Assessment of the Concentrations of Selected Aminothiols in Patients after COVID-19.

Background: Data show that due to endothelial damage and thrombogenic effects, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection may accelerate the development of atherosclerosis and increase the risk of cardiovascular diseases (CVDs). The impaired metabolism of aminothiols increases oxidative stress, as these molecules are involved in antioxidant defense as well as in thiol redox control. In this study, total levels of selected aminothiols (i.e., cysteine (Cys), homocysteine (HCy), and glutathione) in convalescents after coronavirus disease of 2019 (COVID-19) were evaluated. The analyses were made according to the sex of the patients, time from COVID-19 onset, and COVID-19 severity. Methods: The study group consisted of 212 patients after COVID-19. Levels of total aminothiols were assessed in the blood plasma using high-performance liquid chromatography (HPLC). Results: The mean Cys concentrations were higher in men than in women (229.92 µmol/L ± 51.54 vs. 210.35 µmol/L ± 41.90, respectively; p = 0.003). Differences in Cys levels were also noticed in the total study group between patients distinguished due to time from disease onset (226.82 µmol/L ± 40.57 in <12 weeks, 232.23 µmol/L ± 47.99 in patients 12-24 weeks, and 208.08 µmol/L ± 48.43 in patients >24 weeks; p = 0.005). In addition, over 11% of total patients 12-24 weeks from disease onset had Cys levels above 300 µmol/L compared to almost 4% of patients <12 weeks and 2% of patients >24 weeks (p = 0.046). In sex-adjusted subgroups, significant differences due to time from COVID-19 were found in Cys levels in women (p = 0.004) and in glutathione levels in men (p = 0.024). None of the aminothiol levels differed between the subgroups based on the severity of COVID-19. Conclusions: Men had overall higher Cys levels than women. Cys levels were lower >24 weeks after COVID-19 onset than in the earlier period after disease onset. A partial elevation in Cys levels 12-24 weeks after the disease onset may contribute to the increase in CVD risk in the post-COVID-19 period.

Does Alcohol Withdrawal Influence Arterial Stiffness and Classical Risk Factors for Cardiovascular Disease for Persons With Alcohol Use Disorder?

AIMS: The amount and pattern of cigarette and alcohol consumption are highly associated with cardiovascular risk. The aim of the present study was the assessment of changes in arterial stiffness and classical risk factors for cardiovascular disease after alcohol withdrawal and detoxification in persons with alcohol use disorder. METHODS: Two hundred and forty-one individuals (men and women) participated in the investigation. The photoplethysmographic method was applied to assess arterial stiffness in three stages within 6 weeks. Participants were divided into subgroups based on age and sex. Analyses were performed using analysis of variance with repeated measures. RESULTS: Different variations in time of stiffness index (SI) and reflection index (RI) values were recorded. Some increases in triglycerides, total cholesterol, low-density lipoprotein and a decrease in high-density lipoproteins were observed in all analyzed groups. Both systolic and diastolic blood pressure (DP) changed significantly during the 3 weeks of the study only in a group of younger men. The SI is correlated with age and gender. No correlation of RI with sex was found; however, RI was strongly correlated with age, pulse and DP. CONCLUSIONS: The presented study shows that some groups of patients (older women and younger men) after detoxification may be particularly vulnerable to vascular system disorders, i.e. arterial stiffness, making it suggested to include additional observation during therapy.

Photoplethysmographic Measurement of Arterial Stiffness in Polish Patients with Long-COVID-19 Syndrome-The Results of a Cross-Sectional Study.

