title: Tobacco-specific nitrosamine exposures in smokers and nonsmokers exposed to cigarette or waterpipe tobacco smoke.
abstract: BACKGROUND
  The causal relationship between tobacco smoking and a variety of cancers is attributable to the carcinogens that smokers inhale, including tobacco-specific nitrosamines (TSNAs). We aimed to assess the exposure to TSNAs in waterpipe smokers (WPS), cigarette smokers (CS), and nonsmoking females exposed to tobacco smoke.
  
  
  METHODS
  We measured 2 metabolites, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and its glucuronides (NNAl-Gluc) in the urine of males who were either current CS or WPS, and their wives exposed to either cigarette or waterpipe smoke in a sample of 46 subjects from rural Egypt.
  
  
  RESULTS
  Of the 24 current male smokers, 54.2% were exclusive CS and 45.8% were exclusive WPS. Among wives, 59.1% reported exposure to cigarette smoke and 40.9% to waterpipe smoke. The geometric mean of urinary NNAL was 0.19 ± 0.60 pmol/ml urine (range 0.005-2.58) in the total sample. Significantly higher levels of NNAL were observed among male smokers of either cigarettes or waterpipe (0.89 ± 0.53 pmol/ml, range 0.78-2.58 in CS and 0.21-1.71 in WPS) compared with nonsmoking wives (0.04 ± 0.18 pmol/ml, range 0.01-0.60 in CS wives, 0.05-0.23 in WPS wives, p = .000). Among males, CS had significantly higher levels of NNAL compared with WPS (1.22 vs. 0.62; p = .007). However, no significant difference was detected in NNAL levels between wives exposed to cigarette smoke or waterpipe smoke.
  
  
  CONCLUSIONS
  Cigarette smokers levels of NNAL were higher than WPS levels in males. Exposure to tobacco smoke was evident in wives of both CS and WPS. Among WPS, NNAL tended to increase with increasing numbers of hagars smoked/day.
authors.affiliation: Department of Public Health, Cairo University, Cairo, Egypt. gnasr@theunion.org
authors.forename: Ghada
authors.initials: G
authors.lastname: Radwan
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Hecht
authors.forename: Steven G
authors.initials: SG
authors.lastname: Carmella
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Loffredo
mesh_terms: D000328:Adult; D002273:Carcinogens / Q000633:toxicity; D004534:Egypt; D005260:Female; D005965:Glucuronates / Q000652:urine; D006801:Humans; D008297:Male; D008875:Middle Aged; D009602:Nitrosamines / Q000009:adverse effects* / Q000652:urine; D011725:Pyridines / Q000652:urine; D012424:Rural Population; D012907:Smoking / Q000009:adverse effects* / Q000652:urine; D062789:Tobacco Products; D014028:Tobacco Smoke Pollution / Q000009:adverse effects / Q000032:analysis*
chemical_list: C099564:4-((methylnitrosoamino)-1-(3-pyridyl)but-1-yl)beta-omega-glucosiduronic acid; D002273:Carcinogens; D005965:Glucuronates; D009602:Nitrosamines; D011725:Pyridines; D014028:Tobacco Smoke Pollution; C099565:4-(methylnitrosamino)-1-(3-pyridyl)-1-butan-1-ol