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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Benowitz, Neal L. Renner, Caroline C. Lanier, Anne P. Tyndale, Rachel F. Hatsukami, Dorothy K. Lindgren, Bruce Stepanov, Irina Watson, Clifford H. Sosnoff, Connie S. Jacob, Peyton |
| Spatial Coverage | Alaska |
| Description | Country affiliation: United States Author Affiliation: Benowitz NL ( University of California, San Francisco, CA, USA. NBenowitz@MedSFGH.ucsf.edu) |
| Abstract | BACKGROUND: The prevalence of tobacco use, both cigarette smoking and smokeless, including iqmik (homemade smokeless tobacco prepared with dried tobacco leaves mixed with alkaline ash), and of tobacco-related cancer is high in Alaskan Native people (AN). To investigate possible mechanisms of increased cancer risk we studied levels of nicotine and tobacco-specific nitrosamines (TSNA) in tobacco products and biomarkers of tobacco toxicant exposure in Southwestern AN people. METHODS: Participants included 163 cigarette smokers, 76 commercial smokeless tobacco, 20 iqmik, 31 dual cigarette smokers and smokeless tobacco, and 110 nontobacco users. Tobacco use history, samples of tobacco products used, and blood and urine samples were collected. RESULTS: Nicotine concentrations were highest in cigarette tobacco and TSNAs highest in commercial smokeless tobacco products. The AN participants smoked on average 7.8 cigarettes per day. Nicotine exposure, assessed by several biomarker measures, was highest in iqmik users, and similar in smokeless tobacco and cigarette smokers. TSNA exposure was highest in smokeless tobacco users, and polycyclic aromatic hydrocarbon exposure was highest in cigarette smokers. CONCLUSIONS: Despite smoking fewer cigarettes per day, AN cigarette smokers had similar daily intake of nicotine compared to the general U.S. population. Nicotine exposure was greatest from iqmik, likely related to its high pH due to preparation with ash, suggesting high addiction potential compared to other smokeless tobacco products. TSNA exposure was much higher with smokeless tobacco than other product use, possibly contributing to the high rates of oral cancer. IMPACT: Our data contribute to an understanding of the high addiction risk of iqmik use and of the cancer-causing potential of various forms of tobacco use among AN people. |
| File Format | HTM / HTML |
| ISSN | 10559965 |
| e-ISSN | 15387755 |
| DOI | 10.1158/1055-9965.EPI-11-1178 |
| Journal | Cancer Epidemiology Biomarkers & Prevention |
| Issue Number | 6 |
| Volume Number | 21 |
| Language | English |
| Publisher | American Association for Cancer Research |
| Publisher Date | 2012-06-01 |
| Publisher Place | United States |
| Access Restriction | Open |
| Subject Keyword | Discipline Cancer epidemiology Carcinogens Metabolism Indians, North American Nicotine Smoking Ethnology Tobacco, Smokeless Tobacco Alaska Adverse Effects Research Support, N.i.h., Extramural |
| Content Type | Text |
| Resource Type | Article |
| Subject | Epidemiology Oncology |
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