The coronavirus disease 2019 (COVID-19) is associated with an increase in the incidence of cardiovascular diseases (CVD) that persists even several months after the onset of infection. COVID-19 may also have an impact on arterial stiffness, which is a risk factor for CVD. We aimed to analyze if and to what extent arterial stiffness measured by photoplethysmography differed among COVID-19 convalescents depending on the acute phase severity and time elapsed since disease onset. A total of 225 patients (mean age 58.98 ± 8.57 years, 54.7% women) were analyzed after COVID-19 hospitalization at the Cardiac Rehabilitation Department of the Ustron Health Resort (Poland). In the entire study population, no differences were found in the mean values of stiffness index (SI) and reflection index (RI) depending on the severity of the acute COVID-19 and the time since the onset of the disease. There were no differences in the heart rate (HR) according to the severity of acute COVID-19; the mean HR was higher in patients who had COVID-19 less than 12 weeks before the study than in convalescents more than 24 weeks after the acute disease (p = 0.002). The mean values of SI and RI were higher in men than in women (p < 0.001), while the heart rate (HR) was similar in both sexes (p = 0.286). However, multiple linear regression analyses after adjusting for factors influencing arterial stiffness, i.e., sex, age, body mass index, smoking status, hypertension, diabetes, the severity of the acute COVID-19, and the time from the disease onset, confirmed that age, sex, time from disease onset, and diabetes are the most important determinants that could influence arterial stiffness.

The prevalence of waterpipe tobacco smoking among Polish youths.

INTRODUCTION: Waterpipe smoking is gaining popularity among the youth in Poland and is evaluated for the first time in this work. The authors address the social and demographic factors that motivate young people to smoke and attempt to determine which of them contribute to habit formation. MATERIAL AND METHODS: The data were collected among school and university students in Poland during a global survey on various forms of tobacco use. Multivariable regression models were applied for odds-ratio evaluation. The data concern waterpipe and cigarette smoking habits. RESULTS: The survey was completed by 19,097 respondents. The survey included 144 schools and 32 universities from 16 voivodeships in Poland. Respondent gender exhibited the highest ORs (95% Cl), both in the case of current and ever WP users: 2.11 (2.10-2.12) and 2.16 (2.15-2.17), respectively. The other important factor was a place of living: 1.83 (1.82-1.84) and 2.17 (2.16-2.18), respectively. All ORs were statistically significant for p = 0.05. CONCLUSIONS: The prevalence of tobacco smoking among Polish youths is high. Waterpipe tobacco smoking was found to be the second most popular habit after cigarette smoking. Moreover, young smokers use other non-tobacco products in waterpipes, and drink alcohol during smoking sessions. Many young people try waterpipe smoking without previous experience with cigarettes.

Secondhand exposure to vapors from electronic cigarettes.

INTRODUCTION: Electronic cigarettes (e-cigarettes) are designed to generate inhalable nicotine aerosol (vapor). When an e-cigarette user takes a puff, the nicotine solution is heated and the vapor is taken into lungs. Although no sidestream vapor is generated between puffs, some of the mainstream vapor is exhaled by e-cigarette user. The aim of this study was to evaluate the secondhand exposure to nicotine and other tobacco-related toxicants from e-cigarettes. MATERIALS AND METHODS: We measured selected airborne markers of secondhand exposure: nicotine, aerosol particles (PM(2.5)), carbon monoxide, and volatile organic compounds (VOCs) in an exposure chamber. We generated e-cigarette vapor from 3 various brands of e-cigarette using a smoking machine and controlled exposure conditions. We also compared secondhand exposure with e-cigarette vapor and tobacco smoke generated by 5 dual users. RESULTS: The study showed that e-cigarettes are a source of secondhand exposure to nicotine but not to combustion toxicants. The air concentrations of nicotine emitted by various brands of e-cigarettes ranged from 0.82 to 6.23 µg/m(3). The average concentration of nicotine resulting from smoking tobacco cigarettes was 10 times higher than from e-cigarettes (31.60±6.91 vs. 3.32±2.49 µg/m(3), respectively; p = .0081). CONCLUSIONS: Using an e-cigarette in indoor environments may involuntarily expose nonusers to nicotine but not to toxic tobacco-specific combustion products. More research is needed to evaluate health consequences of secondhand exposure to nicotine, especially among vulnerable populations, including children, pregnant women, and people with cardiovascular conditions.

