C D C 's T o b a c c o L a b o r a t o r y

U.S. Department of Health and Human ServicesCenters for Disease Control and Prevention

Division o f L abora tory Sc iencesNational Center for Environmental Health

• r w i ' k * j i

Updated October 2012

The Tobacco Epidemic

Tobacco use is th e lead ing p reven tab le cause o f dea th in th e U n ited States. S m oking results in m ore th a n 400,000

p rem atu re dea ths each year fro m co n d itio n s such as lung cancer, hea rt disease, and em physem a. Exposure to

secondhand to b a cco sm oke causes 3,000 deaths fro m lung cancer each year, has im m e d ia te e ffects on the

card iovascu lar system , and causes co rona ry hea rt disease.

Prevention

The o n ly p roven m eans to p re ve n t dea th and disease fro m sm ok ing is to s top sm ok ing o r to never start.

N onetheless, a b o u t one in five (20%) A m ericans con tinues to sm oke, even th o u g h th e adverse hea lth e ffects are

w e ll kn o w n and p re ve n tio n and cessation p rogram s are read ily available. An e ffe c tive p rog ram to reduce death

and illness fro m to b a cco use m ust co m b in e e ffo rts to decrease to b a cco use w ith e ffo rts to reduce adverse health

o u tcom es fo r sm okers and peop le exposed to secondhand smoke.

Public Health Im p a c t

CDC's Response

CDC's E nv ironm enta l H ealth Labo ra to ry houses th e Tobacco Labora tory, w h ich exam ines b o th in d iv id u a l and

p o p u la tio n exposures to th e chem ica ls in to b a cco p roducts . This la b o ra to ry is u n iq u e because it m easures tox ic

and a d d ic tive substances in to b a cco p roducts , in sm oke and o th e r em issions, and in peop le w h o use tobacco

p ro d u c ts o r are exposed to secondhand sm oke. No o th e r la b o ra to ry in th e federa l g o v e rn m e n t has these

capabilities.

Tobacco sm oke con ta ins m ore th a n 7,000 chem ica l co m ponen ts , and a t least 250 o f these chem ica ls are kn o w n to

harm hum an hea lth . By lo o k in g a t all aspects o f to b a cco use and exposure, scientists in th e Tobacco Labora to ry are

ab le to o b ta in a m ore accurate u n d e rs ta n d in g o f h o w sm okers, non-sm okers (th ro u g h secondhand sm oke), and

sm okeless to b a cco users are exposed to ha rm fu l chem icals. In th e early 1990's, th e Tobacco Labo ra to ry p roduced

data sh ow ing th a t 88% o f th e n o n sm o k in g p o p u la tio n was exposed to to b a cco sm oke (Figure 4.1). This fin d in g

was used as a ju s tif ic a tio n fo r re s tric tin g sm ok ing in p u b lic bu ild ings . The Tobacco Labo ra to ry c o n tin u e d to m o n i­

to r to b a cco exposure over tim e , and fo llo w up m easurem ents show ed a d ra m a tic re d u c tio n in secondhand sm oke

exposure in all segm ents o f th e p o p u la tio n as a resu lt o f these in te rven tions .

PO

PU

LATI

ON

E

XP

OS

ED

Public Health Im p a c t

Figure 4.1Trends in exposure* o f nonsm okers^ to secondhand smoke in the U.S. popu la tion , National Health and N utrition Examination Survey 1988-2002 (Pirkle e t al., 2006)

YEARS SURVEYED

* Serum cotin ine > 0.05 nanograms per m illilite r

"^Aged > 4 years

T o b acco R esearch M odel

CDC's T obacco L a b o ra to ry uses five key a p p ro a ch e s to g u id e c o m p re h e n s iv e research on th e h e a lth im p a c t

o f to b a c c o use. S pec ifica lly , CDC analyzes to b a c c o p ro d u c ts , to b a c c o sm o ke , a nd o th e r em iss ions; d e te rm in e s

h o w p e o p le use to b a c c o p ro d u c ts ; a nd m easures to b a c c o e x p o su re m arke rs in p e op le 's bo d ie s . In th e fu tu re ,

CDC's research w ill d e v e lo p s h o rt- te rm m arke rs to s tu d y h o w u s ing to b a c c o p ro d u c ts ch a n g e s cells in th e

b o d y and h o w th is a ffe c ts d isease (e.g. cancer, h e a rt d isease).

