪茄还与癌症和其他健康疾病有关，雪茄烟雾中含有许多与香烟烟雾相同的有毒物质。不幸的是，与吸烟不同的是，近年来雪茄的吸食量并没有减少，特别是在最常吸食小雪茄的年轻人中。小雪茄是一种短而细长的雪茄，由烟叶包装纸、再造烟草粘合剂和烟叶填料组成。小雪茄之所以吸引年轻消费者，是因为它具有葡萄、樱桃和香草等诱人的口味，而且吸食时会产生甜甜的香气。人们认为与香烟相比，小雪茄的危害较小，这也刺激了年轻人使用小雪茄。事实上，人们普遍认为，通过称为“炒作”的改性过程去除再造烟草粘合剂可以减少小雪茄烟雾毒物的暴露。也许最令人担忧的是，科学界对小雪茄的有毒物质暴露和影响及其各种使用形式（即原始形式或改良形式）知之甚少。了解小雪茄的使用涉及一种跨学科的方法，该方法解决小雪茄烟雾中有毒物质的产生、小雪茄使用者有毒物质的暴露以及与小雪茄使用直接相关的心血管和主观影响。本提案的具体目的是： (1) 比较原始毒物产量 和改良小雪茄，(2) 在实验室中研究原始和改良小雪茄的毒物暴露和影响，以及 (3) 检查参与者在自然环境中吸原始或改良小雪茄时的毒物暴露和影响。值得注意的是，有关卷烟影响的类似信息已被用来为预防和戒烟干预措施提供信息，并指导最近的烟草控制立法工作（即《家庭吸烟预防和烟草控制法》，2009 年）。该项目与 NCI 的强化科学调查领域（连接国家癌症社区：2011 财年年度计划和预算提案）一致，通过“开发确定产品成分变化影响的方法和措施”来支持美国 FDA 对烟草产品的监管。在这种情况下，用户发起修改以减少接触小雪茄烟雾中的有害成分。该提案结合了新开发的分析实验室和临床方法来解决新出现的烟草使用现象。

DESCRIPTION (provided by applicant): Tobacco use accounts for over 400,000 U.S deaths each year due to cardiovascular disorders, cancers, and other health problems. Much of this morbidity and mortality is attributable to the toxicants that cigarette smokers inhale like carcinogens, carbon monoxide (CO), and the dependence-producing drug nicotine. Cigar smoking is also linked to cancer and other health disorders, and cigar smoke contains many of the same toxicants as cigarette smoke. Unfortunately, unlike cigarette smoking, cigar smoking has not declined in recent years, especially among young adults who are the most frequent users of the cigarillo - a short, slender cigar comprised of a tobacco leaf wrapper, a reconstituted tobacco binder, and tobacco leaf filler. Cigarillos appeal to young consumers because of the availability of enticing flavors like grape, cherry, and vanilla, and the sweet aroma produced by cigarillos when smoked. Young adult use of cigarillos has also been spurred by perceptions of reduced harm of cigarillos compared to cigarettes. In fact, there is a widely-held belief that exposure to cigarillo smoke toxicants can be reduced by removing the reconstituted tobacco binder through a modification process known as "hyping." Perhaps most concerning is the scientific community knows very little about the toxicant exposure and effects of cigarillos and its various forms of use (i.e., original or modified forms). Understanding cigarilo use involves a transdisciplinary approach that addresses cigarillo smoke toxicant yield, cigarillo user toxicant exposure, and the cardiovascular and subjective effects associated with cigarillo use directly. The specific aims of this proposal are to: (1) Compare the toxicant yield of original and modified cigarillos, (2) Investigate toxicant exposure and effects of original and modified cigarillos in the laboratory, and (3) Examine toxicant exposure and effect when participants smoke original or modified cigarillos in their natural environment. Notable is that similar information regarding the effects of cigarettes has been used to inform prevention and cessation interventions and to guide recent legislative efforts in tobacco control (i.e., Family Smoking Prevention and Tobacco Control Act, 2009). This project is consistent with NCI's Areas of Intensified Scientific Investigation (Connecting the Nation's Cancer Community: An Annual Plan and Budget Proposal for FY2011) to support the U.S. FDA's regulation of tobacco products by "developing methods and measures for determining the impact of product ingredient changes." In this case, user-initiated modifications to reduce exposure to harmful ingredients in cigarillo smoke. This proposal uses a combination of newly-developed, analytical laboratory and clinical methods to address an emerging tobacco use phenomenon.