Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-30 (of 38 Records) |
Query Trace: Sosnoff C[original query] |
---|
Exposure to polycyclic aromatic hydrocarbons, volatile organic compounds, and tobacco-specific nitrosamines and incidence of esophageal cancer
Etemadi A , Poustchi H , Chang CM , Calafat AM , Blount BC , Bhandari D , Wang L , Roshandel G , Alexandridis A , Botelho JC , Xia B , Wang Y , Sosnoff CS , Feng J , Nalini M , Khoshnia M , Pourshams A , Sotoudeh M , Gail MH , Dawsey SM , Kamangar F , Boffetta P , Brennan P , Abnet CC , Malekzadeh R , Freedman ND . J Natl Cancer Inst 2023 BACKGROUND: Studying carcinogens in tobacco and non-tobacco sources may be key to understanding the pathogenesis and geographic distribution of esophageal cancer. METHODS: Golestan Cohort Study (GCS) has been conducted since 2004 in a region with high rates of esophageal squamous cell carcinoma (ESCC). For this nested study, the cases comprised of all incident cases by Jan 1, 2018; controls were matched to the case by age, sex, residence, time in cohort, and tobacco use. We measured urinary concentrations of 33 exposure biomarkers of nicotine, polycyclic aromatic hydrocarbons (PAHs), volatile organic compounds (VOCs), and tobacco-specific nitrosamines (TSNAs). We used conditional logistic regression to calculate odds ratios (OR) and 95% confidence intervals (95%CI) for associations between the 90th versus the 10th percentiles of the biomarker concentrations and incident ESCC. RESULTS: Among individuals who did not currently use tobacco (148 cases/163 controls), two acrolein metabolites, two acrylonitrile metabolites, one propylene oxide metabolite and one 1,3-butadiene metabolite were significantly associated with incident ESCC (adjusted ORs between 1.8 and 4.3). Among tobacco users (57 cases/63 controls), metabolites of two other VOCs (styrene and xylene) were associated with ESCC (ORs= 6.2 and 9.0). In tobacco users, two TSNAs (NNN and N'-Nitrosoanatabine) were also associated with ESCC. Suggestive associations were seen with some PAHs (especially 2-hydroxynaphthalene) in non-users of tobacco products and other TSNAs in tobacco users. CONCLUSION: These novel associations based on individual-level data and samples collected many years before cancer diagnosis, from a population without occupational exposure, have important public health implications. |
Validating Wave 1 (2014) urinary cotinine and TNE-2 cut-points for differentiating Wave 4 (2017) cigarette use from non-use in the US using data from the PATH Study
Edwards KC , Khan A , Sharma E , Wang L , Feng J , Blount BC , Sosnoff CS , Smith DM , Goniewicz ML , Pearson J , Villanti AC , Delnevo CD , Bover Manderski MT , Hatsukami DK , Niaura R , Everard C , Kimmel HL , Duffy K , Rostron BL , Del Valle-Pinero AY , van Bemmel DM , Stanton CA , Hyland A . Cancer Epidemiol Biomarkers Prev 2023 32 (9) 1233-1241 BACKGROUND: Sex and racial/ethnic identity specific cut-points for validating tobacco use using Wave 1 (W1) of the PATH Study were published in 2020. The current study establishes predictive validity of the W1 (2014) urinary cotinine and Total Nicotine Equivalents-2 (TNE-2) cut-points on estimating Wave 4 (W4; 2017) tobacco use. METHODS: For exclusive and polytobacco cigarette use, weighted prevalence estimates based on W4 self-report alone and with exceeding the W1 cut-point were calculated to identify the percentage missed without biochemical verification. Sensitivity and specificity of W1 cut-points on W4 self-reported tobacco use status were examined. Receiver Operating Characteristic curves were used to determine the optimal W4 cut-points to distinguish P30D users from non-users, and evaluate if the cut-points significantly differed from W1. RESULTS: Agreement between W4 self-reported use and exceeding the W1 cut-points was high overall and when stratified by demographic subgroups (0.7- 4.4% of use was missed if relying on self-report alone). The predictive validity of using the W1 cut-points to classify exclusive cigarette and polytobacco cigarette use at W4 was high (>90% sensitivity and specificity, except among polytobacco Hispanic smokers). Cut-points derived using W4 data did not significantly differ from the W1 derived cut-points (e.g., W1 exclusive= 40.5 ng/mL cotinine [95% CI: 26.1-62.8], W4 exclusive = 29.9 ng/ml cotinine [95% CI: 13.5-66.4]), among most demographic subgroups. CONCLUSION: The W1 cut-points remain valid for biochemical verification of self-reported tobacco use in W4. IMPACT: Findings from can be used in clinical and epidemiological studies to reduce misclassification of cigarette smoking status. |
Anabasine and anatabine exposure attributable to cigarette smoking: National Health and Nutrition Examination Survey (NHANES) 2013-2014
Bendik PB , Rutt SM , Pine BN , Sosnoff CS , Blount BC , Zhu W , Feng J , Wang L . Int J Environ Res Public Health 2022 19 (15) Anabasine and anatabine are minor alkaloids in tobacco products and are precursors for tobacco-specific nitrosamines (TSNAs). The levels of these two compounds have been used to differentiate tobacco product sources, monitor compliance with smoking cessation programs, and for biomonitoring in TSNA-related studies. The concentrations of urinary anabasine and anatabine were measured in a representative sample of U.S. adults who smoked cigarettes (N = 770) during the 2013-2014 National Health and Nutrition Examination Survey (NHANES) study cycle, which was the first cycle where urinary anabasine and anatabine data became available. Weighted geometric means (GM) and geometric least squares means (LSM) with 95% confidence intervals were calculated for urinary anabasine and anatabine categorized by tobacco-use status [cigarettes per day (CPD) and smoking frequency] and demographic characteristics. Smoking 20 CPD was associated with 3.6 higher anabasine GM and 4.8 higher anatabine GM compared with smoking <10 CPD. Compared with non-daily smoking, daily smoking was associated with higher GMs for urinary anabasine (1.41 ng/mL vs. 6.28 ng/mL) and anatabine (1.62 ng/mL vs. 9.24 ng/mL). Urinary anabasine and anatabine concentrations exceeded the 2 ng/mL cut point in 86% and 91% of urine samples from people who smoke (PWS) daily, respectively; in comparison, 100% of them had serum cotinine concentrations greater than the established 10 ng/mL cut point. We compared these minor tobacco alkaloid levels to those of serum cotinine to assess their suitability as indicators of recent tobacco use at established cut points and found that their optimal cut point values would be lower than the established values. This is the first time that anabasine and anatabine are reported for urine collected from a U.S. population-representative sample of NHANES study participants, providing a snapshot of exposure levels for adults who smoked during 2013-2014. The results of this study serve as an initial reference point for future analysis of NHANES cycles, where changes in the national level of urinary anabasine and anatabine can be monitored among people who smoke to show the effect of changes in tobacco policy. |
Geometric mean serum cotinine concentrations confirm a continued decline in secondhand smoke exposure among U.S. nonsmokersNHANES 2003 to 2018