Tobacco Smoke

and Other Emissions

TobaccoProduct

Use

Tobacco Product

Design and Content

Tobacco Markers in the Body

FutureTobaccoResearch

T o b ac co P ro d u c t Design

a n d C o n te n t

To understand how tobacco products are designed and what they contain, the Tobacco Laboratory:

• D evelops la b o ra to ry m e th o d s to s tu d y c iga re tte design,

con ten ts , and em issions.

• Analyzes to b a cco p ro d u c ts fro m a ro u n d th e w o rld , lo o k in g

a t d iffe rences in th e p ro d u c t c o n te n t and design as

com pared w ith A m erican p roducts.

• Perform s research on sm okeless tobacco , hand ro lled

tobacco , c love cigarettes, co u n te rfe it c igare ttes, bidis,

d isso lvab le p roducts , and w a te r p ipe tobacco.

More Information:

Ashley DL, Beeson MD, Johnson DR, M cC raw JM, R ichter P, Pirkle JL, e t al. Tobacco-specific n itrosam ines in tob a cco fro m US brand and non-US b rand cigarettes. N ico tine Tob Res. 2003;5:323-31.

CDC. D e te rm in a tio n o f n ico tine , pH, and m o is tu re c o n te n t o f six com m erc ia l m o is t s n u ff p ro d u c ts -F lo rid a . MMWR. 1999;48:398- 401.

Hearn BA, D ing YS, V aughan C, Z hang L, Polzin G, C audill SP, e t al. S em i-vo la tiles in m ainstream sm oke d e live ry fro m se lect cha rcoa l-filte red c iga re tte b rand variants. Tob C ontro l. 2010 Jun;19(3):223-30.

Pappas RS, S tanfill SB, W atson CH, Ashley DL. Analysis o f to x ic m eta ls in com m erc ia l m o is t s n u ff and A laskan iqm ik . J Anal Toxi­col. 2008;32(5):281-91.

S tanfill SB, B row n CR, Yan X, W atson CH, Ash ley DL. Q ua n tifica ­t io n o f flavo r-re la ted co m p o u n d s in th e u n b u rn e d con te n ts o f b id i and c love c igarettes. J A g ric Food Chem . 2006;54:8580-8.

S tanfill SB, C o n n o lly GN, Z hang L, Jia LT, H e n n in g fie ld JE, R ichter P, e t al. S urve illance o f in te rn a tio n a l oral to b a cco p roducts : Total n ico tin e , un -ion ized n ico tin e and tobacco -spec ific n itrosam ines. Tob C ontro l. 2011;20:e2.

T o bacco S m o ke a n d O th e r Emissions

To analyze tobacco smoke and other emissions, the Tobacco Laboratory:

• Uses sm oking m achines to co lle c t b o th th e p a rticu la te m a tte r

and gases in m ainstream c iga re tte sm oke genera ted accord ing

to in te rn a tio n a l standards.

• Examines h o w p ro d u c t design in fluences sm oke d e live ry to

people.

• C ollects sm oke u n d e r various sm ok ing co n d itio n s to exam ine

h o w d iffe rences in sm oking a lters th e d e live ry o f to x ic and

a d d ic tive substances. People sm oke c igare ttes in d iffe re n t ways;

even in d iv id u a ls va ry h o w th e y sm oke fro m c iga re tte to c iga re tte

d e p e n d in g on m any fa c to rs such as th e p ro d u c t typ e , n ico tin e

a d d ic tio n , m e ta b o lic d ifferences, and activ ities . As a result, the re

are large, na tura l va ria tions in th e a m o u n t o f chem ica ls a sm oker

receives.

r

More Information:D ing YS, Ashley DL, W atson CH. D e te rm in a tio n o f 10 ca rc inogen ic po lycyc lic a ro m a tic hydroca rbons in m ainstream c ig a re tte sm oke. J A g ric Food Chem. 2007;55(15):5966-73.