Influence of inhaled nicotine source on arterial stiffness.

INTRODUCTION: Tobacco smoking leads to changes in hemodynamic parameters such as heart rate and systolic or diastolic blood pressure. It has a direct influence on the elasticity of blood vessels and increases arterial stiffness, which can result in development of atherosclerosis. Data show that the nicotine in tobacco smoke probably is responsible for these changes. Electronic cigarettes (e-cigarettes) were supposedly a healthier alternative to combustible cigarettes because they imitate a process of cigarettes smoking but generate nicotine aerosol without the toxic substances from tobacco combustion. However, the use of e-cigarettes is still controversial because their toxicity, safety and long term use health impact have not been sufficiently studied. AIM: The aim of this study was to evaluate changes in arterial stiffness parameters after smoking a cigarette or e-cigarette use. METHODS: Fifteen healthy women, aged 19-25 years old, smoking ≥5 cigarettes per day for at least two years participated in the study. A non-invasive measurement of arterial stiffness parameters - Stiffness Index (SI) and Reflection Index (RI) - was conducted and systolic and diastolic blood pressure and heart rate were measured before and after smoking a conventional cigarette as well as use of an e-cigarette. RESULTS: Statistically significant changes in the SI and RI were observed before and after smoking of a conventional cigarette [SI: 6.75m/s (6.66 - 6.85, 95% CI) vs 6.56m/s (6.46 - 6.65. 95% CI), p=0.0056; RI: 54.0% (51.5 - 56.7, 95% CI) vs 49.6% (47.5 - 51.8, 95% CI), p=0.010]. The use of e-cigarettes resulted in no statistically significant changes in the SI and RI. After both product use systolic and diastolic blood pressure and heart rate increased but the changes were not statistically significant. CONCLUSIONS: In contrast to conventional cigarette use, the use of electronic cigarettes causes no changes in arterial stiffness. This may indicate lower bioavailability of nicotine from the e-cigarette or an additional effect of other substances present in cigarette smoke but absent in an e-cigarette aerosol.

Electronic cigarette use among teenagers and young adults in Poland.

BACKGROUND: Electronic cigarettes (e-cigarettes) are battery-powered devices developed with the goal of mimicking the action of smoking, including nicotine delivery, without the toxic effects of tobacco smoke. Little is known about the uptake of e-cigarettes among young people. METHODS: A survey was conducted with a cluster sample of 20240 students enrolled at 176 nationally representative Polish high schools and universities between September 2010 and June 2011. We estimated national e-cigarette prevalence among various demographic groups by using population weights. Multiple logistic regression was used to evaluate which demographic factors were independent predictors of 2 outcomes: ever use of e-cigarettes and use in the previous 30 days. RESULTS: Among high school students, aged 15 to 19 years, 23.5% had ever used e-cigarettes and 8.2% had done so within the previous 30 days. Among those in universities, aged 20 to 24 years, 19.0% had ever used an e-cigarette and 5.9% had done so in the previous 30 days. In multivariate analyses that controlled for covariates, smoking cigarettes, male gender, living in an urban area, and having parents who smoke were associated with ever use of e-cigarettes. Overall, 3.2% of never smoking students reported ever use of e-cigarettes. CONCLUSIONS: About one-fifth of Polish youth have tried e-cigarettes; most of them had previously smoked cigarettes. It is unclear whether e-cigarettes are just a novelty that young people try only once or whether they have potential to compete in the marketplace with conventional cigarettes.

[Evaluation of changes in hemodynamic parameters after the use of electronic nicotine delivery systems among regular cigarette smokers]. / Ocena zmian wybranych parametrów hemodynamicznych po uzyciu elektronicznych inhalatorów nikotyny wsród regularnych palaczy papierosów.