Caron KT , Zhu W , Bernert JT , Wang L , Blount BC , Dortch K , Hunter RE , Harmon T , Akins JR , Tsai J , Homa DM , Pirkle JL , Sosnoff CS . Int J Environ Res Public Health 2022 19 (10) The objective of this study was to examine long-term trends in serum cotinine (COT) concentrations, as a measure of secondhand smoke (SHS) exposure, in U.S. nonsmokers using data from the National Health and Nutrition Examination Surveys (NHANES) from 2003 to 2018. We analyzed NHANES serum COT results from 8 continuous NHANES 2 year cycles from 2003 to 2018 using a liquid chromatography–tandem mass spectrometry assay that has been maintained continuously at the Centers for Disease Control and Prevention (CDC) since 1992. Serum COT concentrations (based on the geometric means) among nonsmokers in the U.S. decreased by an average of 11.0% (95% confidence interval (CI) [8.8%, 13.1%]; p < 0.0001) every 2 year cycle. From 2003 to 2018, serum COT concentrations in U.S. nonsmokers declined by 55.0%, from 0.065 ng/mL in 2003–2004 to 0.029 ng/mL in 2017–2018 (p < 0.0001). Significant decreases in serum COT concentrations were observed in all demographic groups. While disparities between these groups seems to be shrinking over time, several previously observed disparities in SHS exposure remain in 2017–2018. Serum COT concentrations of the non-Hispanic Black population remained higher than those of non-Hispanic Whites and Mexican Americans (p < 0.0001). Additionally, serum COT concentrations were significantly higher for children aged 3–5 years than other age groups (p ≤ 0.0002), and men continued to have significantly higher serum COT concentrations than women (p = 0.0384). While there is no safe level of exposure to SHS, the decrease in serum COT concentrations in the U.S. population as well as across demographic groupings represents a positive public health outcome and supports the importance of comprehensive smoke-free laws and policies for workplaces, public places, homes, and vehicles to protect nonsmokers from SHS exposure. © 2022 by the authors. Licensee MDPI, Basel, Switzerland. |
Variability in urinary nicotine exposure biomarker levels between waves 1 (2013-2014) and 2 (2014-2015) in the Population Assessment of Tobacco and Health Study
Ashley DL , Zhu W , Wang L , Sosnoff C , Feng J , Del Valle-Pinero AY , Cheng YC , Chang CM , van Bemmel D , Borek N , Kimmel HL , Silveira ML , Blount BC . Nicotine Tob Res 2022 25 (4) 616-623 INTRODUCTION: To date, no studies have evaluated the consistency of biomarker levels in people who smoke over a long-time period in real-world conditions with a large number of subjects and included use behavior and measures of nicotine metabolism. We evaluated the variability of biomarkers of nicotine exposure over approximately a 1-year period in people who exclusively smoke cigarettes, including intensity and recency of use and brand switching to assess impact on understanding associations with product characteristics. AIMS AND METHODS: Multivariate regression analysis of longitudinal repeated measures of urinary biomarkers of nicotine exposure from 916 adults in the Population Assessment of Tobacco and Health (PATH) Study with demographic characteristics and use behavior variables. Intraclass correlation coefficients (ICCs) were calculated to examine individual variation of nicotine biomarkers and the uncertainty of repeat measures at two time points (Waves 1 and 2). RESULTS: Age, race, and urinary creatinine were significant covariates of urinary cotinine. When including use behavior, recency, and intensity of use were highly significant and variance decreased to a higher extent between than within subjects. The ICC for urinary cotinine decreased from 0.7530 with no use behavior variables in the model to 0.5763 when included. Similar results were found for total nicotine equivalents. CONCLUSIONS: Urinary nicotine biomarkers in the PATH Study showed good consistency between Waves 1 and 2. Use behavior measures such as time since last smoked a cigarette and number of cigarettes smoked in the past 30 days are important to include when assessing factors that may influence biomarker concentrations. IMPLICATIONS: The results of this study show that the consistency of the nicotine biomarkers cotinine and total nicotine equivalents in spot urine samples from Waves 1 to 2 of the PATH Study is high enough that these data are useful to evaluate the association of cigarette characteristics with biomarkers of exposure under real-world use conditions. |
Urinary nicotine metabolites and self-reported tobacco use among adults in the Population Assessment of Tobacco and Health (PATH) Study, 2013-2014
Feng J , Sosnoff CS , Bernert JT , Blount BC , Li Y , Del Valle-Pinero AY , Kimmel HL , van Bemmel DM , Rutt SM , Crespo-Barreto J , Borek N , Edwards KC , Alexander R , Arnstein S , Lawrence C , Hyland A , Goniewicz ML , Rehmani I , Pine B , Pagnotti V , Wade E , Sandlin J , Luo Z , Piyankarage S , Hatsukami DK , Hecht SS , Conway KP , Wang L . Nicotine Tob Res 2022 24 (5) 768-777 INTRODUCTION: The Population Assessment of Tobacco and Health (PATH) Study is a longitudinal cohort study on tobacco use behavior, attitudes and beliefs, and tobacco-related health outcomes, including biomarkers of tobacco exposure in the U.S. population. In this report we provide a summary of urinary nicotine metabolite measurements among adult users and non-users of tobacco from Wave 1 (2013-2014) of the PATH Study. METHODS: Total nicotine and its metabolites including cotinine, trans-3'-hydroxycotinine (HCTT), and other minor metabolites were measured in more than 11 500 adult participants by liquid chromatography tandem mass spectrometry methods. Weighted geometric means (GM) and least square means from statistical modeling were calculated for non-users and users of various tobacco products. RESULTS: Among daily users, the highest GM concentrations of nicotine, cotinine and HCTT were found in exclusive smokeless tobacco users, and the lowest in exclusive e-cigarette users. Exclusive combustible product users had intermediate concentrations, similar to those found in users of multiple products (polyusers). Concentrations increased with age within the categories of tobacco users, and differences associated with gender, race/ethnicity and educational attainment were also noted among user categories. Recent (past 12 months) former users had GM cotinine concentrations that were more than threefold greater than never users. CONCLUSIONS: These urinary nicotine metabolite data provide quantification of nicotine exposure representative of the entire US adult population during 2013-2014 and may serve as a reference for similar analyses in future measurements within this study. IMPLICATIONS: Nicotine and its metabolites in urine provide perhaps the most fundamental biomarkers of recent nicotine exposure. This report, based on Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study, provides the first nationally representative data describing urinary nicotine biomarker concentrations in both non-users, and users of a variety of tobacco products including combustible, e-cigarette and smokeless products. These data provide a urinary biomarker concentration snapshot in time for the entire US population during 2013-2014, and will provide a basis for comparison with future results from continuing, periodic evaluations in the PATH Study. |
Nicotine exposure in the U.S. population: Total urinary nicotine biomarkers in NHANES 20152016
Mazumder S , Shia W , Bendik PB , Achilihu H , Sosnoff CS , Alexander JR , Luo Z , Zhu W , Pine BN , Feng J , Blount BC , Wang L . Int J Environ Res Public Health 2022 19 (6) We characterize nicotine exposure in the U.S. population by measuring urinary nicotine and its major (cotinine, trans-3′-hydroxycotinine) and minor (nicotine 1′-oxide, cotinine N-oxide, and 1-(3-pyridyl)-1-butanol-4-carboxylic acid, nornicotine) metabolites in participants from the 2015–2016 National Health and Nutrition Examination Survey. This is one of the first U.S. population-based urinary nicotine biomarker reports using the derived total nicotine equivalents (i.e., TNEs) to characterize exposure. Serum cotinine data is used to stratify tobacco non-users with no detectable serum cotinine (−sCOT), non-users with detectable serum cotinine (+sCOT), and individuals who use tobacco (users). The molar concentration sum of cotinine and trans-3′-hydroxycotinine was calculated to derive the TNE2 for non-users. Additionally, for users, the molar concentration sum of nicotine and TNE2 was calculated to derive the TNE3, and the molar concentration sum of the minor metabolites and TNE3 was calculated to derive the TNE7. Sample-weighted summary statistics are reported. We also generated multiple linear regression models to analyze the association between biomarker concentrations and tobacco use status, after adjusting for select demographic factors. We found TNE7 is positively correlated with TNE3 and TNE2 (r = 0.99 and 0.98, respectively), and TNE3 is positively correlated with TNE2 (r = 0.98). The mean TNE2 concentration was elevated for the +sCOT compared with the −sCOT group (0.0143 [0.0120, 0.0172] µmol/g creatinine and 0.00188 [0.00172, 0.00205] µmol/g creatinine, respectively), and highest among users (33.5 [29.6, 37.9] µmol/g creatinine). Non-daily tobacco use was associated with 50% lower TNE7 concentrations (p < 0.0001) compared with daily use. In this report, we show tobacco use frequency and passive exposure to nicotine are important sources of nicotine exposure. Furthermore, this report provides more information on non-users than a serum biomarker report, which underscores the value of urinary nicotine biomarkers in extending the range of trace-level exposures that can be characterized. © 2022 by the authors. Licensee MDPI, Basel, Switzerland. |
