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Tobacco Product-Related Health Issues: Toxicants, Biomonitoring, Health Risks, and Chronic Disease

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Toxicology and Public Health".

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 20436

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Dr. Richard Steven Pappas

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Centers for Disease Control and Prevention, Tobacco and Volatiles Branch, 4770 Buford Hwy, MS S110-4, Atlanta, GA 30341, USA
Interests: analysis of tobacco and cannabis products including electronic nicotine delivery systems, electronic cannabinoid delivery systems, and their smoke and aerosol emissions for toxic metals, metalloids, and inorganic particles

Special Issue Information

Dear Colleagues,

Individuals who smoke combustible tobacco products or inhale aerosols from electronic cigarettes and other non-combustion devices are exposed to thousands of toxicants that are both organic and inorganic in nature. Exposure to toxicants from tobacco products through inhalation results in numerous risks for lung injury and chronic disease. In order to address challenges related to the investigation of the health risks of the use of tobacco products, well-validated analyses of smoke or aerosol constituents and the biomonitoring of exposure through analyses of biomarkers in body fluids are necessary. These data are required for assessments of health risks and epidemiological investigations of chronic diseases associated with the use of tobacco products. Manuscripts describing investigations of toxicants in emissions from tobacco products, biomarker investigations related to health risks with well-validated methods, the assessment of health risks from exposure to toxicants from tobacco products, and correlations with chronic disease are welcomed in this Special Issue.

Disclaimer: We will not accept research funded in part or full by any tobacco companies in this Special Issue. For more details, please check: https://www.mdpi.com/1660-4601/15/12/2831/htm.

Dr. Richard Steven Pappas
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

tobacco
cigarettes
cigars
smoke
secondhand smoke
aerosol
particles
heat not burn
electronic cigarettes
smoking
vaping
lung
health risk
COPD
cancer
emphysema
chronic bronchitis
asthma

Published Papers (5 papers)

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Research

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9 pages, 1346 KiB

Open AccessArticle

Short- and Long-Term Stability of Aromatic Amines in Human Urine

by Shrila Mazumder, Rayaj A. Ahamed, Tiffany H. Seyler and Lanqing Wang

Int. J. Environ. Res. Public Health 2023, 20(5), 4135; https://doi.org/10.3390/ijerph20054135 - 25 Feb 2023

Cited by 2 | Viewed by 1572

Abstract

Several aromatic amines (AAs) are established by the International Agency for Research on Cancer as carcinogenic (group 1) or probable/possible carcinogens to humans (group 2A/2B). AAs can be found in mainstream and sidestream smoke from combustible tobacco products, as well as in certain environmental pollution and occupational exposure from several chemical industry sectors. Exposure to AAs can be estimated by measuring their concentrations in urine; however, information about the short-term and long-term stabilities of AAs in urine need to be characterized before conducting large-scale population studies on AA exposure and the potentially harmful effects of AA exposure. In this report, the storage stability of o-toluidine, 2,6-dimethylaniline, o-anisidine, 1-aminonaphthalene, 2-aminonaphthalene, and 4-aminobiphenyl fortified in pooled, filtered, non-smokers’ urine is analyzed by isotope dilution gas chromatography-triple quadrupole mass spectrometry (ID GC-MS/MS). The six AAs were measured in urine samples stored at ~20 °C (collection temperature), 4 °C and 10 °C (short-term transit temperatures), and −20 °C and −70 °C (long-term storage temperatures) over a 10-day period. All six analytes were stable for 10 days at transit and long-term storage temperatures but showed reduced recovery at 20 °C. The instability of the target AAs at 20 °C suggests that immediate storage of freshly voided urine at low temperatures is needed to attenuate degradation. A subset of the urine samples was analyzed following a longer storage duration at −70 °C: all AAs were stable for up to 14 months at this temperature. The stability of the six AAs in urine samples can be maintained at the various temperature levels and storage times expected in a typical study set. Full article

(This article belongs to the Special Issue Tobacco Product-Related Health Issues: Toxicants, Biomonitoring, Health Risks, and Chronic Disease)

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11 pages, 1210 KiB

Open AccessArticle

The Serum Levels of the Heavy Metals Cu, Zn, Cd, and Pb and Progression of COPD—A Preliminary Study

by Elica Valkova, Vasil Atanasov, Tatyana Vlaykova, Tanya Tacheva, Yanitsa Zhelyazkova, Dimo Dimov and Kristian Yakimov

Int. J. Environ. Res. Public Health 2023, 20(2), 1427; https://doi.org/10.3390/ijerph20021427 - 12 Jan 2023

