Cardiovascular disease biomarkers study, Part II: Tobacco-related biomarkers of exposure in exclusive cigarette smokers, exclusive moist snuff consumers, and non-consumers of tobacco.
A CVD biomarkers study conducted in the US measured putative tobacco-related biomarkers in three exclusive cohorts: cigarette smokers, moist snuff consumers and non-consumers of tobacco. Subjects were generally healthy males between the ages of 26-49. Samples for spot-urine and blood (Day 1-Challenge and Day 2-Fasting) were collected and analyzed. Urinary biomarkers of exposure for the following tobacco-related components were determined: nicotine + nine metabolites (NicEQ-T), NNK, benzene, acrolein, PAHs, 1,3-butadiene, acrylamide, crotonaldehyde, o-toluidine, 2-aminonapthalene, 4-ABP and 3-ABP. Urinary biomarkers of effect (isoprostanes iPF2α-III and iPF2α-VI) were measured to determine oxidative stress. All urinary biomarkers were normalized to urinary creatinine. Blood exposure biomarkers included COHb (carboxyhemoglobin), nicotine and cotinine. COHb was significantly higher in smokers compared to both moist snuff consumers and non-consumers on Days 1 and 2. Serum nicotine, measured on Day 1, showed smokers>moist snuff consumers>non-consumers; and on Day 2, moist snuff consumers>smokers>non-consumers. Serum cotinine differed significantly among all cohorts with moist snuff consumers>smokers>non-consumers on both days. All urinary biomarkers principally derived from tobacco combustion by-products were significantly higher in smokers compared to both moist snuff consumers and non-consumers. NicEQ-T differed significantly among all cohorts (moist snuff>smokers>non-consumers) on both days. NNAL (an NNK biomarker) was significantly higher in moist snuff consumers compared to cigarette smokers and non-consumers on Days 1 and 2. The urinary isoprostanes were significantly higher in smokers compared to moist snuff consumers and non-consumers.In this study, these data indicate: 1) urinary biomarkers of tobacco combustion by-products are significantly reduced in smokeless tobacco consumers over smokers, 2) urinary NNAL results for smokeless consumers are consistent with values in the literature, and 3) blood exposure biomarkers adequately characterize the three cohorts studied.