title: Determination of nicotine absorption from multiple tobacco products and nicotine gum.
abstract: BACKGROUND
  Snus is a smokeless tobacco product traditionally used in Scandinavia and available in pouched or loose forms. The objective of this study was to determine nicotine absorption for current pouched and loose snus products in comparison with a cigarette and an over-the-counter nicotine gum.
  
  
  METHODS
  We conducted an open-label, randomized, 6-way, crossover study involving 20 healthy snus and cigarette users. One of 6 products (2 pouched snus, 2 weights of loose snus, a cigarette, and a nicotine gum) was administered at each of 6 visits. Blood samples were taken at intervals over 120 min and sensory perception assessed by questionnaire.
  
  
  RESULTS
  For the 4 smokeless tobacco products and the nicotine gum, blood plasma levels of nicotine were ranked according to total nicotine content as follows: loose snus (27.1 mg nicotine) > pouched snus (14.7 mg nicotine) > loose snus (10.8 mg nicotine) = pouched snus (10.7 mg nicotine) > nicotine gum (4.2 mg nicotine). The area under the plasma concentration-time curve (AUC) and maximum plasma concentration (C(max)) of nicotine ranged from 26.9 to 13.1 ng.h/ml and 17.9 to 9.1 ng.h/ml, respectively across all the products. Nicotine was absorbed more rapidly from the cigarette but systemic exposure was within the range of the smokeless tobacco products (AUC = 14.8 ng.h/ml; C(max) = 12.8 ng.h/ml).
  
  
  CONCLUSIONS
  This study has generated new information on comparative nicotine absorption from a cigarette, loose snus, and pouched snus typical of products sold in Scandinavia. The similar nicotine absorption for 1 g portions of loose and pouched snus with approximately 11 mg of nicotine indicate that absorption kinetics were dependent on quantity of tobacco by weight and total nicotine content rather than product form.
authors.affiliation: Group R&D, British American Tobacco (Investments) Ltd., Southampton, United Kingdom.
authors.forename: Helena
authors.initials: H
authors.lastname: Digard
authors.forename: Christopher
authors.initials: C
authors.lastname: Proctor
authors.forename: Anuradha
authors.initials: A
authors.lastname: Kulasekaran
authors.forename: Ulf
authors.initials: U
authors.lastname: Malmqvist
authors.forename: Audrey
authors.initials: A
authors.lastname: Richter
mesh_terms: D000328:Adult; D019540:Area Under Curve; D001189:Aryl Hydrocarbon Hydroxylases / Q000235:genetics; D065637:Cytochrome P-450 CYP2A6; D005260:Female; D006579:Heterozygote; D006801:Humans; D008046:Lip / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000097:blood* / Q000493:pharmacokinetics; D012472:Salivation / Q000187:drug effects; D062789:Tobacco Products / Q000009:adverse effects*; D014030:Tobacco, Smokeless / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D009538:Nicotine; D001189:Aryl Hydrocarbon Hydroxylases; D065637:Cytochrome P-450 CYP2A6