A relatively new device, described by producers as a device to help smokers quit, nicotine inhaler is an electronic (e-cigarette). Its mission is to provide the body with small doses of nicotine behavior "ceremonial" burning product is not tested for efficacy and toxicity The aim of this study was to compare the effects of nicotine absorbed from cigarette conventional and electronic changes in systolic and diastolic blood pressure and heart rate. Because of the potential interaction of carbon monoxide contained in cigarette smoke and nicotine conventional to changes on the parameters is also going to examine changes in the concentration of carboxyhemoglobin after smoking cigarettes and using e-cigarettes. study group consisted of 42 people, including 21 women and 21 men aged from 18 to 62 years who declared daily cigarette smoking. In this study it was found that as a result of cigarette smoking are increasing all the analyzed conventional hemodynamic parameters, these increases probably normally associated with nicotine absorbed by the smoker with the smoke. It was also a clear increase in carboxyhemoglobin, which is associated with a high concentration of carbon monoxide in cigarette smoke. If you use the e-cigarettes tested were observed increases in diastolic blood pressure and pulse, but none of the parameters did not change significantly, indicating that either the use of e-cigarette by the respondents did not supply the body with absorbable nicotine or for the increase in haemodynamic parameters studied did not correspond only nicotine but also other smoke constituents that interact with nicotine to the smoker body as carbon monoxide.

[Water pipe smoking and psychoactive substances]. / Palenie fajki wodnej a substancje psychoaktywne.

SIGNIFICANCE: In recent years a water pipe gains popularity among Polish young people. Unfortunately, young people use it to burn not only tobacco, but also other addictive and psychoactive substances. AIM OF THE STUDY: The aim of the study was to assess the phenomenon of using a water pipe to smoke psychoactive substances by young people. METHODS: The study was conducted based on the author's guestionnaire. The anonymous test was conducted throughout Poland, selecting randomly ten high schools and two universities from each province. RESULTS: In the survey participated 19 037 people from the region of Poland. 83% of them were high school pupils aged 15-19 years and 17% of them were students aged 20-25 years. 38% of volunteers at least once in their life have smoked a water pipe, and 22% have smoked it during last 30 days. Apart from tobacco 38% of the smoking people used also, apart from the tobacco designet for smoking in a water pipe, psychoactive substances. The most common is marihuana. 16% of school pupils and 17% of students used marihuana, 14% and 15% hashish, 8% and 11% crack, and 11% and 15% boosters. CONCLUSIONS: Presented data from all-Poland research conducted among school pupils and students illustrate only occasional and sporadic experience in drug use and the outright conclusions about the scale of the permanent use of psychoactive substances can not be drawn. A social aspect of a water pipe smoking is favourable to an alcohol consumption and lots of with different psychoactive substances. Due to the scale of the problem it is advisable to do in-depth research about the described phenomenon. It is also advisable to conduct more intensive programs to promote healthy behaviors and increase more attention to the reasons of such behaviour among young people.

Comparison of urine cotinine and the tobacco-specific nitrosamine metabolite 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and their ratio to discriminate active from passive smoking.