D ing YS, Z hang L, Jain RB, Jain N, W ang RY, Ashley DL, e t al.Level o f to bacco -spec ific n itrosam ines and po lycyc lic a ro m a tic hyd roca rbons in m ainstream sm oke fro m d iffe re n t tobacco varieties. Cancer E p idem io l B iom arkers Prev. 2008 Dec;17(12): 3366-71.

Pappas RS, Polzin G, W atson CH, Ashley DL. C adm ium , lead, and th a lliu m in sm oke p a rticu la te fro m c o u n te rfe it c igare ttes co m ­pared to a u th e n tic U.S. brands. Food Chem Toxicol. 2007;45(2): 202-9.

Polzin GM, Z hang L, Hearn BA,Tavakoli AD, Vaughan C, D ing YS, e t al. E ffect o f ch a rcoa lcon ta in ing filte rs on gas phase vo la tile o rgan ic co m pounds. Tob C ontro l. 2008;17(Suppl 1 ):i10-6.

W atson C H ,Trom m el J, Ashley DL. Solid-phase m ic ro e x tra c tio n -

based approach to d e te rm in e free-base n ico tin e in tra p p e d m ainstream c iga re tte sm oke p a rticu la te m atter. J A g ric Food Chem. 2004;52:7240-5.

T o b acco P ro d u c t Use

To understand how tobacco products are used (topography), the Tobacco Laboratory:

• Looks a t h o w m uch sm oke p e o p le d ra w fro m cigarettes.

This can increase th e n ico tin e th e y are g e tt in g , regardless o f

h o w th e package is labeled.

• S tudies p ro d u c ts to assess h o w c ig a re tte design in fluences

th e ways peop le use to b a cco products .

• Looks a t racial and g e n e tic d iffe rences in sm ok ing behav io r

and h o w th e b o d y breaks d o w n n ico tin e (n ico tine m e ta b o ­

lism) and a t h o w these in fluence adverse hea lth e ffects

fro m to b a cco use.

• Looks a t th e transfe r o f sm okeless p ro d u c t in g re d ie n ts to

people .

• Examines th e fa c to rs th a t in fluence th e up take o f n ico tin e and

o th e r chem icals.

More Information:D ing YS, C hou T, Abdul-S alaam S, Hearn BA, W atson CH. D evel­o p m e n t o f a m e th o d to es tim ate m o u th -le ve l benzo [a ]pyrene in take by f i lte r analysis. Cancer E p idem io l B iom arkers Prev. 2012 Jan;21(1):39-44.

W atson CH, M cC raw J, Polzin G, Ashley DL. D e ve lo p m e n t o f a m e th o d to assess c iga re tte sm oke intake. Environ SciTech. 2004; 38:248-53.

T o b ac co Markers in t h e Body

D evelops la b o ra to ry m e th o d s to m easure to b a cco exposure

in hum an b lo o d , saliva, serum , urine, hair, and m econ ium .

Examines th e e ffec ts o f to b a cco -re la te d chem ica ls in a t-risk

p o p u la tio n s (i.e., o ld e r adu lts , p re g n a n t w o m e n , and

ch ild ren).

Perform s sh o rt-te rm stud ies lo o k in g a t d iffe re n t p o p u la tio n s

a ffec ted by tobacco exposure.

M easures m arkers re la ted to to b a cco use, such as co tin in e

and th e to b acco -spec ific n itrosam ine NNAL, and produces

p o p u la tio n -b a se d reference levels segm en ted by age,

sex, and race o r e th n ic ity ; th is in fo rm a tio n is th e n pub lished

in CDC's N ationa l R eport on H um an Exposure to

E nv ironm enta l Chemicals.

Partners w ith o th e r leaders in th e fie ld o f tobacco and

sm ok ing research, such as th e Roswell Park Cancer In s titu te ,

th e M ayo C linic, and th e U n ive rs ity o f C aliforn ia a t San

Francisco, to s tu d y specific chem ica ls in to b a cco p ro d u c ts

and in people .

More Information:

Ashley DL, O 'C onnor RJ, B ernert JT, W atson CH, Polzin GM, Jain RB, e t al. E ffect o f d iffe r in g levels o f tobacco -spec ific n itrosam ines in c iga re tte sm oke on th e levels o f b iom arkers in sm okers. Cancer E p idem io l B iom arkers Prev. 2010 Jun;19(6):1389-98.