Rapid development and validation of a liquid chromatography-tandem mass spectrometry method to measure cannabinoids in bronchoalveolar-lavage fluid of patients with e-cigarette, or vaping, product use-associated lung injury
Brosius CR , Caron KT , Sosnoff CS , Blount BC , Wang L . ACS Omega 2022 7 (1) 443-452 In 2019, the Centers for Disease Control and Prevention responded to an outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI). Bronchoalveolar-lavage (BAL) fluid from EVALI patients was available for analysis to investigate a range of potential toxicants that might be present at the presumed site of lung injury. Our laboratory developed and validated a novel method to measure cannabinoids and their metabolites in BAL fluid to aid in the investigation of the toxicants that might be the cause of EVALI. In this paper, we describe a sensitive liquid chromatography-tandem mass spectrometry method to measure the following six cannabinoids: Δ(9)-tetrahydrocannabinol (THC), THC metabolites 11-nor-9-carboxy-THC and 11-hydroxy-THC, cannabinol, cannabidiol (CBD), and CBD metabolite 7-nor-7-carboxycannabidiol. Cannabinoids were extracted from BAL fluid using solid-phase extraction. Accuracy, precision, stability, and limits of detection were determined from replicate analyses of spiked BAL pools. The lower limits of detection ranged from 0.019 to 0.153 ng/mL for a sample volume of 150 μL. Overall accuracy ranged from 71.0 to 100.8%. Within-run imprecision (measured by the coefficient of variation) was below 8%, and between-run imprecision was below 21% for all analytes and concentrations tested. The method was applied to samples from 59 EVALI case patients. We identified THC, CBD, or their metabolites in 76% of EVALI patient samples. These findings support previous evidence that THC-containing products played a major role in the EVALI outbreak and help to inform public health recommendations. |
Serum Concentrations of Cotinine and Trans-3'-Hydroxycotinine in US Adults: Results From Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health Study
Sosnoff CS , Caron K , Akins JR , Dortch K , Hunter RE , Pine BN , Feng J , Blount BC , Li Y , van Bemmel DM , Kimmel HL , Edwards KC , Goniewicz ML , Hatsukami DK , de Castro BR , Bernert JT , Arnstein S , Borek N , Deng-Bryant Y , Mishina E , Lawrence C , Hyland A , Hecht SS , Conway KP , Pirkle JL , Wang L . Nicotine Tob Res 2021 24 (5) 736-744 INTRODUCTION: The Population Assessment of Tobacco and Health (PATH) Study is a nationally representative cohort of tobacco product users and nonusers. The study's main purpose is to obtain longitudinal epidemiologic data on tobacco use and exposure among the US population. AIMS AND METHODS: Nicotine biomarkers-cotinine (COT) and trans-3'-hydroxycotinine (HCT)-were measured in blood samples collected from adult daily tobacco users and nonusers during Wave 1 of the PATH Study (2013-2014; n = 5012; one sample per participant). Participants' tobacco product use and exposure to secondhand smoke were categorized based on questionnaire responses. Nonusers were subdivided into never users and recent former users. Daily tobacco users were classified into seven tobacco product use categories: exclusive users of cigarette, smokeless tobacco, electronic cigarette, cigar, pipe, and hookah, as well as polyusers. We calculated sample-weighted geometric mean (GM) concentrations of cotinine, HCT, and the nicotine metabolite ratio (NMR) and evaluated their associations with tobacco use with adjustment for potential confounders. RESULTS: The GMs (95% confidence intervals) of COT and HCT concentrations for daily tobacco users were 196 (184 to 208) and 72.5 (67.8 to 77.4) ng/mL, and for nonusers they were 0.033 (0.028 to 0.037) and 0.021 (0.018 to 0.023) ng/mL. Exclusive smokeless tobacco users had the highest COT concentrations of all user groups examined. The GM NMR in daily users was 0.339 (95% confidence interval: 0.330 to 0.350). CONCLUSIONS: These nationally representative estimates of serum nicotine biomarkers could be the basis for reference ranges characterizing nicotine exposure for daily tobacco users and nonusers in the US adult population. IMPLICATIONS: This report summarizes the serum nicotine biomarker measurements in Wave 1 of the PATH Study. We are reporting the first estimates of HCT in serum for daily tobacco users and nonusers in the noninstitutionalized, civilian US adult population; the first nationally representative serum COT estimates for daily exclusive users of different tobacco products and daily polyusers; and the first nationally representative estimate of the serum NMR in daily tobacco users by age, race/ethnicity, and sex. |
Trends in secondhand smoke exposure, 20112018: Impact and implications of expanding serum cotinine range
Tsai J , Homa DM , Neff LJ , Sosnoff CS , Wang L , Blount BC , Melstrom PC , King BA . Am J Prev Med 2021 61 (3) e109-e117 Introduction: The impact of defining secondhand smoke exposure among nonsmokers using an expanded serum cotinine range is currently unknown. Methods: This study assessed the trends in secondhand smoke exposure prevalence among a nationally representative sample of 23,753 U.S. nonsmokers aged ≥3 years. Serum cotinine ranges of 0.05–10 ng/mL (established) and of 0.015–10 ng/mL (expanded) were analyzed in 2021 using data from the 2011–2018 National Health and Nutrition Examination Survey. Results: During 2011–2018, the percentage of people with a serum cotinine range of 0.05–10 ng/mL remained stable (25.3% to 24.6%) across most sociodemographic subgroups but declined significantly among adult Mexican Americans aged ≥20 years (23.9% to 14.1%). However, the percentage of people with serum cotinine range of 0.015–10 ng/mL significantly declined (58.3% to 52.3%) among male individuals (60.9% to 55.0%), among female individuals (56.2% to 50.0%), among adults aged ≥20 years (55.8% to 49.2%), among Mexican Americans (60.9% to 41.2%), among people with a college degree or higher (44.4% to 36.0%), among those who rented their housing (71.7% to 62.5%), among people not living with someone who smoked inside the home (56.1% to 50.0%), and among Mexican Americans aged ≥20 years (60.9% to 39.1%) (all p<0.05 for linear trend test). Conclusions: Expanding the serum cotinine range to 0.015–10 ng/mL more than doubles the estimated proportion of U.S. nonsmokers exposed to secondhand smoke. In contrast to a serum cotinine range of 0.05–10 ng/mL, it suggests that progress has been made in reducing population-level secondhand smoke exposure during 2011–2018, especially among nonsmokers experiencing lower exposure levels. © 2021 |
Urinary cotinine and cotinine + trans-3'-hydroxycotinine (TNE-2) cut-points for distinguishing tobacco use from non-use in the United States: PATH Study (2013-2014)