OBJECTIVES: Cotinine is the most widely used biomarker to distinguish active versus passive smoking. However, there is an overlap in cotinine levels when comparing light or occasional smokers versus heavily exposed passive smokers. 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) is a tobacco-specific nitrosamine measurable in urine with a much longer half-life than cotinine. The aim of the study was to determine optimal cutoff points to discriminate active versus passive smokers and to compare sensitivity and specificity for the use of cotinine, NNAL, and the ratio of the NNAL/cotinine in urine. METHODS: Cotinine and NNAL were measured in urine of 373 active smokers and 228 passive smokers. RESULTS: Geometric mean cotinine levels were 2.03 ng/ml (interquartile interval: 0.43-8.60) and 1,043 ng/ml (658-2,251) and NNAL levels were 5.80 pg/ml (2.28-15.4) and 165 pg/ml (90.8-360) pg/ml in passive and active smokers, respectively. NNAL/cotinine ratio in urine was significantly higher for passive smokers when compared with active smokers (2.85 vs. 0.16, p < .01). The receiver operating characteristics analysis determined optimal cutoff points to discriminate passive versus active smokers: 31.5 ng/ml for cotinine (sensitivity: 97.1% and specificity: 93.9%), 47.3 pg/ml for NNAL (87.4% and 96.5%), and 0.74 x 10⁻³ for NNAL/cotinine ratio (97.3% and 87.3%). CONCLUSIONS: Both urine cotinine and NNAL are sensitive and specific biomarkers for discriminating the source of tobacco smoke exposure. Cotinine is the best overall discriminator when biomarkers are measured while a person has ongoing exposure to tobacco smoke. NNAL because of its long half-life would be particularly useful when there is a delay between exposure and biomarker measurement. The NNAL/cotinine ratio provides similar sensitivity but poorer specificity at discriminating passive versus active smokers when compared with NNAL alone.

Urine cotinine underestimates exposure to the tobacco-derived lung carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone in passive compared with active smokers.

OBJECTIVES: Cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) are widely used biomarkers for tobacco-derived nicotine and the lung carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), respectively. The discrepancy between cotinine levels in relation to disease risk comparing active versus passive smoking suggests a nonlinear tobacco smoke dose-response and/or that cotinine is not providing an accurate measure of exposure to the toxic constituents of secondhand tobacco smoke. METHODS: Cotinine and NNAL were measured in the urine of 373 active smokers and 228 passive smokers. RESULTS: Average cotinine levels were 1,155 (interquartile range, 703-2,715) for active smokers and 1.82 (0.45-7.33) ng/mg creatinine for passive smokers. Average NNAL levels were 183 (103-393) and 5.19 (2.04-11.6) pg/mg creatinine, respectively. NNAL/cotinine ratio in urine was significantly higher for passive smokers when compared with active smokers (2.85 × 10(3) versus 0.16 × 10(3), P < 0.0001). CONCLUSIONS: Passive smoking is associated with a much higher ratio of NNAL/cotinine in the urine compared with active smoking. IMPACT: Cotinine measurement leads to an underestimation of exposure to the carcinogen NNK from secondhand smoke when compared with active smoking.

The role of pharmacists in smoking cessation in Poland.

In Poland, 38.0% of men and 25.6% of women smoke daily. One method for expanding access to smoking cessation services is through community-based pharmacists. Surveys were administered in 2007-2008 to (a) current smokers, (b) members of a pharmacy association, and (c) pharmacy students in their final year of training. Pharmacists were the highest ranked health professionals to whom Polish smokers reported they would turn for information about pharmacological support for smoking cessation. Most pharmacists (79%) reported their knowledge allowed them to provide basic smoking cessation information to their patients. Pharmacy students reported being more able to provide information about the health consequences of tobacco smoking than to help patients quit smoking (85% vs. 61%). In Poland, community-based pharmacists are positioned to provide smoking cessation interventions to all segments of the population. To extend and promote smoking cessation efforts, comprehensive tobacco cessation training should be a required component of the pharmacy school curriculum.

[Influence of smoking topography on respirabile suspended particulates concentrations in main and side stream]. / Wplyw topografii wypalania papierosów na stezenie respirabilnej fazy czasteczkowej glównego i bocznego strumienia dymu.

