Biomarkers of Tobacco Use: Relevance to Tobacco Harm Reduction

Abstract

Cigarette smoking is associated with a large number of adverse health outcomes and continues to be a major contributor to death and disease. Although the best option for cigarette smokers concerned about their health is cessation, tobacco harm reduction is the public health concept that cigarette smokers who are unwilling or unable to quit smoking can switch to alternative non-combustible nicotine-containing products in order to reduce or minimize adverse health effects. Long-term epidemiological studies of alternative non-combustible nicotine-containing products are ideal for the evaluation of product use and clinical disease outcomes. However, in many cases such studies are not available. Biomarkers of exposure and potential harm, relevant to both combustible cigarette exposure and smoking-related diseases, are useful in the assessment of potential changes in health effects resulting from switching to alternative non-combustible nicotine-containing products.KeywordsTobaccoNicotineHarm reductionBiomarkers of exposure (BoE)Biomarkers of potential harm (BoPH)Electronic nicotine delivery systems (ENDS)Tobacco heating products (THP)Smokeless tobaccoSnusSwitchingPotentially reduced exposure products (PREP)Potentially reduced risk products (PRRP)Oxidative stressInflammation