Tobacco-Specific Nitrosamines (NNAL, NNN, NAT, and NAB) Exposures in the US Population Assessment of Tobacco and Health (PATH) Study Wave 1 (2013–2014)
Author:
Xia Baoyun1ORCID, Blount Benjamin C1, Guillot Tonya1, Brosius Christina1, Li Yao1, Van Bemmel Dana M2, Kimmel Heather L3ORCID, Chang Cindy M2, Borek Nicolette2, Edwards Kathryn C4, Lawrence Charlie4ORCID, Hyland Andrew5, Goniewicz Maciej L5ORCID, Pine Brittany N1, Xia Yang1, Bernert John T1, De Castro B Rey1, Lee John1, Brown Justin L1, Arnstein Stephen1, Choi Diane1, Wade Erin L1, Hatsukami Dorothy6, Ervies Gladys2, Cobos Angel1ORCID, Nicodemus Keegan1, Freeman Dana1, Hecht Stephen S6ORCID, Conway Kevin3, Wang Lanqing1
Affiliation:
1. Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 2. Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD 3. Division of Epidemiology, Services and Prevention Research, National Institute of Drug Abuse, Bethesda, MD 4. Behavioral Health and Health Policy, Westat, Rockville, MD 5. Roswell Park Comprehensive Cancer Center, Roswell Park Cancer Institute, Buffalo, NY 6. Masonic Cancer Center, University of Minnesota, Minneapolis, MN
Abstract
Abstract
Introduction
The tobacco-specific nitrosamines (TSNAs) are an important group of carcinogens found in tobacco and tobacco smoke. To describe and characterize the levels of TSNAs in the Population Assessment of Tobacco and Health (PATH) Study Wave 1 (2013–2014), we present four biomarkers of TSNA exposure: N′-nitrosonornicotine, N′-nitrosoanabasine, N′-nitrosoanatabine, and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) which is the primary urinary metabolite of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone.
Methods
We measured total TSNAs in 11 522 adults who provided urine using automated solid-phase extraction coupled to isotope dilution liquid chromatography–tandem mass spectrometry. After exclusions in this current analysis, we selected 11 004 NNAL results, 10 753 N′-nitrosonornicotine results, 10 919 N′-nitrosoanatabine results, and 10 996 N′-nitrosoanabasine results for data analysis. Geometric means and correlations were calculated using SAS and SUDAAN.
Results
TSNA concentrations were associated with choice of tobacco product and frequency of use. Among established, every day, exclusive tobacco product users, the geometric mean urinary NNAL concentration was highest for smokeless tobacco users (993.3; 95% confidence interval [CI: 839.2, 1147.3] ng/g creatinine), followed by all types of combustible tobacco product users (285.4; 95% CI: [267.9, 303.0] ng/g creatinine), poly tobacco users (278.6; 95% CI: [254.9, 302.2] ng/g creatinine), and e-cigarette product users (6.3; 95% CI: [4.7, 7.9] ng/g creatinine). TSNA concentrations were higher in every day users than in intermittent users for all the tobacco product groups. Among single product users, exposure to TSNAs differed by sex, age, race/ethnicity, and education. Urinary TSNAs and nicotine metabolite biomarkers were also highly correlated.
Conclusions
We have provided PATH Study estimates of TSNA exposure among US adult users of a variety of tobacco products. These data can inform future tobacco product and human exposure evaluations and related regulatory activities.
Funder
National Institute on Drug Abuse National Institutes of Health Center for Tobacco Products Food and Drug Administration U.S. Department of Health and Human Services Centers for Disease Control and Prevention
Publisher
Oxford University Press (OUP)
Subject
Public Health, Environmental and Occupational Health
Cited by
35 articles.
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