Goniewicz Maciej L
Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Elam and Carlton Streets, Buffalo NY 14226, United States.
Addict Neurosci. 2023 Jun;6. doi: 10.1016/j.addicn.2023.100077. Epub 2023 Feb 26.
This perspective summarizes available evidence on biomarkers of exposure in electronic nicotine delivery system (ENDS) users to aid the overall assessment of the health consequences of using ENDS. Identification of novel biomarkers of exposure specific to ENDS use remains challenging because chemicals emitted from ENDS devices have many familiar sources. The biomarker levels of many tobacco-related toxicants measured in biological samples collected from ENDS users did not differ significantly from non-users, except for nicotine metabolites and a small number of biomarkers of exposure to volatile organic compounds and tobacco-specific tobacco nitrosamines. Several studies have shown that while exposed to nicotine, long-term exclusive ENDS users showed significantly lower levels of toxicant biomarkers than cigarette smokers. Studies have also shown that concurrent users of ENDS and combustible cigarettes ('dual users') are not reducing overall exposure to harmful toxicants compared to exclusive cigarette smokers. Because of an absence of validated ENDS-specific biomarkers, we recommend combining several biomarkers to differentiate tobacco product user groups in population-based studies and monitor ENDS compliance in randomized controlled trials. Using a panel of biomarkers would provide a better understanding of health effects related to ENDS use.
这一观点总结了关于电子尼古丁传送系统（ENDS）使用者接触生物标志物的现有证据，以帮助全面评估使用ENDS对健康的影响。由于ENDS设备释放的化学物质来源众多，识别特定于ENDS使用的新型接触生物标志物仍然具有挑战性。从ENDS使用者收集的生物样本中测量的许多与烟草相关的有毒物质的生物标志物水平，除了尼古丁代谢物以及少量接触挥发性有机化合物和烟草特有亚硝胺的生物标志物外，与非使用者相比并无显著差异。几项研究表明，长期仅使用ENDS的使用者在接触尼古丁时，其有毒物质生物标志物水平明显低于吸烟者。研究还表明，与仅吸卷烟者相比，同时使用ENDS和可燃卷烟者（“双重使用者”）并未减少对有害有毒物质的总体接触。由于缺乏经过验证的特定于ENDS的生物标志物，我们建议在基于人群的研究中结合多种生物标志物来区分烟草产品使用者群体，并在随机对照试验中监测ENDS的依从性。使用一组生物标志物将有助于更好地了解与使用ENDS相关的健康影响。