Cited by 4 | Viewed by 1645

Abstract

There is evidence in previous studies that high levels of heavy metals may play a key role in the development of COPD due to the induction of chronic inflammation and oxidative stress. In this preliminary study, we used atomic absorption spectrophotometry to measure the levels of four heavy metals (Cu, Zn, Cd, and Pb) in blood serum of COPD patients and controls over 2 years. Clinical data on disease progression or absence were collected in patients living in the industrial region of Stara Zagora, Bulgaria. The mean values of Cu in the serum of patients with COPD and the control group were 374.29 ± 15.03 μg/L and 238.55 ± 175.31 μg/L, Zn—2010.435 ± 670.006 μg/L and 1672.78 ± 934.27 μg/L, Cd—0.334 ± 0.0216 μg/L and 0.395 ± 0.110 μg/L and Pb—0.0732 ± 0.009 μg/L and 0.075 ± 0.0153 μg/L. This is probably because these elements are biogenic and are used in the body for its anti-oxidant protection. In fact, it cannot be stated with certainty that elevated levels of Cu and Zn in the environment have a negative impact in COPD patients. There was a trend towards higher levels of the toxicants lead and cadmium in COPD patients compared to the control group of patients. There is a statistically unproven trend toward higher levels of lead and cadmium in COPD patients compared to controls, which to some extent supports our hypothesis that there is a relationship between environmental lead and cadmium levels and the COPD manifested. In COPD patients, a positive correlation was found between BMI and serum Cu levels (r = 0.413, p = 0.005). A higher concentration of serum Cu was found in men with BMI ≥ 30, compared to those with BMI < 30. There is also a positive correlation to a lesser extent between CRP and cadmium (r = 0.380; p = 0.019) and lead (r = 0.452; p = 0.004). The correlation of lead and cadmium with PSA also shows that these elements may also be associated with the presence of inflammatory processes. A significant negative correlation exists between Pb in the serum of patients with COPD and their blood hemoglobin (r = −356; p = 0.028). The results of our study suggest that higher doses of the trace elements Cu and Zn do not always have a negative effect in patients with COPD, while the toxicants Pb and Cd may be involved in COPD exacerbation and can be used as prognostic biomarkers for progression. Further studies are warranted to confirm these preliminary results. Full article

(This article belongs to the Special Issue Tobacco Product-Related Health Issues: Toxicants, Biomonitoring, Health Risks, and Chronic Disease)

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Review

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14 pages, 2190 KiB

Open AccessReview

Classification, Perception, and Toxicity of Emerging Flavored Oral Nicotine Pouches

by Sadiya Bi Shaikh, Chad Newton, Wai Cheung Tung, Yehao Sun, Dongmei Li, Deborah Ossip and Irfan Rahman

Int. J. Environ. Res. Public Health 2023, 20(5), 4526; https://doi.org/10.3390/ijerph20054526 - 3 Mar 2023

Cited by 5 | Viewed by 4727

Abstract

Introduction: Oral Nicotine Pouches (ONPs) are the new form of nicotine pouches that have become a type of emerging smokeless tobacco product sold by various tobacco companies. These smokeless tobacco products are marketed for usage all over as snus containing tobacco-derived nicotine (natural) or as tobacco-free nicotine (synthetic) as substitutes for other tobacco products. Based on perception and socio-behavioral aspects, ONPs have become popular tobacco products among adolescents/young adults, and over 50% of young adult users of ONP use flavored ONPs, such as menthol/mint, tobacco, dessert/candy, and fruity, which are the most popular flavors. Various new ONP flavors are currently popular locally as well as in the online market. Tobacco, menthol, and fruit-flavored ONPs could motivate cigarette smokers to change to ONPs. Methods: We expanded our knowledge on natural/synthetic ONP flavor wheels to available data on ONPs, describing, in detail, their flavors and brands (US and Europe) in both natural and synthetic ONP categories. We classified over 152 snus and 228 synthetic ONPs into the following flavor categories: “Tobacco”, “Menthol/Mint”, “Fruity”, “Candy/Deserts”, “Drink”, “Aroma”, “Spices”, and “Mixed Flavors”. Results: Based on total numbers, we found the most popular ONP flavors, sold as tobacco and menthol, to be among natural ONPs; among synthetic ONPs, fruity and menthol are the most prominent flavors, with varying concentrations of nicotine and other flavoring chemicals, including coolant WS-23. We also showed possible molecular targets and toxicities, due to exposure to ONPs, activating several signaling cascades such as AKT and NF-kappaB, which might possibly lead to apoptosis and epithelial mesenchymal transition (EMT). Conclusions: Considering the marketing of ONP products with various flavor profiles and with most of these products containing tobacco/menthol/fruit flavor, it is likely to have regulation and a marketing disclaimer on some of these products. Further, it would be logical to determine how the market reacts in terms of compliance and non-compliance with flavor restrictions by the regulatory agencies. Full article

