Assessment of toxicological validity using tobacco emission condensates: A comparative analysis of emissions and condensates from 3R4F reference cigarettes and heated tobacco products.

The tobacco emission condensate, henceforth referred to as "tobacco condensate," plays a critical role in assessing the toxicity of tobacco products. This condensate, derived from tobacco emissions, provides an optimized liquid concentrate for storage and concentration control. Thus, the validation of its constituents is vital for toxicity assessments. This study used tobacco condensates from 3R4F cigarettes and three heated tobacco product (HTP) variants to quantify and contrast organic compounds (OCs) therein. The hazard index (HI) for tobacco emissions and condensates was determined to ascertain the assessment validity. The total particulate matter (TPM) for 3R4F registered at 17,667 µg cig-1, with its total OC (TOC) at 3777 µg cig-1. HTPs' TPM and TOC were 9342 ± 1918 µg cig-1 and 5258 ± 593 µg stick-1, respectively. 3R4F's heightened TPM likely arises from tar, while HTPs' OC concentrations are influenced by vegetable glycerin (2236-2688 µg stick-1) and propylene glycol (589-610 µg stick-1). During the condensation process, a substantial proportion of OCs in 3R4F smoke underwent significant concentration decreases, in contrast to HTPs, where fewer than half of the examined OCs exhibited notable concentration declines. The HI for tobacco emissions exhibited a marginally higher value compared to tobacco condensate, with variations ranging from 7.92% (HTPs) to 18.6% (3R4F), denoting a minimal differential. These observations emphasize the importance of accurate OC recovery techniques to maintain the validity and reliability of toxicity assessments based on tobacco condensates. This study not only deepens the comprehension of chemical behaviors in tobacco products but also establishes a novel benchmark for their toxicity evaluation, with profound implications for public health strategies and consumer protection.

Development of a standardized new cigarette smoke generating (SNCSG) system for the assessment of chemicals in the smoke of new cigarette types (heat-not-burn (HNB) tobacco and electronic cigarettes (E-Cigs)).

To systematically regulate new types of cigarettes for which their safety has yet to be verified, such as heat-not-burn (HNB) products and electronic cigarettes (E-Cigs), the identification of chemicals in the new cigarette smoke is necessary. However, this is challenging due to the large number of new cigarette types and their different vaporization approaches. To address this issue, we herein report the development of a standardized new cigarette smoke generating (SNCSG) system based on heating-temperature control, which is able to generate smoke for all types of new cigarettes. Validation of the developed system was also carried out through analysis of the carbonyl compounds (e.g., formaldehyde and acetaldehyde) in the new cigarette smoke of HNB products and E-Cigs generated by the SNCSG system under different heating temperatures. The analytical results were used to validate the SNCSG system by comparison with those of previous studies. In all new cigarette smoke samples, the formaldehyde and acetaldehyde concentrations increased dramatically upon increasing the heating temperatures, especially over the reference heating range of each HNB device (mean concentration (µg/cigarette, n = 5 (HNB and E-Cig samples)): formaldehyde = 0.373-5.841 (250-320 °C), and acetaldehyde = 0.088-27.60 (250-320 °C). In the case of the HNB samples, the concentration differences determined by the heating temperatures of the tobacco stick were statistically significant, with p-values (ANOVA) of 1.85E-10 (formaldehyde) and 1.73E-08 (acetaldehyde). In the majority of smoke samples, acrolein and propionaldehyde were detected under relatively high heating temperature conditions (>250 °C) at 0.50 ± 1.76 µg/(cigarette or 10 µL), while acetone was detected under low heating temperature conditions (<250 °C) at 0.09 ± 0.17 µg/(cigarette or 10 µL). These results indicate that the developed SNCSG system could be suitable for application in the regulation of new types of cigarettes, regardless of the cigarette type and heating approach.

The Economic Effect of Early Management in Patients with Early Chronic Obstructive Pulmonary Disease: Results from a Population-Based Nationwide Survey.

PURPOSE: The economic effect of regular follow-up and early management in patients with early chronic obstructive pulmonary disease (COPD) has not yet been clarified. Therefore, this study aimed to estimate the economic effect of regular follow-up and early management in these patients. METHODS: Patients with early COPD were identified from the Korea National Health and Nutrition Examination Survey. We analyzed medical utilization and cost for 2 years without any missing data by using the Korean National Health Insurance data. Patients with routine healthcare maintenance were defined as, after diagnosis, those with regular visits to the hospital and receiving early management of COPD. RESULTS: Among 1204 patients with early COPD, the patients who were classified as the group with routine healthcare maintenance (69/146; 47.3%) and the group with intermittent healthcare user (79/1058; 7.5%) visited to hospital for the next 2 years. The patients with routine healthcare maintenance had lower cost of inpatient service and frequencies of emergency room (ER) visit and intensive care unit (ICU) admission than intermittent healthcare users (cost of inpatient service, $4595 vs. $4953 per person; ER visit, 7.2 vs. 11.5; ICU admission, 4.3 vs. 7.7). Even in patients with COPD and FEV1 ≥ 80, early intervention through follow-up reduced the cost of inpatient service because these patients could have had less severe acute exacerbations than intermittent healthcare users. CONCLUSION: Patients with early COPD, even those with FEV1 ≥ 80, need regular follow-up for early management and disease control as well as for reducing the socioeconomic burden of the disease.