Evaluation of biomarkers of exposure in adult cigarette smokers using Marlboro snus.

INTRODUCTION: It has been reported that adult smokers (AS) may be considering smokeless tobacco products as an alternative to smoking. The objective of this study was to evaluate the change in exposure in AS using Marlboro snus (MSNUS) (a tobacco pouch product in test market in June 2007). METHODS: AS were randomized into the following groups--CS: subjects (n = 30) continue smoking their own brand; DU: subjects (n = 60) reduced their daily cigarette consumption by >or=50% and were allowed to use MSNUS; SN: subjects (n = 15) stopped smoking their cigarettes but were allowed to use MSNUS; NT: subjects (n = 15) were not allowed to use any tobacco products for the entire duration of the 8-day study. Biomarkers of smoke exposure (BOE) measured at baseline and postbaseline were 24-hr urinary excretion of metabolites of N-nitrosamines, nicotine (urine and plasma), aromatic amines, benzene, and polycyclic aromatic hydrocarbon; urine mutagenicity; and carboxyhemoglobin at various timepoints. RESULTS: Statistically significant (p < .05) reductions in all the urinary BOE were observed in the DU group compared with the CS group. After correcting for the residual effect, a proportionate reduction (approximately 50%) in most of the biomarkers was observed. Even larger reductions, similar to the NT group, were observed in the SN group. DISCUSSION: The proportionate reduction in exposure when reducing the number of cigarettes by 50% and using MSNUS, under the consumption patterns observed, suggest that the AS did not appear to alter their smoking behavior. The added exposure from MSNUS usage in this group was minimal. The AS sustained substantial reductions in exposure when using MSNUS exclusively.

Short term effects of reduced exposure to cigarette smoke on white blood cells, platelets and red blood cells in adult cigarette smokers.

UNLABELLED: Previous studies indicate that cigarette smokers have a 5-30% higher white blood cell counts (WBC) compared to non-smokers and higher red blood cell counts. METHODS: This study was to pool hematology data from three similar studies and analyze the data for effects on WBC, its subpopulations, platelets, red blood cell count (RBC) and hematocrit in adult cigarette smokers three days after using an electrically heated cigarette smoking system (EHCSS) as a potential reduced exposure product (PREP) or no-smoking compared to smoking a conventional cigarette. RESULTS: Lower exposure to cigarette smoke in adult, long term smokers, by using an EHCSS or stopping smoking, leads to statistically significant decreases of up to 9% in WBC, neutrophils, lymphocytes, platelets, RBC and hematocrit within three days. Switching from CC-smoking to EHCSS-smoking or no-smoking resulted in lower WBC and vice versa within 3 days. CONCLUSION: This clinical model may be used as a screening tool to find new technologies that could provide insights on changes in inflammation resulting from the change in cigarette smoke.

Heart rate variability increases with reductions in cigarette smoke exposure after 3 days.

BACKGROUND: Smoking has been shown to influence the tone of the autonomic nervous system as reflected by heart rate variability (HRV). To date, no information is available as to whether 24-hour HRV might differentiate users of different tobacco products. OBJECTIVE: To assess the differences in HRV derived from the 24-hour electrocardiogram (ECG) following the use of 2 tobacco products of potentially different exposures. METHODS: Thirty adult Caucasian male smokers (mean age: 42.8 + 5.7 years) smoking 20 to 40 cigarettes/ day were randomized in a 3-way crossover study design to either smoke a conventional cigarette (CC, tar: 11 mg, Nic: 0.8 mg), to use the Electrically Heated Cigarette Smoking System (EHCSS: tar: 5 mg, Nic: 0.3 mg, according to the Federal Trade Commission [FTC]), or to stop smoking (NS) for 3 days each. The 24 hours ECGs were recorded during the last 24 hours of each exposure period. RESULTS: A 24-hour ECG showed highest mean values for standard deviation of all normal-to-normal heart beat (NN) intervals (SDNN), standard deviation of all 5-minute averaged NN intervals in a 24-hour period (SDANN), mean of the standard deviations of the NN intervals calculated from all 5-minute segments in a 24-hour period (SDNNI), percentage (P) of all NN intervals that differ by 50 milliseconds of all NN (PNN50%), the square root of the mean of all squared differences between adjacent NN intervals in 24-hour period (RMSSD), and total number of all NN intervals divided by the height of the histogram of all NN intervals measured on a discrete scale with bins of 7 x 8125 ms (1/128 seconds; HRVTI) when participants stopped smoking followed by the use of the reduced exposure product and CC. CONCLUSION: Heart rate variability tended to increase with reduced smoke exposure.