title: Evidence supporting product standards for carcinogens in smokeless tobacco products.
abstract: Smokeless tobacco products sold in the United States vary significantly in yields of nicotine and tobacco-specific nitrosamines (TSNA). With the passage of the Family Smoking Prevention and Tobacco Control Act, the Food and Drug Administration now has the authority to establish product standards. However, limited data exist determining the relative roles of pattern of smokeless tobacco use versus constituent levels in the smokeless tobacco product in exposure of users to carcinogens. In this study, smokeless tobacco users of brands varying in nicotine and TSNA content were recruited from three different regions in the U.S. Participants underwent two assessment sessions. During these sessions, demographic and smokeless tobacco use history information along with urine samples to assess biomarkers of exposure and effect were collected. During the time between data collection, smokeless tobacco users recorded the amount and duration of smokeless tobacco use on a daily basis using their diary cards. Results showed that independent of pattern of smokeless tobacco use and nicotine yields, levels of TSNA in smokeless tobacco products played a significant role in carcinogen exposure levels. Product standards for reducing levels of TSNA in smokeless tobacco products are necessary to decrease exposure to these toxicants and potentially to reduce risk for cancer.
authors.affiliation: University of Minnesota, Masonic Cancer Center, Minneapolis, Minnesota. Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota. hatsu001@umn.edu.
authors.forename: Dorothy K
authors.initials: DK
authors.lastname: Hatsukami
authors.affiliation: University of Minnesota, Masonic Cancer Center, Minneapolis, Minnesota.
authors.forename: Irina
authors.initials: I
authors.lastname: Stepanov
authors.affiliation: Oregon Research Institute, Eugene, Oregon.
authors.forename: Herb
authors.initials: H
authors.lastname: Severson
authors.affiliation: Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Joni A
authors.initials: JA
authors.lastname: Jensen
authors.affiliation: University of Minnesota, Masonic Cancer Center, Minneapolis, Minnesota.
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Lindgren
authors.affiliation: George Washington University, School of Public Health, Washington, District of Columbia.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Horn
authors.affiliation: Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Samir S
authors.initials: SS
authors.lastname: Khariwala
authors.affiliation: Oregon Research Institute, Eugene, Oregon.
authors.forename: Julia
authors.initials: J
authors.lastname: Martin
authors.affiliation: University of Minnesota, Masonic Cancer Center, Minneapolis, Minnesota.
authors.forename: Steven G
authors.initials: SG
authors.lastname: Carmella
authors.affiliation: University of Minnesota, Masonic Cancer Center, Minneapolis, Minnesota.
authors.forename: Sharon E
authors.initials: SE
authors.lastname: Murphy
authors.affiliation: University of Minnesota, Masonic Cancer Center, Minneapolis, Minnesota.
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Hecht
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000652:urine; D002273:Carcinogens / Q000737:chemistry*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D009538:Nicotine / Q000737:chemistry; D009602:Nitrosamines / Q000737:chemistry / Q000652:urine*; D009922:Oregon; D012044:Regression Analysis; D014030:Tobacco, Smokeless / Q000009:adverse effects* / Q000592:standards; D014481:United States; D014486:United States Food and Drug Administration; D014903:West Virginia
chemical_list: D015415:Biomarkers; D002273:Carcinogens; D009602:Nitrosamines; D009538:Nicotine