Compared to regular cigarette users, those who use smokeless tobacco have been found to have higher levels of nicotine and carcinogens – two cancer-causing toxins. Men and younger individuals are common users of smokeless tobacco products, although the usage is less than that of regular cigarettes. Author Brian Rostron, Ph.D., said, “Previous small studies have found high levels of toxic constituents including carcinogens [cancer-causing agents] in smokeless tobacco users, but analyses of nationally representative data have been generally lacking to date.”
The research team analyzed data on biomarkers of exposure to seven parts of smoking, including nicotine and tobacco-specific nitrosamine, from 23,684 individuals. Respondents were put into four groups based on their usage. The groups were: 16,313 nontobacco users, 488 exclusive smokeless tobacco users, 6,791 exclusive cigarette smokers, and 92 dual cigarette and smokeless tobacco users.
Nicotine exposure was higher in smokeless tobacco users compared to traditional cigarette smokers. Nitrosamine was also higher in smokeless tobacco than regular cigarettes.
Dr. Rostron added, “Our analysis of data from NHANES, a large, nationally representative study of U.S. health behaviors and outcomes, generated results consistent with those from previous smaller studies. Levels of biomarkers of exposure to nicotine and the cancer-causing tobacco constituent NNK were higher among exclusive smokeless tobacco users than exclusive cigarette smokers. This continues to put smokeless tobacco users at risk for adverse health effects, including cancer.”
He concluded: “Our findings demonstrate the need for continuing study of the toxic constituents of smokeless tobacco as well as their health effects on the individuals who use them. This is why the FDA and CDC [Centers for Disease Control and Prevention] are continuing to analyze and monitor biomarker levels among tobacco users and why the FDA and NIH [National Institutes of Health] are collaborating on the Population Assessment of Tobacco and Health (PATH) Study, a large longitudinal study in which biospecimens such as blood and urine have been collected.”
The findings were published in Cancer Epidemiology, Biomarkers & Prevention.