title: Toxic metal and nicotine content of cigarettes sold in China, 2009 and 2012.
abstract: BACKGROUND
  Metals of primary health concern can accumulate in the tobacco plant and contribute to smokers' exposures to carcinogens, a significant cause of the millions of smoking-related deaths in China each year. These exposures are due to the smoker's addiction to nicotine.
  
  
  OBJECTIVE
  This study sought to explore toxic heavy metal and nicotine concentrations in the tobacco of Chinese cigarette brands purchased in 2009 and 2012, as well as its regional variation.
  
  
  METHODS
  Cigarette packs for this study were purchased from seven Chinese cities in 2009 and 2012, and 91 pairs of cigarettes were matched based on UPC for comparison. Ten cigarette sticks were randomly selected from each pack and tested using polarised energy dispersive X-ray fluorescence (XRF) for arsenic (As), cadmium (Cd), chromium (Cr), nickel (Ni) and lead (Pb) concentrations. Nicotine analysis was conducted following Coresta's Recommended Method N°62. Data analysis was conducted using SPSS, encompassing descriptive statistics, correlations and generalised estimating equations to observe changes in brand varieties overtime.
  
  
  RESULTS
  On average, from 2009 to 2012, As, Cd, Cr and Pb concentrations have decreased in Chinese tobacco. Of the seven cities where the cigarette brands were purchased, only four cities showed significant differences of the selected metals from 2009 to 2012. However, there was no significant change in the tobacco nicotine content from 2009 to 2012.
  
  
  CONCLUSIONS
  Tobacco in Chinese cigarettes purchased in seven geographically disbursed cities contains consistently high levels of metals, including carcinogens like Cd. One source may be the improper use of fertilisers. These numbers should be monitored more carefully and regulated by health officials.
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: O'Connor
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA.
authors.forename: Liane M
authors.initials: LM
authors.lastname: Schneller
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA.
authors.forename: Rosalie V
authors.initials: RV
authors.lastname: Caruso
authors.affiliation: Department of Earth & Environmental Sciences, University of St Andrews, Fife, UK.
authors.forename: W Edryd
authors.initials: WE
authors.lastname: Stephens
authors.affiliation: Chinese Centers for Disease Control and Prevention, Beijing, China Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.affiliation: Chinese Centers for Disease Control and Prevention, Beijing, China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Yuan
authors.affiliation: Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada Ontario Institute for Cancer Research, Toronto, Ontario, Canada School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: Geoffrey T
authors.initials: GT
authors.lastname: Fong
mesh_terms: D002273:Carcinogens / Q000032:analysis*; D002681:China; D003132:Commerce / Q000639:trends; D006801:Humans; D019216:Metals, Heavy / Q000032:analysis*; D009538:Nicotine / Q000032:analysis*; D013052:Spectrometry, X-Ray Emission / Q000379:methods; D062789:Tobacco Products / Q000032:analysis*
chemical_list: D002273:Carcinogens; D019216:Metals, Heavy; D009538:Nicotine
keywords: Carcinogens; Low/Middle income country; Surveillance and monitoring