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Research paper
Different profiles of carcinogen exposure in Chinese compared with US cigarette smokers
  1. Neal L Benowitz1,2,
  2. Quan Gan3,
  3. Maciej L Goniewicz4,
  4. Wei Lu3,
  5. Jiying Xu3,
  6. Xinjian Li3,
  7. Peyton Jacob III1,2,
  8. Stanton Glantz2,5
  1. 1Division of Clinical Pharmacology and Experimental Therapeutics, Medical Service, Departments of Medicine, and Bioengineering & Therapeutic Sciences, University of California San Francisco, San Francisco, California, USA
  2. 2Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA
  3. 3Shanghai Center for Disease Control and Prevention, Shanghai, China
  4. 4Department of Health Behavior, Division of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Buffalo, New York, USA
  5. 5Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
  1. Correspondence to Dr Neal L Benowitz, Division of Clinical Pharmacology and Experimental Therapeutics, Medical Service, Departments of Medicine, and Bioengineering & Therapeutic Sciences, University of California, San Francisco, Box 1220, San Francisco, CA 94143-1220, USA; neal.benowitz{at}ucsf.edu

Abstract

Background Differences in carcinogen exposure from different cigarette products could contribute to differences in smoking-associated cancer incidence among Chinese compared with US smokers.

Methods Urine concentrations of metabolites of nicotine, the tobacco-specific nitrosamine (TSNA) 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), and polycyclic aromatic hydrocarbon metabolites (PAHs) were compared in 238 Chinese and 203 US daily smokers.

Results Comparing Chinese versus US smokers, daily nicotine intake and nicotine intake per cigarette smoked were found to be similar. When normalised for cigarettes per day, urine NNAL excretion was fourfold higher in US smokers, while the excretion of urine metabolites of the PAHs fluorene, phenanthrene and pyrene metabolites was 50% to fourfold higher in Chinese smokers (all, p<0.0001). Similar results were seen when NNAL and PAHs excretion was normalised for daily nicotine intake.

Conclusions Patterns of carcinogen exposure differ, with lower exposure to TSNA and higher exposure to PAHs in Chinese compared with US smokers. These results most likely reflect country differences in cigarette tobacco blends and manufacturing processes, as well as different environmental exposures.

Trial registration number NCT00264342.

  • Carcinogens
  • Global health
  • Nicotine

https://doi.org/10.1136/tobaccocontrol-2014-051945

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