Edwards KC , Naz T , Stanton CA , Goniewicz ML , Hatsukami DK , Smith DM , Wang L , Villanti A , Pearson J , Blount BC , Bansal-Travers M , Feng J , Niaura R , Bover Manderski MT , Sosnoff CS , Delnevo CD , Duffy K , Del Valle-Pinero AY , Rostron BL , Everard C , Kimmel HL , van Bemmel DM , Hyland A . Cancer Epidemiol Biomarkers Prev 2021 30 (6) 1175-1184 BACKGROUND: Determine the overall, sex-, and racially/ethnically-appropriate population-level cotinine and total nicotine equivalents (TNE-2, the molar sum of the two major nicotine metabolites) cut-points to distinguish tobacco users from non-users across multiple definitions of use (e.g., exclusive vs. polytobacco, and daily vs. non-daily). METHODS: Using Wave 1 (2013-2014) of the U.S. Population Assessment of Tobacco and Health (PATH) Study, we conducted weighted Receiver Operating Curve (ROC) analysis to determine the optimal urinary cotinine and TNE-2 cut-points, stratified by sex and race/ethnicity. RESULTS: For past 30-day exclusive cigarette users, the cotinine cut-point that distinguished them from non-users was 40.5 ng/mL, with considerable variation by sex (male: 22.2 ng/mL; female: 43.1 ng/mL) and between racial/ethnic groups (non-Hispanic other: 5.2 ng/mL; non-Hispanic black: 297.0 ng/mL). A similar, but attenuated, pattern emerged when assessing polytobacco cigarette users (overall cut-point= 39.1 ng/mL, range= 5.5 ng/mL- 80.4 ng/mL) and any tobacco users (overall cut-point= 39.1 ng/mL, range= 4.8 ng/mL- 40.0 ng/mL). Using TNE-2, which is less impacted by racial differences in nicotine metabolism, produced a comparable pattern of results although reduced the range magnitude. CONCLUSIONS: Due to similar frequency of cigarette use among polytobacco users, overall cut-points for exclusive cigarette use were not substantially different from cut-points that included polytobacco cigarette use or any tobacco use. Results revealed important differences in sex and race/ethnicity appropriate cut-points when evaluating tobacco use status and established novel urinary TNE-2 cut-points. IMPACT: These cut-points may be used for biochemical verification of self-reported tobacco use in epidemiologic studies and clinical trials. |
Concentrations of cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) in US non-daily cigarette smokers
Gutiérrez-Torres DS , Wang L , Blount BC , Xia B , Sosnoff CS , Shiels MS , Inoue-Choi M , Etemadi A , Freedman ND . Cancer Epidemiol Biomarkers Prev 2021 30 (6) 1165-1174 BACKGROUND: Accumulating evidence suggests that non-daily smokers have higher disease and mortality risks than never smokers. Yet, the accuracy of self-reported non-daily cigarette smoking is poorly understood. METHODS: We examined the concordance between self-reported non-daily smoking and serum cotinine in 18,835 adult participants (20 years or older) of the 2007-2014 National Health and Nutrition Examination Surveys, in comparison with daily smokers and non-smokers. We also analyzed concentrations of the urinary biomarker 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) by smoking status. RESULTS: In the study sample, 77.8% (14,660) reported currently not smoking (non-smokers), 18.3% (3,446) smoked every day (daily smokers) and 3.9% (729) smoked on some days of the past month (non-daily smokers). Just 2.1% of non-smokers had cotinine concentrations in the active smoking range (>10 ng/mL), compared to 70.4% of non-daily and 98.8% of daily smokers. Non-daily smokers reported smoking a median of 24 cigarettes per month (interquartile range (IQR): 9-60) and had substantially higher concentrations of NNAL (Median: 72.5, IQR: 14.8-211.0 pg/mL) than non-smokers (Median: 0.4, IQR: 0.4-2.1 pg/mL), though lower than daily smokers (Median: 294.0, IQR: 148.0-542.0 pg/mL). Among non-daily smokers, concentrations of cotinine and NNAL were positively correlated with days and cigarettes smoked per month (P<0.001). CONCLUSIONS: We observed excellent concordance between self-reported non-daily cigarette smoking and concentrations of serum cotinine. IMPACT: These results provide evidence for the validity of self-reported non-daily smoking and indicate that non-daily smokers are exposed to substantial concentrations of carcinogenic nitrosamines regardless of the low number of cigarettes they smoke per month. |
Differences in exposure to nicotine, tobacco-specific nitrosamines, and volatile organic compounds among electronic cigarette users, tobacco smokers, and dual users from three countries
Smith DM , Shahab L , Blount BC , Gawron M , Kosminder L , Sobczak A , Xia B , Sosnoff CS , Goniewicz ML . Toxics 2020 8 (4) Country-level differences in nicotine vaping products used and biomarkers of exposure among long-term e-cigarette users and dual users remain understudied. This cross-sectional study was conducted in 2014 in the United States (n = 166), United Kingdom (n = 129), and Poland (n = 161). We compared patterns of tobacco product use and nicotine and toxicant exposure among cigarette-only smokers (n = 127); e-cigarette-only users (n = 124); dual users of tobacco cigarettes and e-cigarettes (n = 95); and non-users (control group, n = 110) across three countries using mixed-effects linear regression. Compared with cigarette smokers, e-cigarette-only users had lower levels of toxicant biomarkers, but higher levels of nicotine biomarkers. Dual users had higher levels of toxicant biomarkers than e-cigarette-only users but similar levels to cigarette-only smokers. E-cigarette users in Poland, who overwhelmingly used refillable tank devices, exhibited greater levels of nicotine, and toxicant biomarkers relative to e-cigarette users in US/UK. Despite smoking fewer cigarettes, dual users from Poland exhibited similar levels of nicotine biomarkers compared with UK dual users, but higher than US dual users. Country-level differences in e-cigarette devices used and smoking behaviors (e.g., intensity) may contribute to differences in biomarker levels among users of the same products residing in different countries. |
Biomarkers of exposure among USA adult hookah users: Results from wave 1 of the Population Assessment of Tobacco and Health (PATH) Study (2013-2014)
Travers MJ , Rivard C , Sharma E , Retzky S , Yucesoy B , Goniewicz ML , Stanton CA , Chen J , Callahan-Lyon P , Kimmel HL , Xia B , Wang Y , Sosnoff CS , De Jesús VR , Blount BC , Hecht SS , Hyland A . Int J Environ Res Public Health 2020 17 (17) Hookah smoking has become common in the USA, especially among young adults. This study measured biomarkers of exposure to known tobacco product toxicants in a population-based sample of exclusive, established hookah users. Urinary biomarker data from 1753 adults in Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study were used to compare geometric mean concentrations of biomarkers of exposure in exclusive, established past 30-day hookah users to never users of tobacco. Geometric mean ratios were calculated comparing hookah user groups with never users adjusting for age, sex, race/ethnicity, education, past 30-day marijuana use, secondhand smoke exposure and creatinine. Past 30-day hookah users (n = 98) had 10.6 times the urinary cotinine level of never tobacco users. Compared to never tobacco users, past 30-day hookah users had 2.3 times the level of the carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), a metabolite of the tobacco-specific nitrosamine (TSNA) 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), 1.3 times higher polycyclic aromatic hydrocarbons (PAHs) 3-hydroxyfluorene and 1-hydroxypyrene, 1.8 times higher levels of acrylonitrile, 1.3 times higher levels of acrylamide, and 1.2 times higher levels of acrolein exposure. These data indicate that hookah use is a significant source of exposure to nicotine, carcinogens, and respiratory toxicants. |
Secondhand marijuana exposure in a convenience sample of young children in New York City
