title: Evaluation of biomarkers of exposure in adult cigarette smokers using Marlboro snus.
abstract: BACKGROUND
  It has been reported that adult smokers (AS) may be considering smokeless tobacco products as an alternative to smoking. The objective of this study was to evaluate the change in exposure in AS using Marlboro snus (MSNUS) (a tobacco pouch product in test market in June 2007).
  
  
  METHODS
  AS were randomized into the following groups--CS: subjects (n = 30) continue smoking their own brand; DU: subjects (n = 60) reduced their daily cigarette consumption by >or=50% and were allowed to use MSNUS; SN: subjects (n = 15) stopped smoking their cigarettes but were allowed to use MSNUS; NT: subjects (n = 15) were not allowed to use any tobacco products for the entire duration of the 8-day study. Biomarkers of smoke exposure (BOE) measured at baseline and postbaseline were 24-hr urinary excretion of metabolites of N-nitrosamines, nicotine (urine and plasma), aromatic amines, benzene, and polycyclic aromatic hydrocarbon; urine mutagenicity; and carboxyhemoglobin at various timepoints.
  
  
  RESULTS
  Statistically significant (p < .05) reductions in all the urinary BOE were observed in the DU group compared with the CS group. After correcting for the residual effect, a proportionate reduction (approximately 50%) in most of the biomarkers was observed. Even larger reductions, similar to the NT group, were observed in the SN group.
  
  
  CONCLUSIONS
  The proportionate reduction in exposure when reducing the number of cigarettes by 50% and using MSNUS, under the consumption patterns observed, suggest that the AS did not appear to alter their smoking behavior. The added exposure from MSNUS usage in this group was minimal. The AS sustained substantial reductions in exposure when using MSNUS exclusively.
authors.affiliation: Altria Client Services, Center for Research and Technology, 601 East Jackson Street, Richmond, VA 23219, USA. mohamadi.sarkar@altria.com
authors.forename: Mohamadi
authors.initials: M
authors.lastname: Sarkar
authors.forename: Jianmin
authors.initials: J
authors.lastname: Liu
authors.forename: Tamara
authors.initials: T
authors.lastname: Koval
authors.forename: Jingzhu
authors.initials: J
authors.lastname: Wang
authors.forename: Shixia
authors.initials: S
authors.lastname: Feng
authors.forename: Richard
authors.initials: R
authors.lastname: Serafin
authors.forename: Yan
authors.initials: Y
authors.lastname: Jin
authors.forename: Yuli
authors.initials: Y
authors.lastname: Xie
authors.forename: Kirk
authors.initials: K
authors.lastname: Newland
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Roethig
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D015415:Biomarkers / Q000652:urine; D002070:Butadienes / Q000652:urine; D002248:Carbon Monoxide / Q000652:urine; D004784:Environmental Monitoring / Q000379:methods*; D005260:Female; D006801:Humans; D019570:Inhalation Exposure / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000652:urine*; D009602:Nitrosamines / Q000652:urine; D011721:Pyrenes / Q000032:analysis; D012906:Smoke / Q000032:analysis*; D012907:Smoking / Q000652:urine*; D014030:Tobacco, Smokeless / Q000032:analysis*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002070:Butadienes; D009602:Nitrosamines; D011721:Pyrenes; D012906:Smoke; D009538:Nicotine; C016583:4-(N-methyl-N-nitrosamino)-1-(3-pyridyl)-1-butanone; D002248:Carbon Monoxide; C031763:1,3-butadiene; C033146:1-hydroxypyrene