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.

Variations in nicotine yields between single cigarettes.

INTRODUCTION AND AIMS: It is beyond any doubt that nicotine yield in cigarettes as determined using standard ISO method bears almost no relation to smokers' actual intake. However, the ISO method is still in use in many countries where the government is responsible for controlling and monitoring cigarette quality. The aim of the study was to measure the nicotine yield in single cigarettes and to evaluate their statistical distribution among the same brand. MATERIALS AND METHODS: Nicotine yields were measured according to the ISO method in single cigarettes of the twenty most popular Polish brands of cigarettes. RESULTS: Relative standard deviation of nicotine yields in single cigarettes of the same brands varied from 16% to 34%. Relative differences between nicotine yields in a single cigarette of a particular brand and the mean value varied from -65% to +76%. DISCUSSION AND CONCLUSIONS: The results indicate high variation in nicotine yields between cigarettes of the same brand. Such variation might affect compensatory smoking. This provides another reason why yields estimated using the standard ISO method are potentially misleading to smokers. Further studies are needed to better understand the implications of within-brand variability in yields for tobacco product regulation.

[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.

[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.

[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.

[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.

[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.

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.

[Tobacco smoke exposure levels and lipide profile]. / Stopien narazenia na dym tytoniowy a profil lipidowy.

Toxic tobacco smoke exposure to human organism is strictly related to progress of atherosclerosis changes. One of the mechanisms of these effects is a change of blood lipoprotein fraction concentrations. The concentrations of the lipid profile parameters (TCL, HDL, LDL, TG) and the chosen biomarkers (urine cotinine and 1-hydroxypyrene and blood carboxyhaemoglobine) were determined. It was studied whether the procedure of the groups determination (nonsmokers, passive and active smokers) affect the calculated average values of lipid profile parameters. The role of the applied biomarkers for the detection of the effects related to the tobacco smoke exposure is also discussed. It is concluded that there is no difference among the lipid profiles of passive smokers and nonsmokers. Cigarette smoking increases and lowers the TG and HDL concentrations, respectively. Urine cotinine seems to be the best indicator of tobacco smoke exposure among three chosen biomarkers. Study subjects were 300 male and female volunteers.

["How does smoker really smoke?"--preliminary report on smoking topography among Polish smokers]. / "Jak naprawde pali palacz?"--wyniki wstepne badan topografii palenia populacji palaczy w Polsce.

Levels of toxic substances in tobacco smoke are undeniably influenced by temperature-oxygen conditions in which the smoke is generated. These conditions depend on the way the cigarette is smoked (smoking topography). Smoking topography may be characterized by such factors as: puff volume and its velocity, intervals between puffs and a number of puffs per cigarette. Vast majority of formerly published papers on tobacco smoke composition present data obtained in accordance with ISO (International Standard Organization) and FTC (Federal Trade Commission) standards concerning conditions of tobacco smoke production. Currently, the standard methods for tobacco smoke generation in lab conditions are frequently questioned by researchers, since such methods do not give reliable results as far as toxic substances delivery to smokers' bodies is concerned. To determine the real doses a tobacco smoker is exposed to, first of all smoking topography should be measured in a given population. The aim of this study was to characterize smoking topography among Poles and its statistical assessment. 129 volunteers were involved in the research. To assure representativeness of the group of smokers, in the first step of the study a demographic structure analysis of smokers' population in Poland was carried out (the authors used data provided by GUS (Central Statistical Office). Smokers were divided into study groups in terms of their sex and age and also detailed information on tobacco addiction (number of cigarettes smoked, its brand and type etc.). Smoking topography was measured using a portable CreSSmicro device (Plowshare Technologies, USA). Mean puff volume in the examined group was 60 ml and was 78% higher than the puff volume used for tobacco smoke control according to the ISO method (35 ml). Mean measured puff velocity (48 ml/ sec.) was as much as 120% higher comparing to ISO (17.5 ml/sec.). Mean duration time of puff in the examined group was 1.7 sec. (2 sec. in the ISO standard method) so the difference was not very significant but still 13.2%. However, mean interval between puffs in our group was 20 sec.--threefold lower than in the ISO method (60 sec.). Moreover, examining the variability of subsequent puffs, the authors found out that the puff volume lowers as the cigarette is smoked. All measured smoking topography parameters were highly dispersed within the examined population of smokers.

