People who use an increased amount of non-cigarette tobacco products like e-cigarettes are more likely to develop oral cancer, reports a new study. The findings of the study are published in the Journal of Dental Research.
At the 96th General Session of the International Association for Dental Research (IADR), University of California gave a poster presentation "Nicotine and Carcinogen Exposure by Tobacco Product Type and Dual-Use."
‘Tobacco use remains the Chief cause of oral cancer, and multiple-use of these products increases the risk of oral cancer.’
Tobacco use remains a leading cause of oral cancer, but the tobacco landscape is evolving with increasing use of non-cigarette tobacco products and dual-use of multiple product types.
Chaffee and co-author Neal Benowitz, also from the University of California, San Francisco, evaluated exposure to known carcinogens according to recent use of different tobacco product types, alone or in combination.
Data were analyzed from the Population Assessment of Tobacco and Health which includes a sample of U.S. adults who provided urine specimens for analysis of tobacco-specific nitrosamines (TSNAs) N'-nitrosonornicotine (NNN), a known oral and esophageal carcinogen, 4-(methynitrosamino)-1-(3)-pyridyle-1-butanol (NNAL), a metabolite of lung carcinogen (NNK) and total nicotine equivalents.
Participants were categorized according to use of combustible which includes cigarettes, cigars, water pipe, pipes, blunts (marijuana-containing cigars), smokeless which includes moist snuff, chewing tobacco and snus, e-cigarettes and nicotine replacement products. For each product, recent use was defined as within the prior 3-days and non-use defined as none within 30-days.
All tobacco use categories demonstrated high nicotine and TSNA concentrations relative to non-users. TSNA exposures were highest among smokeless tobacco users, whether used or together with other product types. Exclusive e-cigarette users were exposed to lower NNN and NNAL levels than other product users, despite comparable nicotine exposure. However, most e-cigarette users concurrently used combustible tobacco resulting in TSNA exposure similar to exclusive cigarette smokers.
The analysis shows that the vast majority of non-cigarette tobacco users are exposed to carcinogen levels comparable to or exceeding exposure among exclusive cigarette smokers levels that are likely to place users at substantial risk.