Biomarkers of Exposure to Tobacco-Related Toxicants among Adult Nicotine Pouch Users.

IF 3 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Nicotine & Tobacco Research Pub Date : 2025-09-09 DOI:10.1093/ntr/ntaf185

Hongying Daisy Dai, Brian Young

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引用次数: 0

Abstract

Introduction: Nicotine pouches (NPs) are an emerging nicotine delivery system. Understanding nicotine and toxicant exposure among NP users compared with users of other tobacco products and non-users is critical for informing public health strategies.

Methods: Data (n = 4527) were drawn from the Population Assessment of Tobacco and Health Study Wave 7 (2022-2023). Participants were classified into four mutually exclusive groups: non- tobacco users, exclusive NP users, exclusive e-cigarette users, and exclusive cigarette smokers. Geometric mean concentrations of biomarkers from urinary nicotine metabolites, minor tobacco alkaloids, and heavy metals were compared across groups using general linear model adjusted for demographics and current marijuana use.

Results: Despite having higher levels of nicotine metabolites than non-tobacco users (e.g., cotinine, 2137.2 vs. 0.2 ng/mg creatinine, p<.0001), exclusive NP users showed no significant differences in levels of metals or minor tobacco alkaloids (p>.05). Exclusive NP users had comparable levels of nicotine metabolites to exclusive cigarette smokers (p>.05), but significantly higher concentrations of certain nicotine metabolites than exclusive e-cigarette users (e.g., TNE-2: 27.3 vs. 7.0, p=.02). Meanwhile, exclusive NP users exhibited lower levels of anabasine (0.6 vs. 9.3 ng/mg creatinine, p<.0001), anatabine (0.4 vs. 14.7 ng/mg creatinine, p<.0001), and lead (0.2 vs. 0.4 ng/mg creatinine, p=.003) than exclusive cigarette smokers and lower levels of lead (p=.02) than exclusive e-cigarette users.

Conclusions: NP users have substantially elevated nicotine exposure without a corresponding rise in selected tobacco alkaloids or metals. Findings from objective biomarker measures could inform harm reduction strategies and shape regulatory policies concerning emerging nicotine products.

Implications: Nicotine pouches are gaining popularity in the United States. The long-term health effects of nicotine pouch use remain unknown, and this national study offered early evidence into the scope of toxicant exposure associated with nicotine pouch use. Exclusive nicotine pouch users exhibited higher levels of nicotine metabolites but lower concentrations of anabasine and lead compared to cigarette smokers, indicating that nicotine pouches may serve as a potential harm-reduction strategy for combustible cigarette smokers. Findings from this study add to the current field of tobacco regulatory science and may inform future efforts to evaluate their effectiveness in smoking cessation or substitution.

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成年尼古丁袋使用者暴露于烟草相关毒物的生物标志物。

尼古丁袋（NPs）是一种新兴的尼古丁输送系统。与其他烟草制品使用者和非使用者相比，了解烟草使用者的尼古丁和有毒物质暴露情况对于制定公共卫生战略至关重要。方法：数据（n = 4527）取自烟草与健康研究第7期人口评估（2022-2023）。参与者被分为四个相互排斥的组：非烟草使用者、专用NP使用者、专用电子烟使用者和专用香烟吸烟者。尿尼古丁代谢物、微量烟草生物碱和重金属生物标志物的几何平均浓度通过人口统计学和当前大麻使用调整后的一般线性模型进行了组间比较。结果：尽管吸烟者的尼古丁代谢物水平高于非吸烟者（例如，可替宁为2137.2纳克/毫克，肌酐为0.2纳克/毫克，p.05）。纯NP使用者的尼古丁代谢物水平与纯香烟使用者相当（p>.05），但某些尼古丁代谢物浓度明显高于纯电子烟使用者（例如，TNE-2: 27.3 vs. 7.0, p= 0.02）。与此同时，纯NP使用者表现出较低的木碱水平（0.6 vs. 9.3 ng/mg肌酐）。结论：NP使用者尼古丁暴露量显著增加，但未相应增加选定的烟草生物碱或金属。客观生物标志物测量的结果可以为减少危害的策略提供信息，并形成有关新兴尼古丁产品的监管政策。启示：尼古丁袋在美国越来越受欢迎。使用尼古丁袋对健康的长期影响尚不清楚，这项全国性研究提供了早期证据，表明使用尼古丁袋与有毒物质接触的范围有关。与吸烟者相比，尼古丁烟袋使用者的尼古丁代谢物水平较高，但烟碱和铅的浓度较低，这表明尼古丁烟袋可能是可燃香烟吸烟者减少危害的潜在策略。这项研究的发现为当前的烟草管理科学领域增添了新的内容，并可能为今后评估其在戒烟或替代吸烟方面的有效性提供信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nicotine & Tobacco Research 医学-公共卫生、环境卫生与职业卫生

CiteScore

8.10

自引率

10.60%

发文量

268

审稿时长

3-8 weeks

期刊介绍： Nicotine & Tobacco Research is one of the world''s few peer-reviewed journals devoted exclusively to the study of nicotine and tobacco. It aims to provide a forum for empirical findings, critical reviews, and conceptual papers on the many aspects of nicotine and tobacco, including research from the biobehavioral, neurobiological, molecular biologic, epidemiological, prevention, and treatment arenas. Along with manuscripts from each of the areas mentioned above, the editors encourage submissions that are integrative in nature and that cross traditional disciplinary boundaries. The journal is sponsored by the Society for Research on Nicotine and Tobacco (SRNT). It publishes twelve times a year.