Content of toxic components of cigarette, cigarette smoke vs cigarette butts: A comprehensive systematic review.

The commercially sold cigarettes contain more than 7000 chemicals, and their combustion produces potential toxicants in mainstream smoke (MS), sidestream smoke (SS), secondhand smoke (SHS), thirdhand smoke (THS), and discarded cigarette butts (CBs). We conducted a systematic review of published literature to compare the toxicants produced in each of these phases of tobacco combustion (MS, SS, and CBs). The initial search included 12,301 articles, but after screening and final restrictions considering the aims of this review, 159 published studies were selected for inclusion. Additionally, SHS and THS are briefly discussed here. Overall, polycyclic aromatic hydrocarbons (PAHs) and other aromatic hydrocarbons have been represented in more studies than other compounds. However, metals and nitrosamines were detected in higher concentrations than other components in SS. The concentrations of most PAHs and other aromatic hydrocarbons in MS and SS are higher compared to concentrations found in CBs. Also, the concentrations of all the studied carbonyl compounds, aldehydes and ketones in SS and MS were higher than in CBs. The mean levels of alcohols and phenols in SS were higher than those reported for both MS and CBs. Tobacco toxicants are inhaled by smokers and transmitted to the environment through SS, SHS, THS, and discarded CBs. However, further studies are necessary to assess adverse effects of toxicants found in CBs and THS not only on human health, but also on the environment and ecosystems. The results of this review provide updated information on the chemical contents of MS, SS, SHS, THS, and CBs. It adds to the growing understanding that smoking creates major health problems for smokers and passive smokers, but also that it generates environmental hazards with consequences to the ecosystems and human health through discarded CBs, SHS, and THS exposure.