Sangmo L , Braune T , Liu B , Wang L , Zhang L , Sosnoff CS , Blount BC , Wilson KM . Pediatr Res 2020 89 (4) 905-910 BACKGROUND: Biomarkers of exposure to marijuana smoke can be detected in the urine of children with exposure to secondhand marijuana smoke, but the prevalence is unclear. METHODS: We studied children between the ages of 0 to 3 years who were coming in for well-child visits or hospitalized on the inpatient general pediatric unit between 2017 and 2018 at Kravis Children's Hospital at Mount Sinai. Parents completed an anonymous survey, and urine samples were analyzed for cotinine and 11-nor-9-carboxy-Delta9-tetrahydrocannabinol (COOH-THC), a metabolite of Delta9-tetrahydrocannabinol. RESULTS: Fifty-three children had urine samples available for analysis. COOH-THC was detectable in 20.8% of the samples analyzed and urinary cotinine was detectable in 90.2%. High levels of tobacco exposure (defined as cotinine >/=2.0 ng/ml) were significantly associated with COOH-THC detection (p < 0.01). We found that 34.8% of children who lived in attached housing where smoking was allowed within the property had detectable COOH-THC compared to 13.0% of children who lived in housing where smoking was not allowed at all. CONCLUSIONS: This study adds to the growing evidence that children are being exposed to marijuana smoke, even in places where recreational marijuana use is illegal. It is critical that more research be done on the impact of marijuana smoke exposure on children's health and development. IMPACT: We found that 20.8% of the 53 children recruited from Mount Sinai Hospital had detectable marijuana metabolites in their urine.Children with household tobacco smoke exposure and children who lived in attached housing where smoking was allowed on the premises were more likely to have detectable marijuana smoke metabolites.This study adds to the growing evidence that children are being exposed to marijuana smoke, even in places where marijuana remains illegal by state law. As states consider marijuana legalization, it is critical that the potential adverse health effects from marijuana exposure in children be taken into account. |
Opiate and tobacco use and exposure to carcinogens and toxicants in Golestan Cohort Study
Etemadi A , Poustchi H , Calafat AM , Blount BC , De Jesus VR , Wang L , Pourshams A , Shakeri R , Inoue-Choi M , Shiels MS , Roshandel G , Murphy G , Sosnoff CS , Bhandari D , Feng J , Xia B , Wang Y , Meng L , Kamangar F , Brennan P , Boffetta P , Dawsey SM , Abnet CC , Malekzadeh R , Freedman ND . Cancer Epidemiol Biomarkers Prev 2020 29 (3) 650-658 BACKGROUND: There is little information on human exposure to carcinogens and toxicants related to opiate use, alone or combined with tobacco. METHODS: Among male participants of the Golestan Cohort Study in Northeast Iran, we studied 28 never users of either opiates or tobacco, 33 exclusive cigarette smokers, 23 exclusive users of smoked opiates, and 30 opiate users who also smoked cigarettes (dual users; 21 smoked opiates and 9 ingested them). We quantified urinary concentrations of 39 exposure biomarkers: tobacco alkaloids, tobacco specific nitrosamines (TSNAs), polycyclic aromatic hydrocarbons (PAHs), and volatile organic compounds (VOCs) and used decomposition to parse out the share of the biomarker concentrations explained by opiate use and nicotine dose. RESULTS: Dual users had the highest concentrations of all biomarkers, but exclusive cigarette smokers and exclusive opiate users had substantially higher concentrations of PAH and VOC biomarkers than never users. Decomposition analysis showed that opiate use contributed a larger part of the PAH concentrations than nicotine dose, and the sum of 2- and 3-hydroxyphenanthrene ( summation operator2,3-phe) resulted almost completely from opiate use. Two acrylamide metabolites, a 1,3-butadiene metabolite, and a dimethylformamide metabolite were more strongly explained by opiate use. Acrylamide metabolites and summation operator2,3-phe were significantly higher in opiate smokers than opiate eaters; other biomarkers did not vary by the route of opiate intake. CONCLUSION: Both cigarette smokers and opiate users (by smoking or ingestion) were exposed to many toxicants and carcinogens. IMPACT: This high exposure, particularly among dual opiates and cigarette users can have substantial global public health impact. |
Vitamin E acetate in bronchoalveolar-lavage fluid associated with EVALI
Blount BC , Karwowski MP , Shields PG , Morel-Espinosa M , Valentin-Blasini L , Gardner M , Braselton M , Brosius CR , Caron KT , Chambers D , Corstvet J , Cowan E , De Jesus VR , Espinosa P , Fernandez C , Holder C , Kuklenyik Z , Kusovschi JD , Newman C , Reis GB , Rees J , Reese C , Silva L , Seyler T , Song MA , Sosnoff C , Spitzer CR , Tevis D , Wang L , Watson C , Wewers MD , Xia B , Heitkemper DT , Ghinai I , Layden J , Briss P , King BA , Delaney LJ , Jones CM , Baldwin GT , Patel A , Meaney-Delman D , Rose D , Krishnasamy V , Barr JR , Thomas J , Pirkle JL . N Engl J Med 2019 382 (8) 697-705 BACKGROUND: The causative agents for the current national outbreak of electronic-cigarette, or vaping, product use-associated lung injury (EVALI) have not been established. Detection of toxicants in bronchoalveolar-lavage (BAL) fluid from patients with EVALI can provide direct information on exposure within the lung. METHODS: BAL fluids were collected from 51 patients with EVALI in 16 states and from 99 healthy participants who were part of an ongoing study of smoking involving nonsmokers, exclusive users of e-cigarettes or vaping products, and exclusive cigarette smokers that was initiated in 2015. Using the BAL fluid, we performed isotope dilution mass spectrometry to measure several priority toxicants: vitamin E acetate, plant oils, medium-chain triglyceride oil, coconut oil, petroleum distillates, and diluent terpenes. RESULTS: State and local health departments assigned EVALI case status as confirmed for 25 patients and as probable for 26 patients. Vitamin E acetate was identified in BAL fluid obtained from 48 of 51 case patients (94%) in 16 states but not in such fluid obtained from the healthy comparator group. No other priority toxicants were found in BAL fluid from the case patients or the comparator group, except for coconut oil and limonene, which were found in 1 patient each. Among the case patients for whom laboratory or epidemiologic data were available, 47 of 50 (94%) had detectable tetrahydrocannabinol (THC) or its metabolites in BAL fluid or had reported vaping THC products in the 90 days before the onset of illness. Nicotine or its metabolites were detected in 30 of 47 of the case patients (64%). CONCLUSIONS: Vitamin E acetate was associated with EVALI in a convenience sample of 51 patients in 16 states across the United States. (Funded by the National Cancer Institute and others.). |
Evaluation of bronchoalveolar lavage fluid from patients in an outbreak of e-cigarette, or vaping, product use-associated lung injury - 10 states, August-October 2019
Blount BC , Karwowski MP , Morel-Espinosa M , Rees J , Sosnoff C , Cowan E , Gardner M , Wang L , Valentin-Blasini L , Silva L , De Jesus VR , Kuklenyik Z , Watson C , Seyler T , Xia B , Chambers D , Briss P , King BA , Delaney L , Jones CM , Baldwin GT , Barr JR , Thomas J , Pirkle JL . MMWR Morb Mortal Wkly Rep 2019 68 (45) 1040-1041 CDC, the Food and Drug Administration (FDA), state and local health departments, and multiple public health and clinical partners are investigating a national outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI). Based on data collected as of October 15, 2019, 86% of 867 EVALI patients reported using tetrahydrocannabinol (THC)-containing products in the 3 months preceding symptom onset (1). Analyses of THC-containing product samples by FDA and state public health laboratories have identified potentially harmful constituents in these products, such as vitamin E acetate, medium chain triglyceride oil (MCT oil), and other lipids (2,3) (personal communication, D.T. Heitkemper, FDA Forensic Chemistry Center, November 2019). Vitamin E acetate, in particular, might be used as an additive in the production of e-cigarette, or vaping, products; it also can be used as a thickening agent in THC products (4). Inhalation of vitamin E acetate might impair lung function (5-7). |
