Department of Psychology, Virginia Commonwealth University, PO Box 842018, Richmond, VA 23284-2018, USA.
Nicotine Tob Res. 2010 Apr;12(4):336-43. doi: 10.1093/ntr/ntq003. Epub 2010 Feb 16.
Potential-reduced exposure products (PREPs) are marketed as a way for smokers to continue using tobacco while possibly lessening their tobacco toxicant intake. Some tobacco-based PREPs are combustible and intended to be smoked, while others are noncombustible and intended to be administered orally (e.g., Camel Snus [CS] tobacco sachets and Ariva tobacco tablets). The ability of these noncombustible PREPs to reduce smokers' exposure to cigarette-delivered toxicants and suppress tobacco abstinence symptoms effectively is unclear. Clinical laboratory methods have been used to measure combustible PREP-associated toxicant exposure and abstinence symptom suppression and could be applied to evaluating the effects of orally administered noncombustible PREPs.
In this study, 21 smokers (6 women) participated in four 5-day conditions that differed by product used: CS, Ariva, own brand cigarettes, or no tobacco. Measures included expired-air carbon monoxide (CO), the urinary metabolite of nicotine (cotinine), the urinary metabolite of the carcinogen NNK (NNAL-T), and subjective effect ratings.
Relative to own brand, all other conditions were associated with CO and cotinine levels that were lower and abstinence symptom ratings that were greater. Only no-tobacco use was associated with significantly lower NNAL levels. Acceptability ratings were also lower in all conditions relative to own brand.
Although these oral products reduce exposure to CO, their ineffective abstinence symptom suppression and low acceptability may limit their viability as PREPs. As with combustible PREPs, clinical laboratory study of orally administered noncombustible PREPs will be a valuable part of any comprehensive PREP evaluation strategy.
潜在减害产品（PREPs）被宣传为一种让吸烟者继续使用烟草的方式，同时可能减少他们摄入的烟草毒素。一些基于烟草的 PREPs 是可燃的，旨在吸烟，而另一些是非可燃的，旨在口服（例如，骆驼鼻烟 [CS] 烟草小袋和 Ariva 烟草片）。这些非可燃 PREPs 减少吸烟者接触香烟中传递的毒素和有效抑制烟草戒断症状的能力尚不清楚。临床实验室方法已被用于测量可燃 PREP 相关的毒素暴露和戒断症状抑制，并且可以应用于评估口服非可燃 PREPs 的效果。
在这项研究中，21 名吸烟者（6 名女性）参与了四个为期 5 天的条件，这些条件因使用的产品而异：CS、Ariva、自有品牌香烟或不使用烟草。测量包括呼出的一氧化碳（CO）、尼古丁的尿代谢物（可替宁）、致癌物质 NNK 的尿代谢物（NNAL-T）和主观效果评分。
与自有品牌相比，所有其他条件都与 CO 和可替宁水平较低以及戒断症状评分较高相关。只有不使用烟草与 NNAL 水平显著降低相关。与自有品牌相比，所有条件的可接受性评分也较低。
尽管这些口服产品减少了 CO 的暴露，但它们对戒断症状的抑制效果不佳且可接受性较低，可能限制了它们作为 PREPs 的可行性。与可燃 PREPs 一样，对口服非可燃 PREPs 的临床实验室研究将是任何全面 PREP 评估策略的重要组成部分。
