Miller Connor R, Schneller-Najm Liane M, Leigh Noel J, Agar Thomas, Quah Anne Ck, Cummings K Michael, Fong Geoffrey T, O'Connor Richard J, Goniewicz Maciej L
Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo-SUNY, Buffalo, New York.
Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York.
Cancer Epidemiol Biomarkers Prev. 2025 Feb 6;34(2):298-307. doi: 10.1158/1055-9965.EPI-24-0836.
Comparisons of nicotine and toxicant exposures between people who use different alternative tobacco products remain underexplored.
This cross-sectional, multicountry study analyzed urinary metabolites of nicotine, tobacco-specific nitrosamines [4-methylnitrosamino-1-3-pyridyl-1-butanone (NNK)], and volatile organic compounds (acrolein, acrylamide, and acrylonitrile) among established users (n = 550) in Japan and Canada. Participants exclusively or concurrently used nicotine vaping products (NVP; Canada only), heated tobacco products (HTP; Japan only), and combustible cigarettes (CC; Japan and Canada) or abstained (Japan and Canada).
All product groups showed substantial nicotine exposure. Both HTPs and NVPs exposed exclusive users to lower toxicant levels than exclusive CC use. Canadian participants who exclusively used NVPs exhibited lower NNK and acrolein exposure but higher acrylamide exposure than Japanese participants who exclusively used HTPs. Concurrent use of CCs alongside alternative products exposed users to higher toxicant levels compared with exclusive use of either alternative product.
Exclusive use of alternative tobacco products results in significant nicotine exposure but substantially lower toxicant exposure compared with exclusive CC use. People who use HTPs in Japan may experience higher exposure to nicotine and certain toxicants (NNK and acrolein) than people who use NVPs in Canada. Concurrent use results suggest that partially substituting CCs with alternative products may reduce toxicant exposure but to a lesser extent than completely transitioning to alternative products.
Exposure patterns between two popular alternative tobacco products differ. The overall toxicant exposure from these products is lower than from CCs, providing critical data for regulatory decisions and public health considerations.
不同替代烟草产品使用者之间尼古丁和有毒物质暴露情况的比较仍未得到充分研究。
这项横断面、多国研究分析了日本和加拿大成年使用者（n = 550）尿液中的尼古丁、烟草特有亚硝胺[4-甲基亚硝胺基-1-(3-吡啶基)-1-丁酮（NNK）]和挥发性有机化合物（丙烯醛、丙烯酰胺和丙烯腈）代谢物。参与者仅使用或同时使用尼古丁电子烟产品（仅在加拿大）、加热烟草产品（仅在日本）、可燃香烟（在日本和加拿大）或不使用任何烟草产品（在日本和加拿大）。
所有产品组均显示出大量的尼古丁暴露。与仅使用可燃香烟相比，加热烟草产品和电子烟产品使仅使用它们的使用者接触到的有毒物质水平更低。仅使用电子烟产品的加拿大参与者与仅使用加热烟草产品的日本参与者相比，NNK和丙烯醛暴露较低，但丙烯酰胺暴露较高。与仅使用任何一种替代产品相比，可燃香烟与替代产品同时使用会使使用者接触到更高的有毒物质水平。
与仅使用可燃香烟相比，仅使用替代烟草产品会导致大量尼古丁暴露，但有毒物质暴露显著降低。在日本使用加热烟草产品的人可能比在加拿大使用电子烟产品的人接触到更高水平的尼古丁和某些有毒物质（NNK和丙烯醛）。同时使用的结果表明，用替代产品部分替代可燃香烟可能会减少有毒物质暴露，但程度低于完全转向替代产品。
两种流行的替代烟草产品之间的暴露模式不同。这些产品的总体有毒物质暴露低于可燃香烟，为监管决策和公共卫生考虑提供了关键数据。
