title: Increased pouch sizes and resulting changes in the amounts of nicotine and tobacco-specific N-nitrosamines in single pouches of Camel Snus and Marlboro Snus.
abstract: BACKGROUND
  Initial analyses of the novel smokeless tobacco products Camel Snus and Marlboro Snus demonstrated that these products contain relatively low amounts of nicotine and the carcinogenic tobacco-specific nitrosamines N'-nitrosonornicotine (NNN) and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), as compared with traditional smokeless products. It is unknown whether the modifications in packaging, flavors, and pouch sizes that occurred for both Camel Snus and Marlboro Snus since their first introduction to the market were accompanied by any changes in nicotine or nitrosamine levels.
  
  
  METHODS
  We examined the available data on nicotine and NNN and NNK levels in 60 samples of Camel Snus and 87 samples of Marlboro Snus that were analyzed in our laboratory between 2006 and 2010.
  
  
  RESULTS
  Due to the increase in pouch size, the amounts of total nicotine, unprotonated nicotine, and the sum of NNN and NNK present in the large Camel Snus pouches released in 2010 are 1.9-fold, 2.4-fold, and 3.3-fold higher, respectively, than in the original smaller pouches that entered the market in 2006. Total and unprotonated nicotine content in the current version of Marlboro Snus pouches are 2.1-fold and 1.9-fold higher, respectively, and the sum of NNN and NNK is 1.5-fold lower than in the original version.
  
  
  CONCLUSIONS
  We observed an increase in nicotine content in single portions of Camel Snus and Marlboro Snus, and an increase in tobacco-specific N-nitrosamine content in single portions of Camel Snus, due to the increases in pouch size that occurred between 2006 and 2010. This finding stresses the importance of tobacco product regulation and ingredient disclosures.
authors.affiliation: Masonic Cancer Center, University of Minnesota, 420 Delaware Street SE-MMC 806, Minneapolis, MN 55455, USA. stepa011@umn.edu
authors.forename: Irina
authors.initials: I
authors.lastname: Stepanov
authors.forename: Joni
authors.initials: J
authors.lastname: Jensen
authors.forename: Lois
authors.initials: L
authors.lastname: Biener
authors.forename: Robin L
authors.initials: RL
authors.lastname: Bliss
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Hecht
authors.forename: Dorothy K
authors.initials: DK
authors.lastname: Hatsukami
mesh_terms: D000328:Adult; D002273:Carcinogens / Q000032:analysis*; D006801:Humans; D009538:Nicotine / Q000032:analysis*; D009602:Nitrosamines / Q000032:analysis*; D014030:Tobacco, Smokeless / Q000032:analysis*; D055815:Young Adult
chemical_list: D002273:Carcinogens; D009602:Nitrosamines; D009538:Nicotine