[Effect of tobacco smoking on skin and mucosa appearance, ageing and pathological conditions]. / Wplyw palenia papierosów na wyglad, starzenie sie i zmiany patologiczne skóry i blon sluzowych.

Tobacco smoking is considered to be one of the main factors that negatively affect the skin, mucous membranes and teeth, i.e. the body parts that decide on the so called 'healthy look' and 'attraction'. This paper is a review of literature on the subject of harmful and pathological influence of tobacco smoking on the skin and the immunological system. Furthermore, the paper described such smoking results as wrinkle development, skin elasticity and thickness loss, as well as a decreased ability of tissues to regenerate. Finally, the authors discussed various diseases connected with tobacco use: changes in the skin, teeth and mucous membranes, and cancerous lesions.

[Use of hair nicotine as a tool to assess tobacco smoke exposure]. / Zastosowanie oznaczen nikotyny we wlosach jako narzedzia do oceny narazenia na dym tytoniowy.

The first paper concerning hair nicotine determination was published in 1983 by Ishiyama et al. Since then, examining hair nicotine content has become a valuable tool facilitating assessment of exposure to tobacco smoke in various groups of people (active and passive smokers or even neonates and fetus). The present article describes briefly recent research studies on the use of hair nicotine as a biomarker. Furthermore, the paper describes various determination techniques related to nicotine in hair, as well as advantages and disadvantages of hair nicotine as a biomarker.

[Varenicline--a new chance for smokers?]. / Wareniklina--nowa szansa dla palaczy?

Cigarette smokers believe that quitting smoking is the hardest thing in their life. Modern pharmacology offers a wide range of various drugs and therapies that might support smoking cessation. One of the most effective drug is varenicline. Varenicline has been introduced this year to Polish pharmaceutical market by Pfizer company under the trade name Champix. The aim of the study was to critically review all new information about Champix pharmacology and pharmacokinetics but also evaluate safety and economical aspects of using this new drug. From the presented data it might be concluded that nowadays varenicline is the most effective drug used in smoking cessation (about 40%). The unique properties of varenicline, which is a partial agonist and antagonist to alpha4beta2 nicotinic receptor, are the reasons of dual mechanism of the drug action. The agonist effect is caused by binding to nicotinic receptors and stimulating receptor-mediated activity. The antagonist effect occurs when varenicline blocks the ability of nicotine to activate nicotinic receptors. The most frequently adverse effects of varenicline are: nausea, headache, insomnia, and abnormal dreams. Although the price of complete therapy with Champix seems to be quite high, but potential benefits (in case of therapy finished successfully) are much higher than these costs. Pharmacological properties of varenicline described in the article, along with its high relative effectiveness and safeness, make the drug very attractive and promising for the smokers who want to quit.

[Genetically modified tobacco--chance or threat for smokers?]. / Genetycznie modyfikowany tyton--szansa czy zagrozenie dla palaczy?

Tobacco (Nicotiana sp.) is of the most often used model plants for research in the field of physiology, biochemistry, molecular biology and genetic engineering. Tobacco was also the first plant subject to genetic transformation--in 1983 the plant was introduced with the kanamycin resistance gene. The internet database PubMed includes roughly 3,500 records concerning transgenic tobacco, out of which nearly 200 works were published this year. Advancement of state-of-the-art techniques of genetic engineering offers new, as yet unprecedented opportunities to take advantage of tobacco. Apparently tobacco is not only a source of carcinogenic tobacco smoke, but also a plant which due to genetic modifications may be used in a positive way in medicine and biological sciences. The aim of the article is to summarize the role of genetically modified Nicotiana genus plants in modern medicine and environmental protection. The publication describes the usage of transgenic plants in the tobacco industry and evaluates possible effects of such applications. Moreover, potential possibilities of deployment of genetically modified tobacco for production of anti-virus and antibacterial vaccinations, interferon, antibodies, etc. have been characterized.