B enow itz NL, B ernert JT, C araballo RS, H o liday DB, W ang J. O p tim a l serum co tin in e levels fo r d is tin g u ish in g c iga re tte sm okers and nonsm okers w ith in d iffe re n t ra c ia l/e th n ic g roups in th e U n ited States b e tw een 1999 and 2004. Am J E p idem io l. 2009;169:236-48.

Bernert JT, Jain RB, Pirkle JL, W ang L, M ille r BB, Sam pson EJ. U rina ry to b acco -spec ific n itrosam ines and 4 -a m in o b i- pheny l h e m o g lo b in ad d u cts m easured in sm okers o f e ith e r regu la r o r lig h t c igarettes. N ic Tob Res. 2005;7(5):729-38.

Bernert JT, Pirkle JL, Xia Y, Jain RB, Ash ley DL, Sam pson EJ. U rine conce n tra tio n s o f a to b acco -spec ific n itrosam ine carc inogen in th e U.S. p o p u la tio n fro m secondhand sm oke exposure. Cancer E p idem io l B iom arkers Prev. 2010 Nov;19(11):2969-77.

C ham bers DM , Ocariz JM, M cG uirk MF, B loun t BC. Im p a c t o f c iga re tte sm oking on vo la tile o rgan ic c o m p o u n d (VOC) b lo o d levels in th e U.S. P opu la tion : NHANES 2003-2004. Environ Int. 2011 N ov;37(8):1321-8.

Pirkle JL, B ernert JT, Caudill SP, S osno ff CS, Pechacek TF. Trends in th e exposure o f nonsm okers in th e U.S. p o p u la tio n to second-hand sm oke: 1988 th ro u g h 2002. Environ H ealth Perspect. 2006;114(6):853-8.

Seyler T, B ernert JT. Analysis o f u rin a ry 4 -a m in o b ip h e n y l and selected m e ta b o lite s in sm okers and nonsm okers by ta n d e m mass sp ec trom etry . B iom arkers. 2011 May;16(3):212-21.

Xia Y, B ernert JT, Jain RB, Ash ley DL, Pirkle JL. Tobacco-specific n itro sa m in e 4- (m e th y ln itro sa m in o )-1 -(3 -p y ridy l)- 1 -bu tano l (NNAL) in sm okers in th e u n ite d states: NHANES 2007-2008. B iom arkers. 2010 N ov 29.

Future T o b a c c o Research

In the future, the Tobacco Laboratory plans to:

• Look m ore closely a t th e e ffects o f to b a cco exposure on

hum an b iom arkers and o th e r phys io lo g ic processes.

• D eve lop sh o rt-te rm m arkers o f th e lo n g -te rm adverse

hea lth e ffects o f to b a cco use.

• Id e n tify o th e r chem ica ls in to b a cco o r p ro d u c t design

fea tu res th a t b oost o r m a in ta in a d d ic tio n .

• D eve lop tests to m easure m a jo r cancer-causing chem icals,

pesticides, and o th e r to x ic ch e m ica ls -su ch as lead, ch ro m iu m ,

he te rocyc lic am ines, and c y a n id e - in tobacco p roducts ,

to b a cco sm oke, a n d /o r peop le exposed to tobacco.

• Exam ine in d iv id u a l sm oking pa tte rns to a id in d e ve lo p in g

o p tim iz e d cessation strategies.

CDC works 24/7 keeping America safe from health, safety and security threats, both foreign and domestic. Whether diseases start at home or abroad, are chronic or acute, curable or preventable, human error or deliberate attack, CDC fights it and supports communi­ties and citizens to prevent it. CDC is the nation's health protection agency -saving lives, protecting people from health threats, and saving money through prevention.

Centers for Disease Control and Prevention National Center for Environmental Health Division of Laboratory Sciences

M ail S top F-474770 Buford H ighw ay, NEA tlan ta , GA 30341 -3724

Telephone (to ll free): 1-800-CD C-lnfo (1-800-232-4636) Email: CDCINFO@ cdc.govW eb site: w w w .c d c .g o v /b io m o n ito rin g /a p p lie d _ u s e s .h tm l