Environmental tobacco smoke exposure in relation to family characteristics, stressors and chemical co-exposures in California girls
Windham GC , Soriano JW , Dobraca D , Sosnoff CS , Hiatt RA , Kushi LH . Int J Environ Res Public Health 2019 16 (21) Childhood environmental tobacco smoke (ETS) exposure is a risk factor for adverse health outcomes and may disproportionately burden lower socioeconomic status groups, exacerbating health disparities. We explored associations of demographic factors, stressful life events, and chemical co-exposures, with cotinine levels, among girls in the CYGNET Study. Data were collected from families of girls aged 6-8 years old in Northern California, through clinic exams, questionnaires and biospecimens (n = 421). Linear regression and factor analysis were conducted to explore predictors of urinary cotinine and co-exposure body burdens, respectively. In unadjusted models, geometric mean cotinine concentrations were higher among Black (0.59 ug/g creatinine) than non-Hispanic white (0.27), Asian (0.32), or Hispanic (0.34) participants. Following adjustment, living in a rented home, lower primary caregiver education, and lack of two biologic parents in the home were associated with higher cotinine concentrations. Girls who experienced parental separation or unemployment in the family had higher unadjusted cotinine concentrations. Higher cotinine was also associated with higher polybrominated diphenyl ether and metals concentrations. Our findings have environmental justice implications as Black and socio-economically disadvantaged young girls experienced higher ETS exposure, also associated with higher exposure to other chemicals. Efforts to reduce ETS and co-exposures should account for other disparity-related factors. |
Evaluation of tobacco smoke and diet as sources of exposure to two heterocyclic aromatic amines for the U.S. population: NHANES 2013-2014
Zhang L , Wang L , Li Y , Xia Y , Chang CM , Xia B , Sosnoff CS , Pine BN , deCastro BR , Blount BC . Cancer Epidemiol Biomarkers Prev 2019 29 (1) 103-111 BACKGROUND: Heterocyclic aromatic amines (HAAs) are a group of hazardous substances produced during combustion of tobacco or high-temperature cooking of meats. 2-Amino-9H-pyrido[2,3-b]indole (AalphaC) is a major carcinogenic HAAs in tobacco smoke. METHODS: Urinary AalphaC, used as a marker of AalphaC exposure, was analyzed on spot urine samples from adult participants of the 2013-2014 cycle of the National Health and Nutrition Examination Survey (NHANES; N=1,792). AalphaC was measured using isotope-dilution liquid chromatography-tandem mass spectrometry. Exclusive combusted tobacco smokers were differentiated from non-users of tobacco products through both self-report and serum cotinine data. RESULTS: Among exclusive smokers, sample-weighted median urinary AalphaC was 40 times higher than non-users. Sample-weighted regression models showed that urinary AalphaC increased significantly with serum cotinine among both exclusive tobacco users and non-users with second-hand smoke exposure. Among non-users, eating beef cooked at high temperature was associated with a significant increase in urinary AalphaC, while consuming vegetables was associated with decreased AalphaC. In addition, smoking one-half pack of cigarettes per day was associated with a significant increase of 23.6 pg AalphaC/mL calculated at geometric mean of AalphaC, controlling for potential confounders. In comparison, increase in AalphaC attributable to consuming the 99th percentile of beef cooked at high temperature was 0.99 pg AalphaC/mL. CONCLUSIONS: Both exclusive smokers and non-users of tobacco in the general U.S. population are exposed to AalphaC from tobacco smoke, with additional, lesser contributions from certain dietary components. IMPACT: AalphaC is an important biomarker that is associated with tobacco smoke exposure. |
A biomonitoring assessment of secondhand exposures to electronic cigarette emissions
Johnson JM , Naeher LP , Yu X , Sosnoff C , Wang L , Rathbun SL , De Jesus VR , Xia B , Holder C , Muilenburg JL , Wang JS . Int J Hyg Environ Health 2019 222 (5) 816-823 BACKGROUND: Electronic cigarette (e-cigarette) conventions regularly bring together thousands of users around the world. In these environments, secondhand exposures to high concentrations of e-cigarette emissions are prevalent. Some biomarkers for tobacco smoke exposure may be used to characterize secondhand e-cigarette exposures in such an environment. METHODS: Participants who did not use any tobacco product attended four separate e-cigarette events for approximately six hours. Urine and saliva samples were collected from participants prior to the event, immediately after the event, 4-h after the event, and the next morning (first void). Urine samples from 34 participants were analyzed for cotinine, trans-3'-hydroxycotinine, S-(3-hydroxypropyl)-N-acetylcysteine (3-HPMA), S-carboxyethyl-N-acetylcysteine (CEMA), select tobacco-specific nitrosamines (TSNAs), and 8-isoprostane. Saliva samples were analyzed for cotinine and trans-3'-hydroxycotinine. RESULTS: Data from 28 of 34 participants were used in the data analysis. Creatinine-adjusted urinary cotinine concentrations increased up to 13-fold and peaked 4-h after completed exposure (range of adjusted geometric means [AGMs]=0.352-2.31mug/g creatinine). Salivary cotinine concentrations were also the highest 4-h after completed exposure (range of AGMs=0.0373-0.167ng/mL). Salivary cotinine and creatinine-corrected concentrations of urinary cotinine, trans-3'-hydroxycotinine, CEMA, and 3-HPMA varied significantly across sampling times. Urinary and salivary cotinine, urinary trans-3'-hydroxycotinine, and urinary 3-HPMA concentrations also varied significantly across events. CONCLUSION: Secondhand e-cigarette exposures lasting six hours resulted in significant changes in exposure biomarker concentrations of both nicotine and acrolein but did not change exposure to tobacco-specific nitrosamines. Additional research is needed to understand the relationship between biomarker concentrations and environmental concentrations of toxicants in e-cigarette emissions. |
Biomarkers of exposure among U.S. Adult cigar smokers: Population Assessment of Tobacco and Health (PATH) Study Wave 1 (2013-2014)
Chang CM , Rostron BL , Chang JT , Corey CG , Kimmel HL , Sosnoff CS , Goniewicz ML , Edwards KC , Hatsukami DK , Wang Y , Del Valle-Pinero AY , Yang M , Travers MJ , Arnstein S , Taylor K , Conway K , Ambrose BK , Borek N , Hyland A , Wang L , Blount BC , van Bemmel DM . Cancer Epidemiol Biomarkers Prev 2019 28 (5) 943-953 BACKGROUND: Given the diverse cigar market and limited data on biomarker patterns by cigar type, we compared biomarkers of nicotine and tobacco toxicants among cigar smokers and other groups. METHODS: Using Wave 1 urinary biomarker data from 5,604 adults in the Population Assessment of Tobacco and Health (PATH) Study, we compared geometric mean concentrations among cigar-only smokers (all cigars and separately for traditional, cigarillo, and filtered cigars), cigarette-only smokers, dual cigar/cigarette smokers, and never users of tobacco. We calculated geometric mean ratios (GMR) comparing groups with never users adjusting for sex, age, race/ethnicity, education and creatinine. RESULTS: Some day cigar-only smokers had lower biomarker concentrations than every day cigar-only smokers but higher than never users. Every day cigar-only smokers (n=61) had lower TNE-2 (cotinine+trans-3'-hydroxycotinine) compared to every day cigarette-only (n=2217;p<0.0001) and dual cigar/cigarette smokers (n=601;p<0.0001). Several biomarkers, including NNAL (NNK metabolite) and CYMA (metabolite of acrylonitrile), were comparable in these groups. In exploratory analyses, every day filtered cigar-only (n=7) smokers had higher biomarker concentrations compared to every day traditional cigar-only smokers (n=12) and cigarillo-only smokers (n=24). Every day smokers of each cigar type were similar to exclusive cigarette smokers. For some biomarkers, particularly for every day filtered cigar-only smokers, concentrations were higher. CONCLUSIONS: For some biomarkers, every day cigar-only smokers were comparable to every day cigarette-only smokers. Exploratory analyses suggest that biomarkers vary by cigar type with every day filtered cigar-only smokers having the highest concentrations. IMPACT: High exposure to harmful constituents among cigar smokers is a continuing health issue. |