INTRODUCTION: The aim of the study was: 1) to assess RSPs concentration in MS and SS of the cigarettes smoked in a wide variety of topography parameters (various: puff volumes [V], puff flows [W] and breaks between puffs [T]); 2) to assess smokers' exposure to tobacco-smoke-derived respirabile suspended particles. METHODS: Tobacco smoke was generated using a self-constructed automatic smoking machine. The device is highly accurate and precise (SD +/- 1%), which was confirmed by checking smoking topography parameters with CressMicro portable monitor (Plowshare, USA). One full-flavored cigarette brand, available commercially in Poland was used for RSPs determination. The topography parameters were changed as follows: V (25-60 ml); W (27-52 ml/s) and T (20-60s). The MS and SS were collected in containers of 51 and 201, respectively. Additionally, the SS was sampled according to ISO 3308. Finally, RSP2.5 were measured using DustTrak 8520 (TSI, USA). RESULTS: MS RSP2.5 concentration varied from 0.14 +/- 0.01 (V = 25 ml, W = 52 ml/s, T = 60s) to 2.215 +/- 0.17 mg/cig. (V = 60 ml, W = 52 ml/ s, T =20s), whereas the SS RSP2.5 concentration varied from 2.79 +/- 0.03 (V = 25 ml, W = 41 m/s, T = 60 s) to 18.3 +/- 1.0 mg/cig (V = 35 ml, W = 35 ml/s, T = 20s). The MS and SS RSP2.5 concentration in ISO 3308 conditions (V = 35 ml, W = 17.5 ml/s, T = 60 s) were 0.39 +/- 0.02 and 3.71 +/- 0.24 mg/cig., respectively. RSP2.5 levels determined with topography conditions which corresponded to the way Polish smokers smoke cigarettes (V = 60 mL, F = 3 8 mL/sec, T = 20 sec) were as follows: 0.74 +/- 0.08 for MS and 3.31 +/- 0.17 mg/cig for SS. There was a positive correlation between both V and F and RSP2.5 levels in MS. It was noticed that by increasing V and W parameters, the RSP2.5 in MS rises, while by decreasing T gives an opposite effect. As far as the RSP2.5 in SS is concerned, it is positively correlated with V value. CONCLUSIONS: Smoking topography strongly affects smokers' exposure to RSP2.5. It confirms that using ISO standards for determination RPS2.5 derived from tobacco smoke might reflect inadequately active and passive smokers' exposure do RSP2.5.

[Knowledge and attitudes toward smoke-free law among smoking and non-smoking medical students]. / Znajomosc norm prawnych zwiazanych z zakazem palenia wsród palacych i niepalacych studentów kierunków medycznych.

UNLABELLED: Tobacco smoking is common among various social groups. There is still high prevalence of smoking among health care professionals. AIM OF THE STUDY: The aim of the study was to assess knowledge about smoke-free law in public places in Poland among smoking and nonsmoking students of selected medical university. We surveyed 50 students of one medical university aged 23 +/- 2 years. Control group consisted with 61 students of other universities located in the same region aged 23 +/- 3 years. We developed a new survey to assess students knowledge about smoke-free regulations and their implementations in various public places. Smoking status was verified with exhaled carbon monoxide levels (COex). RESULTS: 57% off all surveyed students declared being familiar with smoke-free law. However, we detected a significant difference between the knowledge of medical vs. nonmedical students (76% vs. 41%, p < 0.05). The knowledge about smoke-free law in Poland among students is not sufficient, especially among nonmedical students.

[Waterpipe smoking among adolescents in Silesia region of Poland]. / Fajka wodna jako alternatywny sposób palenia tytoniu przez mlodziez na terenie województwa slaskiego.

SIGNIFICANCE: Waterpipe has been used for many centuries in Asia and Africa regions to smoke tobacco leaves. In recent years it has been gaining popularity also among adolescents and youths in Poland. AIM OF THE STUDY: The aim of the study was to examine waterpipe smoking prevalence among adolescents living in Silesia region of Poland. We investigated if waterpipe is used as alternative way to smoke tobacco and awareness among adolescents about heath risk of waterpipe smoking. METHODS: We surveyed 769 students of high schools located in Silesia region of Poland. RESULTS: Mean age of surveyed students was 16.5 years, and 52.5% were females. Our results showed that prevalence of waterpipe was higher than cigarette smoking (46.7% vs. 34.6%). Prevalence of waterpipe smoking among girls was almost the same as among boys. Most of the surveyed students used waterpipe as an alternative tool to smoke tobacco. CONCLUSIONS: The prevalence of waterpipe smoking among Polish adolescents is very high. There is an urgent need for education about health risks of waterpipe use in Poland.