(This article belongs to the Special Issue Tobacco Product-Related Health Issues: Toxicants, Biomonitoring, Health Risks, and Chronic Disease)

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15 pages, 642 KiB

Open AccessReview

Chemical Profiles and Toxicity of Electronic Cigarettes: An Umbrella Review and Methodological Considerations

by Nargiz Travis, Marie Knoll, Steven Cook, Hayoung Oh, Christopher J. Cadham, Luz María Sánchez-Romero and David T. Levy

Int. J. Environ. Res. Public Health 2023, 20(3), 1908; https://doi.org/10.3390/ijerph20031908 - 20 Jan 2023

Cited by 9 | Viewed by 2784

Abstract

Background: Electronic cigarettes (ECs) are often marketed as a safer alternative to combustible tobacco products. The global EC market has rapidly expanded since their introduction, creating an urgent need for research describing the toxicity and chemical composition of ECs. We conducted an umbrella review to summarize the evidence from existing systematic reviews (SRs). Methods: The search for SRs was conducted across four electronic databases through 25 January 2022. Methodological quality was assessed using the AMSTAR-2 quality appraisal tool. Results: Twenty-five SRs were included in our umbrella review. Chemical profiles widely varied across studies included in the reviews, which was mainly attributed to the lack of standardized protocols investigating the constituents, and differences in EC devices and e-liquids tested. Metals were more abundant in some EC aerosols than cigarettes, while carbonyls were typically found at lower levels. There was consistent evidence of in vitro toxicity from EC aerosol and e-liquid exposure. AMSTAR-2 revealed important limitations across reviews. Conclusions: While most reviews concluded that ECs were likely less harmful than cigarettes, there was hesitancy to draw clear conclusions due to variable analytical procedures and inconsistent findings among the included studies. Future SRs with improved methodology and reporting are needed to adequately inform tobacco regulatory actions. Full article

(This article belongs to the Special Issue Tobacco Product-Related Health Issues: Toxicants, Biomonitoring, Health Risks, and Chronic Disease)

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23 pages, 1165 KiB

Open AccessReview

Health Effects of Electronic Cigarettes: An Umbrella Review and Methodological Considerations

by Nargiz Travis, Marie Knoll, Christopher J. Cadham, Steven Cook, Kenneth E. Warner, Nancy L. Fleischer, Clifford E. Douglas, Luz María Sánchez-Romero, Ritesh Mistry, Rafael Meza, Jana L. Hirschtick and David T. Levy

Int. J. Environ. Res. Public Health 2022, 19(15), 9054; https://doi.org/10.3390/ijerph19159054 - 25 Jul 2022

Cited by 10 | Viewed by 8996

Abstract

E-cigarettes are often marketed as a safer alternative to combustible cigarettes. However, their health effects, especially those associated with long-term use, remain largely uncertain. We conducted an umbrella review of the cardiopulmonary and carcinogenic risks of e-cigarette use, distinguishing between short-term and long-term health effects. The search for systematic reviews was conducted across four electronic databases through 25 January 2022. Methodological quality was assessed using the AMSTAR-2 quality appraisal tool. Seventeen systematic reviews, including five meta-analyses, were included in our umbrella review. There was a clear underreporting of e-cigarette devices and e-liquid types, e-cigarette and cigarette exposure, and the health and smoking status of study participants. Overall, the findings suggest that short-term use of e-cigarettes may be associated with acute cardiopulmonary risks, although to a lesser extent than cigarette use. Long-term e-cigarette use may have pulmonary/respiratory benefits in those who switch from chronic cigarette smoking, particularly in individuals with asthma and chronic obstructive pulmonary disease (COPD). Evidence on intermediate and long-term carcinogenic effects is lacking. This umbrella review underscores the urgent need for systematic reviews with better adherence to established reporting guidelines, consistent definitions of duration of e-cigarette use, a focus on newer devices, and accounting for the impacts of former or current smoking. Full article

(This article belongs to the Special Issue Tobacco Product-Related Health Issues: Toxicants, Biomonitoring, Health Risks, and Chronic Disease)

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