Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland.
Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.
Cancer Epidemiol Biomarkers Prev. 2017 Oct;26(10):1525-1530. doi: 10.1158/1055-9965.EPI-17-0338. Epub 2017 Jul 14.
Few studies have examined differences in product consumption patterns and nicotine and tobacco-specific nitrosamines (TSNA) exposure between single versus dual- and poly-tobacco users. We applied the Tobacco Product Use Patterns (T-PUPs) model to fill this gap in the literature. Data from adults (age ≥18 years) who used any tobacco products during the 5 days prior to participating in the 1999-2012 National Health and Nutrition Examination Survey (NHANES) were analyzed. Participants were classified into seven T-PUPs: (1) cigarettes only, (2) noncigarette combustibles only, (3) noncombustibles only, (4) dual noncigarette combustibles and noncombustibles, (5) dual cigarettes and noncombustibles, (6) dual cigarettes and noncigarette combustibles, and (7) poly-tobacco use. Weighted regression models were used to compare product consumption, serum cotinine, and urinary total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (i.e., NNAL) levels between single-, dual-, and poly-tobacco T-PUPs. Dual- and poly-tobacco T-PUPs were associated with lower product consumption compared with single-product T-PUPs only in some cases (e.g., dual cigarette and noncombustible users smoked cigarettes on 0.6 fewer days in the past 5 days compared with cigarette-only users; < 0.05). Dual- and poly-tobacco T-PUPs had either nondistinguishable or higher levels of serum cotinine and urinary total NNAL than corresponding single-product T-PUPs. Product consumption, and nicotine and TSNAs exposure of dual- and poly-tobacco product category users somewhat differ from those of single-product category users as defined by the T-TUPs model. Higher levels of cotinine and NNAL among dual- and poly-tobacco T-TUPs users compared with the single-product T-TUPs users may indicate health concerns. .
很少有研究调查过单一、双重和多重烟草使用者在产品消费模式和尼古丁及烟草特异性亚硝胺（TSNA）暴露方面的差异。我们应用烟草产品使用模式（T-PUPs）模型来填补这一文献空白。数据分析的对象为在参加 1999-2012 年全国健康和营养检查调查（NHANES）前 5 天使用任何烟草产品的成年人（年龄≥18 岁）。参与者被分为七种 T-PUPs：（1）仅吸烟，（2）仅使用非吸烟燃烧物，（3）仅使用非燃烧物，（4）双重使用非吸烟燃烧物和非燃烧物，（5）双重使用吸烟和非燃烧物，（6）双重使用吸烟和非吸烟燃烧物，以及（7）多重使用烟草。使用加权回归模型比较了单一、双重和多重烟草 T-PUPs 之间的产品消费、血清可替宁和尿液中总 4-（甲基亚硝胺基）-1-（3-吡啶基）-1-丁醇（即 NNAL）水平。在某些情况下，与单一产品 T-PUPs 相比，双重和多重烟草 T-PUPs 仅与较低的产品消费相关（例如，与仅吸烟的使用者相比，双重吸烟和非燃烧物使用者在过去 5 天中每天吸烟的天数减少了 0.6 天；<0.05）。双重和多重烟草 T-PUPs 的血清可替宁和尿液总 NNAL 水平要么无法区分，要么高于相应的单一产品 T-PUPs。与 T-TUPs 模型定义的单一产品类别使用者相比，双重和多重烟草产品类别使用者的产品消费以及尼古丁和 TSNA 暴露情况有些不同。与单一产品 T-TUPs 使用者相比，双重和多重烟草 T-TUPs 使用者的可替宁和 NNAL 水平较高，这可能表明存在健康问题。