[Relationship between nicotine dependence and smoking topography]. / Zróznicowanie sposobu wypalania papierosów a stopien uzaleznienia od nikotyny.

SIGNIFICANCE: The way smoker smokes his cigarette (smoking topography) depends on many factors, like his age and sex, or the type of cigarettes he smokes. Smoking topography includes a puff volume, a number of puffs taken during smoking one cigarette, a frequency and time of puffing, and the intervals between puffs. AIM OF THE STUDY: The aim of the study was to verify if the level of nicotine dependence affects smoking topography. METHODS: We investigated 59 regular smokers (33 females and 26 males), in the age of 34 +/- 12. The level of nicotine dependence was determined with Fagerström Test (FTND) and Nicotine Dependence Syndrome Scale (NDSS). Smoking topography was measured five times during a single day. Smokers smoked their regular brands of cigarettes. RESULTS: We showed, that the puff volume and intervals between puff strongly correlated with the level of nicotine dependence. When using NDSS test, we found that the total puff volume and the number of puffs taken from a single cigarette correlated with a drive to smoke. Negative correlation was found between the total puff volume and the number of puffs taken from a single cigarette and a tolerance. Continuity of smoking affected a number of puffs and the intervals between puffs. CONCLUSION: Nicotine dependence affects smoking topography.

Elimination kinetics of the tobacco-specific biomarker and lung carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol.

4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) is tobacco specific and has a longer half-life than other tobacco biomarkers studied thus far. An accurate measurement of the NNAL half-life is important for optimal use to assess exposure to tobacco smoke. We determined the half-life of NNAL in urine in eight daily smokers on a clinical research ward and in five occasional smokers in a real-life environment. Total NNAL in urine was monitored for 14 days in daily smokers after stopping smoking and for up to 60 days in occasional smokers. The average half-life for the terminal phase in the daily smoker group using a two-compartmental body model was 10.3 days (beta phase), and using a noncompartmental model, it was 9.1 days. In the occasional group, these values were 17.6 and 16.0 days, respectively. The alpha-phase half-lives were 14.3 and 27.8 hours for the two groups, respectively. The inter-subject coefficient of variation of the NNAL terminal half-life ranged from 14% to 30%, and the intra-subject coefficient of variation ranged from 3% to 18%. There was very good agreement between the plasma and urinary half-lives in two subjects with plasma analyses: 7.4 versus 7.9 days and 9.2 versus 10.7 days. Mean renal clearance of NNAL was 13 +/- 2.3 mL/min. The terminal half-life of NNAL of 10 to 18 days indicates that this biomarker can be used to detect tobacco smoke exposure for 6 to 12 weeks after cessation of exposure and requires a similar time to assess the steady levels of NNAL after switching from one tobacco product to another.

Exposure to carbon monoxide from second-hand tobacco smoke in Polish pubs.

Carbon monoxide (CO) is one of the more toxic agents present in the gas phase of second-hand tobacco smoke. There is sufficient evidence suggesting that passive smokers are involuntarily poisoned by low CO concentrations. At lower doses, CO affects the central nervous system leading to deterioration in visual perception, manual dexterity, learning, driving performance, and attention level. The effects of chronic inhalation of CO at doses corresponding to tobacco smoking on the cardiovascular system are not well investigated but might involve myocardial hypertrophy and arrhythmias. In people with pre-existing disease, CO pollution alone may result in increased morbidity and mortality. In the study CO levels were monitored in 22 Polish pubs. The temporary CO concentration varied in examined pubs from 0 to 33.11 ppm. The average 8-hours CO concentration varied from 0.21 to 10.20 ppm. Nine percent of pubs exceeded the WHO or EU limit value at some point during the monitoring process. The average weekly CO concentration in all examined microenvironments varied from 0 to 4.80 ppm. The most important factor influencing CO concentration was air-exchange through open doors and windows. In pubs where doors and windows were closed, the following statistical important factors influencing CO concentration were found: 1. the number of smokers present in the pub, 2. the pub's capaciousness, and 3. and the pub's location. The results of the study show that second-hand tobacco smoke is a significant source of CO in Polish pubs. Passive smokers in Polish pubs might be exposed to very high CO concentration exceeding EU reference value.

