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Epidemiology of Cancer by Tobacco Products and the Significance of TSNA
Published in Roger O. McClellan, Critical Reviews in Toxicology, 2017
Prakash C. Gupta, P. R. Murti, R. B. Bhonsle
ABSTRACT: Globally, oral cancer is one of the ten common cancers. In some parts of the world, including the Indian subcontinent, oral cancer is a major cancer problem. Tobacco use is the most important risk factor for oral cancer. The most common form of tobacco use, cigarette smoking, demonstrates a very high relative risk — in a recent cohort study (CPS II), even higher than lung cancer. In areas where tobacco is used in a smokeless form, oral cancer incidence is generally high. In the West, especially in the U.S. and Scandinavia, smokeless tobacco use consists of oral use of snuff. In Central, South, and Southeast Asia smokeless tobacco use encompasses nass, naswar, khaini, mawa, mishri, gudakhu, and betel quid. In India tobacco is smoked in many ways; the most common is bidi, others being chutta, including reverse smoking, hooka, and clay pipe. A voluminous body of research data implicating most of these forms of tobacco use emanates from the Indian subcontinent. These studies encompass case and case-series reports, and case- control, cohort, and intervention studies. Collectively, the evidence fulfills the epidemiological criteria of causality: strength, consistency, temporality, and coherence. The biological plausibility is provided by the identification of several carcinogens in tobacco, the most abundant and strongest being tobacco-specific N-nitrosamines such as N-nitrosonornicotine (NNN) and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK). These are formed by N-nitrosation of nicotine, the major alkaloid responsible for addiction to tobacco. The etiological relationship between tobacco use and oral cancer has provided us with a comprehensive model for understanding carcinogenesis.
Tobacco Products
Published in Barry L. Johnson, Maureen Y. Lichtveld, Environmental Policy and Public Health, 2017
Barry L. Johnson, Maureen Y. Lichtveld
Smokeless tobacco is one of the most addictive and potent ways of consuming tobacco [19]. Half a can (17 g) of U.S.-style moist snuff contains 236 mg of nicotine; more than twice the daily nicotine consumption of the next potent tobacco product, Snus. In fact, holding an average size dip in the mouth for just 30 min can deliver as much nicotine as smoking three cigarettes. The CDC has summarized the adverse health of smokeless tobacco as follows [19]: “Smokeless tobacco is associated with many health problems. Using smokeless tobacco
Heavy metal blood concentrations in association with sociocultural characteristics, anthropometry and anemia among Kenyan adolescents
Published in International Journal of Environmental Health Research, 2022
Jillian Ashley-Martin, Lora Iannotti, Carolyn Lesorogol, Charles E. Hilton, Charles Owuor Olungah, Theodore Zava, Belinda L. Needham, Yuhan Cui, Eleanor Brindle, Bilinda Straight
Median blood Cd levels (0.24 µg/L) among Samburu adolescents were higher than reported in North American and European biomonitoring studies (Schulz et al. 2009; Health Canada 2019; CDC 2019) and also higher than the Kinshasa based study (Tuakuila et al. 2015) (Table 7). Soils in the Great Rift valley of Kenya contain relatively high concentrations of Cd and Hg due to urbanization, intensification of agricultural practices and subsequent release of metals into the atmosphere and soil (Mungai et al. 2016). Metals in soil can be absorbed by plants and, ultimately, contribute to an individual’s body burden (ATSDR 2018). Local environmental sampling is necessary to elucidate whether soil metal concentrations differ between the highlands and lowlands. Use of smokeless tobacco, i.e., chewing tobacco and snuff, is another potential source of Cd exposure and is common in this population, particularly among lowlands residents (Straight 2007). Cd blood concentrations in individuals who use smokeless tobacco are lower than in cigarette smokers, (Marano et al. 2012; Rostron et al. 2015) but may still contribute to Cd body burden.