[New prospects of nicotine dependence treatment--vaccines]. / Nowe perspektywy leczenia uzaleznienia od nikotyny--szczepionki.

Smoking is considered to be one of the main threats to health in many societies around the world. Despite carrying out numerous large-scale campaigns promoting a healthy life-style and stimulant avoidance, nicotine dependence still concerns a huge group of people. What is more, almost half of the population is exposed to passive contact with tobacco smoke. At present, there is a whole range of pharmaceutical and non-pharmaceutical means of fighting nicotine dependence. The dramatic development of medical sciences in recent years, especially of the fields connected with biotechnology, resulted in working out of a new method of nicotinism treatment--antinicotinic vaccines. The starting point for working out of such drugs was the mechanism of nicotine action on central nervous system. The idea behind the vaccine is to prevent nicotine from passing through the blood-brain barrier. Nicotine molecules, due to their size and lipophilic character, can easily enter the brain. The mechanism of the antinicotinic vaccine's action consists in producing specific antibodies, which combined with nicotine in the bloodstream are to create immune complexes big enough not to enter the brain. Currently, clinical trails of three vaccines are being carried out: TA-NIC (Xenova Group, UK), NicVAX (NABI Biopharmaceuticals, USA), CYT002-NicQb (Cytos Biotechnology, Switzerland). The results indicate that this form of treatment is interesting when it comes to its effectiveness and in the future may become a routine method of nicotine dependence treatment.

[Problems of abuse of and dependence on Nicotine Replacement Therapy (NRT)]. / Problemy naduzywania i uzaleznienia od Nikotynowej Terapii Zastepczej (NTZ).

Smoking addiction consists in co-existence of pharmacological nicotine dependence and behavioral dependence. The most commonly used nicotine dependence pharmacotherapy is the Nicotine Replacement Therapy (NRT). At first, NRT preparations in many countries have been available on prescription only. Gradual introduction of NRT into over-the-counter sale involved the possibility of abuse. As a consequence, patients could become dependent on nicotine contained in the preparations, which are meant to be therapeutic. The analysis of results of current studies indicates that a small fraction of NRT patients (0.4-17%) uses it for a time longer than recommended. Thorough research assessing particular dependence symptoms do not, however, reveal such symptoms as: pleasure or satisfaction connected with taking the NRT preparations, subjective sense of dependence, difficulty in ceasing using NRT or occurrence of withdrawal symptoms. Thus, it has been suggested that NRT dependence occurs extremely rare is often times confused with chronic use. On the other hand, numerous studies show increased effectiveness of prolonged Nicotine Replacement Therapy, especially in heavy smokers. It is believed that a prolonged therapy using one NRT preparation does not pose any threat of severe side effects, just like simultaneous using of two NRT preparations or using NRT while continuing smoking. Conclusions drawn from current studies are reflected in the state-of-the-art guidelines concerning NRT use.

The complex analytical method for assessment of passive smokers' exposure to carbon monoxide.

Carbon monoxide (CO) is one of the toxic constituents in tobacco smoke. The aim of the study was to evaluate a complex analytical method that allows quantification of the exposure of passive smokers to CO. The exposed volunteers were placed in the model room where portions of cigarettes (5, 10, or 15 cigarettes every 30 or 60 min over 4 h) were smoked using a homemade smoking machine. The concentrations of CO and of the ventilation marker (methane) were monitored for the duration of each experiment. CO and methane were analyzed on-line using GC-FID with methanization. Carboxyhemoglobin (COHb) was analyzed twice: just before and after the experiment. After hemolysis of a 100-microL blood sample, CO was quantitatively released by adding 10% K3[Fe(CN)6] inside a small reactor and under stable pressure transported through a microtube with an absorbing agent on a chromatography loop. The proposed analytical method allows us to quantify exposure of passive smokers by measuring the dose-effect correlation. We observed that increasing COHb levels were directly correlated with the CO concentration in the air, but were also intermediately correlated with the frequency and number of smoked cigarettes and with the ventilation coefficient.