[Exposure to respirable suspended particles in smoking and non-smoking sections of pubs in southern Poland]. / Narazenie na pyl respirabilny w pubach poludniowej Polski z wydzielonymi miejscami dla palacych papierosy i niepalacych.

Particulate matter (PM), including fine particulate matter (PM2.5), is one of the main pollutant which it damages of human health seriously. Tobacco smoke is significant source of PM2.5 in indoor microenvironments. New bill of complete smoking ban in all public places in Poland is currently under consideration in polish parliament. Proposed maximum allowed concentration of PM2.5 for all non-smoking sections is 0.03 mg/m3. Concentrations of tobacco-specific fine particulate matter (PM2.5) were monitored in thirteen pubs located in southern part of Poland during winter season. All examined pubs had two types of sections: smoking and non-smoking. PM2.5 concentrations were monitored during one hour in each section using DustTrak monitor (TSI Inc., USA). The Wilcoxon matched pair test was used to compare pollutant concentrations in smoking vs. non-smoking sections. Average 1-hour PM2.5 concentration in smoking sections was 1.25 +/- 1.85 mg/ m3 and varied from 0.18 do 7.21 mg/ m3. Average 1-hour PM2.5 concentration in non-smoking sections was 0.35 +/- 0.29 mg/m3 and varied from 0.056 to 1.01 mg/m3. The highest temporary PM2.5 concentration of 25.5 mg/m3 was found in a pub located in cellar storey were with volume of 60 m3, 13 smokers and no air-condition. There was little difference in PM2.5 levels between smoking and non-smoking section.

[Estimation of optimal levels of tobacco biomarkers to distinguish active and passive smokers using ROC analysis]. / Wykorzystanie krzywych ROC do optymalizowania wartosci granicznych biomarkerów w celu klasyfikacji badanych osób do grupy czynnych lub biernych palaczy.

Many epidemiological studies on health consequences of tobacco smoke exposure require classification of examined subjects either as active or passive smokers. Receiver operating characteristics (ROC) curves are useful for organizing cut-off values of tobacco biomarkers and visualizing their performance. The cut-off values might be applied to distinguish cigarette smokers and persons involuntary exposed to second-hand tobacco smoke (SHS). Aim of the study was estimation of optimal levels of three biomarkers (cotinine, 1-hydroxypyren, and carboxyhemoglobin) to distinguish active and passive smokers using ROC curves. 98 subjects (62% females) were qualified to the study. Mean age was 40 +/- 12 years. Active smokers (n = 38) had an average smoking history of 9 +/- 8 years and declared smoking at least 5 cigarettes per day (mean 17 +/- 7). Passive smokers (n = 60) declared being exposed to environmental tobacco smoke either at home or work (n = 18) or other indoor microenvironments, where they spent some time during their daily activity (n = 42). Cut-off values were determined for each biomarker using ROC curves. Optimal cut-off values were: 327 microg/g creatinine for cotinine, 47 ng/g creatinine for hydroxypyren, and 1.27% HbCO for carboxyhemoglobin. Among three studied biomarkers, cotinine showed the best sensitivity of 97.4% and specificity of 90.0%. Carboxyhemoglobin showed sensitivity of 89.5% and specificity of 93.3%, whereas 1-hydroxypyren 76.3% and 78.3%, respectively. Analysis of ROC curves appears to be a way to distinguish active and passive smokers using various tobacco biomarkers.