Skip to main content
PMC home page
Tobacco Control logoLink to Tobacco Control
. 2003 Sep;12(3):317–321. doi: 10.1136/tc.12.3.317

Tobacco specific nitrosamines and potential reduced exposure products for smokers: a preliminary evaluation of AdvanceTM

A Breland 1, M Acosta 1, T Eissenberg 1
PMCID: PMC1747748  PMID: 12958395

Abstract

Objective: To develop a method for evaluating the carcinogen delivery of potential reduced exposure products (PREPs) like AdvanceTM, a PREP marketed to reduce smokers' exposure to one tobacco specific nitrosamine (TSN), NNK, a potent lung carcinogen.

Design, setting, and participants: Latin square ordered, three condition, outpatient, crossover design with 12 smokers of light or ultra-light cigarettes (15 or more cigarettes/day). In each five day condition, participants either smoked own brand, AdvanceTM, or no cigarettes. Also, on the first and last day of each condition, participants smoked one cigarette in the laboratory.

Main outcome measures: Subject rated measures of tobacco/nicotine withdrawal, expired air carbon monoxide, urine concentrations of cotinine and NNAL (one TSN biomarker), puff volume, duration, number, and interpuff interval.

Results: Relative to own brand, AdvanceTM produced similar withdrawal suppression, slightly lower carbon monoxide, equivalent cotinine, and 51% lower NNAL concentrations. The lowest cotinine and NNAL concentrations were observed in the no cigarette condition. Participants took fewer puffs when smoking AdvanceTM.

Conclusions: Past experience with PREPs that failed to reduce smoking's harm demonstrates the need for clinical methods in PREP evaluation. This study shows how assessing PREP induced changes in withdrawal and exposure to carbon monoxide, nicotine, and carcinogens may help predict PREP harm reduction potential. Adequate withdrawal suppression, slightly lower concentrations of carbon monoxide, and reduction of one TSN biomarker were observed for AdvanceTM. In the future, clinical methods like those described here may be valuable for evaluating PREPs before they are marketed publicly.

Full Text

The Full Text of this article is available as a PDF (151.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Breland A. B., Acosta M. C., Eissenberg T. Tobacco specific nitrosamines and potential reduced exposure products for smokers: a preliminary evaluation of Advance. Tob Control. 2003 Sep;12(3):317–321. doi: 10.1136/tc.12.3.317. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Breland A. B., Evans S. E., Buchhalter A. R., Eissenberg T. Acute effects of Advance: a potential reduced exposure product for smokers. Tob Control. 2002 Dec;11(4):376–378. doi: 10.1136/tc.11.4.376. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Breland Alison B., Buchhalter August R., Evans Sarah E., Eissenberg Thomas. Evaluating acute effects of potential reduced-exposure products for smokers: clinical laboratory methodology. Nicotine Tob Res. 2002;4 (Suppl 2):S131–S140. doi: 10.1080/1462220021000032780. [DOI] [PubMed] [Google Scholar]
  4. Carmella S. G., Akerkar S. A., Richie J. P., Jr, Hecht S. S. Intraindividual and interindividual differences in metabolites of the tobacco-specific lung carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) in smokers' urine. Cancer Epidemiol Biomarkers Prev. 1995 Sep;4(6):635–642. [PubMed] [Google Scholar]
  5. Djordjevic M. V., Stellman S. D., Zang E. Doses of nicotine and lung carcinogens delivered to cigarette smokers. J Natl Cancer Inst. 2000 Jan 19;92(2):106–111. doi: 10.1093/jnci/92.2.106. [DOI] [PubMed] [Google Scholar]
  6. Fagerström K. O. Measuring degree of physical dependence to tobacco smoking with reference to individualization of treatment. Addict Behav. 1978;3(3-4):235–241. doi: 10.1016/0306-4603(78)90024-2. [DOI] [PubMed] [Google Scholar]
  7. Hecht S. S. Tobacco smoke carcinogens and lung cancer. J Natl Cancer Inst. 1999 Jul 21;91(14):1194–1210. doi: 10.1093/jnci/91.14.1194. [DOI] [PubMed] [Google Scholar]
  8. Hecht Stephen S. Human urinary carcinogen metabolites: biomarkers for investigating tobacco and cancer. Carcinogenesis. 2002 Jun;23(6):907–922. doi: 10.1093/carcin/23.6.907. [DOI] [PubMed] [Google Scholar]
  9. Tiffany S. T., Drobes D. J. The development and initial validation of a questionnaire on smoking urges. Br J Addict. 1991 Nov;86(11):1467–1476. doi: 10.1111/j.1360-0443.1991.tb01732.x. [DOI] [PubMed] [Google Scholar]

Articles from Tobacco Control are provided here courtesy of BMJ Publishing Group

RESOURCES