Urinary biomarkers of carcinogenic exposure among cigarette, waterpipe and smokeless tobacco users and never users of tobacco in the Golestan Cohort Study
Etemadi A , Poustchi H , Chang CM , Blount BC , Calafat AM , Wang L , De Jesus VR , Pourshams A , Shakeri R , Shiels MS , Inoue-Choi M , Ambrose BK , Christensen CH , Wang B , Murphy G , Ye X , Bhandari D , Feng J , Xia B , Sosnoff CS , Kamangar F , Brennan P , Boffetta P , Dawsey SM , Abnet CC , Malekzadeh R , Freedman ND . Cancer Epidemiol Biomarkers Prev 2019 28 (2) 337-347 BACKGROUND: How carcinogen exposure varies across users of different, particularly non-cigarette, tobacco products remains poorly understood. METHODS: We randomly selected 165 participants of Golestan Cohort Study from northeastern Iran: 60 never users of any tobacco, 35 exclusive cigarette, 40 exclusive (78% daily) waterpipe, and 30 exclusive smokeless tobacco (nass) users. We measured concentrations of 39 biomarkers of exposure in 4 chemical classes in baseline urine samples: tobacco alkaloids, tobacco-specific nitrosamines (TSNAs), polycyclic aromatic hydrocarbons (PAHs), and volatile organic compounds (VOCs). We also quantified the same biomarkers in a second urine sample, obtained five years later, among continuing cigarette smokers and never tobacco users. RESULTS: Nass users had the highest concentrations of tobacco alkaloids. All tobacco users had elevated TSNA concentrations which correlated with nicotine dose. In both cigarette and waterpipe smokers, PAH and VOC biomarkers were higher than never tobacco users and nass users, and highly correlated with nicotine dose. PAH biomarkers of phenanthrene and pyrene, and two VOC metabolites (phenylmercapturic acid and phenylglyoxylic acid) were higher in waterpipe smokers than all other groups. PAH biomarkers among Golestan never tobacco users were comparable to those in U.S. cigarette smokers. All biomarkers had moderate to good correlations over five years, particularly in continuing cigarette smokers. CONCLUSION: We observed two patterns of exposure biomarkers that differentiated the use of the combustible products (cigarettes and waterpipe) from the smokeless product. Environmental exposure from non-tobacco sources appeared to contribute to the presence of high levels of PAH metabolites in the Golestan Cohort. |
Exposure to secondhand smoke among nonsmokers - United States, 1988-2014
Tsai J , Homa DM , Gentzke AS , Mahoney M , Sharapova SR , Sosnoff CS , Caron KT , Wang L , Melstrom PC , Trivers KF . MMWR Morb Mortal Wkly Rep 2018 67 (48) 1342-1346 Exposure to secondhand smoke from burning tobacco products can cause sudden infant death syndrome, respiratory infections, ear infections, and asthma attacks in infants and children, and coronary heart disease, stroke, and lung cancer in adult nonsmokers (1). There is no risk-free level of secondhand smoke exposure (2). CDC analyzed questionnaire and laboratory data from the National Health and Nutrition Examination Survey (NHANES) to assess patterns of secondhand smoke exposure among U.S. nonsmokers. The prevalence of secondhand smoke exposure among U.S. nonsmokers declined substantially during 1988-2014, from 87.5% to 25.2%. However, no change in exposure occurred between 2011-2012 and 2013-2014, and an estimated one in four nonsmokers, or approximately 58 million persons, were still exposed to secondhand smoke during 2013-2014. Moreover, marked disparities persisted across population groups. Exposure prevalence was highest among nonsmokers aged 3-11 years (37.9%), non-Hispanic blacks (50.3%), and those who were living in poverty (47.9%), in rental housing (38.6%), or with someone who smoked inside the home (73.0%), or among persons who had less than a high school education (30.7%). Comprehensive smoke-free laws and policies for workplaces and public places and smoke-free rules for homes and vehicles can further reduce secondhand smoke exposure among all nonsmokers. |
Systemic absorption of nicotine following acute secondhand exposure to electronic cigarette aerosol in a realistic social setting
Melstrom P , Sosnoff C , Koszowski B , King BA , Bunnell R , Le G , Wang L , Thanner MH , Kenemer B , Cox S , DeCastro BR , McAfee T . Int J Hyg Environ Health 2018 221 (5) 816-822 Evidence suggests exposure of nicotine-containing e-cigarette aerosol to nonusers leads to systemic absorption of nicotine. However, no studies have examined acute secondhand exposures that occur in public settings. Here, we measured the serum, saliva and urine of nonusers pre- and post-exposure to nicotine via e-cigarette aerosol. Secondarily, we recorded factors affecting the exposure. Six nonusers of nicotine-containing products were exposed to secondhand aerosol from ad libitum e-cigarette use by three e-cigarette users for 2h during two separate sessions (disposables, tank-style). Pre-exposure (baseline) and post-exposure peak levels (Cmax) of cotinine were measured in nonusers' serum, saliva, and urine over a 6-hour follow-up, plus a saliva sample the following morning. We also measured solution consumption, nicotine concentration, and pH, along with use behavior. Baseline cotinine levels were higher than typical for the US population (median serum session one=0.089ng/ml; session two=0.052ng/ml). Systemic absorption of nicotine occurred in nonusers with baselines indicative of no/low tobacco exposure, but not in nonusers with elevated baselines. Median changes in cotinine for disposable exposure were 0.007ng/ml serum, 0.033ng/ml saliva, and 0.316ng/mg creatinine in urine. For tank-style exposure they were 0.041ng/ml serum, 0.060ng/ml saliva, and 0.948ng/mg creatinine in urine. Finally, we measured substantial differences in solution nicotine concentrations, pH, use behavior and consumption. Our data show that although exposures may vary considerably, nonusers can systemically absorb nicotine following acute exposure to secondhand e-cigarette aerosol. This can particularly affect sensitive subpopulations, such as children and women of reproductive age. |
Age at pubertal onset in girls and tobacco smoke exposure during pre- and postnatal susceptibility windows
Windham GC , Lum R , Voss R , Wolff M , Pinney SM , Teteilbaum SL , Sosnoff CS , Dobraca D , Biro F , Hiatt RA , Greenspan LC , Galvez M , Kushi LH . Epidemiology 2017 28 (5) 719-727 BACKGROUND: Tobacco smoke contains known hormonally active chemicals and reproductive toxicants. Several studies have examined prenatal maternal smoking and offspring age at menarche, but few examined earlier pubertal markers, nor accounted for exposure during childhood. Our objective was to examine pre- and postnatal smoke exposure in relation to timing of early pubertal events. METHODS: An ethnically diverse cohort of 1239 girls was enrolled at age 6-8 years old for a longitudinal study of puberty at three US sites. Girls participated in annual or semi-annual exams to measure anthropometry and Tanner breast and pubic hair stages. Prenatal and current tobacco smoke exposures, as well as covariates, were obtained from parent questionnaire. Cotinine was measured in urine collected at enrollment. Using accelerated failure time models, we calculated adjusted time ratios for age at pubertal onset (maturation stages 2 or higher) and smoke exposure. RESULTS: Girls with higher prenatal (≥5 cigarettes per day) or secondhand smoke exposure had earlier pubic hair development than unexposed (adjusted time ratio: 0.92 [95% CI = 0.87, 0.97] and 0.94 [95% CI = 0.90, 0.97], respectively). Including both exposures in the same model yielded similar associations. Higher urinary cotinine quartiles were associated with younger age at breast and pubic hair onset in unadjusted models, but not after adjustment. CONCLUSIONS: Greater prenatal and childhood secondhand smoke exposure were associated with earlier onset of pubic hair, but not breast, development. These exposures represent modifiable risk factors for early pubertal development that should be considered for addition to the extensive list of adverse effects from tobacco smoke. |
Smoking behavior and exposure: Results of a menthol cigarette cross-over study
Watson CV , Richter P , de Castro BR , Sosnoff C , Potts J , Clark P , McCraw J , Yan X , Chambers D , Watson C . Am J Health Behav 2017 41 (3) 309-319 OBJECTIVE: Our objective was to improve understanding of the differences in use behavior and exposure when smoking menthol and non-menthol cigarettes using a 2-part cross-over design. METHODS: Adult daily smokers were assigned randomly to alternate between 2 weeks of exclusively smoking a menthol test cigarette or a non-menthol test cigarette. Urine and saliva were collected for biomarker measurements; carbon monoxide (CO) was measured, and participants smoked test cigarettes through a CreSS(R) smoking topography device during 3 clinic visits. Participants turned in their cigarette butts from the test periods for determination of mouth level nicotine and completed subjective questionnaires related to the test cigarettes. RESULTS: Regardless of cigarette preference, participants had higher salivary cotinine when smoking the non-menthol test cigarette, but there were no significant differences detected in urine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol between the 2 test cigarettes. Mouth level nicotine, puff volume, and puff duration were significantly higher when smoking the menthol brand. Both menthol and non-menthol smokers reported significantly lower enjoyment and satisfaction scores for test cigarettes compared with their brand of choice. CONCLUSIONS: Our results suggest that mentholation has an effect on measures of smoking behavior and that mouth level nicotine is a useful indicator of between-brand smoke exposure. |
Detecting biomarkers of secondhand marijuana smoke in young children
Wilson KM , Torok MR , Wei B , Wang L , Robinson M , Sosnoff CS , Blount BC . Pediatr Res 2016 81 (4) 589-592 BACKGROUND: The impact of secondhand marijuana smoke exposure on children is unknown. New methods allow detection of secondhand marijuana smoke in children. METHODS: We studied children ages 1 month to 2 years hospitalized with bronchiolitis in Colorado from 2013-2015. Parents completed a survey, and urine samples were analyzed for cotinine using LC/MS/MS (LOD 0.03 ng/ml) and marijuana metabolites including COOH-THC (LOD 0.015 ng/ml). RESULTS: A total of 43 subjects had urine samples available for analysis. Most (77%) of the subjects were male, and 52% were less than 1 year of age. COOH-THC was detectable in 16% of the samples analyzed (THC+); the range in COOH-THC concentration was .04-1.5 ng/ml. 2 subjects had levels >1 ng/ml. Exposure did not differ by gender or age. Non-white children had more exposure than white children (44% vs. 9%; p<.05). 56% of children with cotinine >2.0 ng/ml were THC+, compared with 7% of those with lower cotinine (p<.01). CONCLUSIONS: Metabolites of marijuana smoke can be detected in children; in this cohort, 16% were exposed. Detectable COOH-THC is more common in children with tobacco smoke exposure. More research is needed to assess the health impacts of marijuana smoke exposure on children and inform public health policy. |
Temporal trends of secondhand smoke exposure: Nonsmoking workers in the United States (NHANES 2001-2010)
Wei B , Bernert JT , Blount BC , Sosnoff CS , Wang L , Richter P , Pirkle JL . Environ Health Perspect 2016 124 (10) 1568-1574 BACKGROUND: The workplace is one of the major locations outside of the home for nonsmokers' exposure to secondhand smoke (SHS). New policies in many states and localities restrict or prohibit smoking in the worksites and information on current trends in the exposure of nonsmokers to SHS across various occupational groups is therefore needed. OBJECTIVE: To evaluate temporal trends in SHS exposure among nonsmoking workers in the United States, and identify those occupations with workers with the highest levels of SHS exposure. METHODS: We combined serum cotinine (sCOT) measurements and questionnaire data from five survey cycles of the National Health and Nutrition Examination Survey (NHANES: 2001-2010). Trends of SHS exposure by occupations were examined by percent changes and least-squares geometric means (LSGMS) of sCOT concentrations computed using sample-weighted multiple regression models. RESULTS: Between NHANES 2001-02 and 2009-10, LSGMs of sCOT levels had changed -25% (95% CI: -39, -7%) in nonsmoking workers. The largest decrease was identified among food preparation workers -54% (95% CI: -74, -19%), followed by white collar (-40%, 95% CI: -56, -19%) and blue collar workers (-32%, 95% CI: -51, -5%). LSGMs of sCOT remained highest in food preparation workers in all survey cycles, but the gap between occupations narrowed in the latest survey cycle (2009-10). For instance, the gap in LSGMs of sCOT between food preparation and science/education workers dropped above 70% during 2000 to 2010. CONCLUSIONS: During the period from 2001 to 2010, the overall SHS exposure in nonsmoking workers has declined with substantial decline in food preparation/service and blue-collar workers. Although disparities persist in SHS exposure, the gap among occupations has narrowed. |
Urinary concentrations of PAH and VOC metabolites in marijuana users
Wei B , Alwis KU , Li Z , Wang L , Valentin-Blasini L , Sosnoff CS , Xia Y , Conway KP , Blount BC . Environ Int 2015 88 1-8 BACKGROUND: Marijuana is seeing increased therapeutic use, and is the world's third most-popular recreational drug following alcohol and tobacco. This widening use poses increased exposure to potentially toxic combustion by-products from marijuana smoke and the potential for public health concerns. OBJECTIVES: To compare urinary metabolites of polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs) among self-reported recent marijuana users and nonusers, while accounting for tobacco smoke exposure. METHODS: Measurements of PAH and VOC metabolites in urine samples were combined with questionnaire data collected from participants in the National Health and Nutrition Examination Surveys (NHANES) from 2005 to 2012 in order to categorize participants (≥18years) into exclusive recent marijuana users and nonusers. Adjusted geometric means (GMs) of urinary concentrations were computed for these groups using multiple regression analyses to adjust for potential confounders. RESULTS: Adjusted GMs of many individual monohydroxy PAHs (OH-PAHs) were significantly higher in recent marijuana users than in nonusers (p<0.05). Urinary thiocyanate (p<0.001) and urinary concentrations of many VOC metabolites, including metabolites of acrylonitrile (p<0.001) and acrylamide (p<0.001), were significantly higher in recent marijuana users than in nonusers. CONCLUSIONS: We found elevated levels of biomarkers for potentially harmful chemicals among self-identified, recent marijuana users compared with nonusers. These findings suggest that further studies are needed to evaluate the potential health risks to humans from the exposure to these agents when smoking marijuana. |
- Page last reviewed:Feb 1, 2024
- Page last updated:May 06, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure