Smokeless Tobacco Products Research Articles

Oral Cancer Incidence Among Adult Males With Current or Former Use of Cigarettes or Smokeless Tobacco: Population-Based Study.

Tobacco use has been identified as a risk factor for oral cancer worldwide. However, relative oral cancer incidence among adults who smoke cigarettes, use smokeless tobacco products (ST), have transitioned from cigarettes to ST, quit cigarettes and/or ST ("quitters"), or never used tobacco has not been well studied. We aim to present population-based oral cancer incidence rates for adults who smoke cigarettes, use ST, are former smokers who now use ST, or quit. We estimated cross-sectional incidence rates and incidence rate ratios (IRRs) using data from statewide cancer registries (Colorado, Florida, North Carolina, and Texas) and population counts derived from national surveys using combined data from 2014-2017. A random-effect meta-analysis approach was used to summarize estimates among these groups, based on multiple imputation-based IRR estimates by state and age group while considering potential heterogeneity. A total of 19,536 oral cancer cases were identified among adult males 35 years and older in the study geographies and period. The oral cancer incidence rate among adults who smoke was significantly higher than the ST group (2.6 times higher, 95% CI 2.0-3.3, P<.001), 3.6 (95% CI 3.2-4.1, P<.001) times higher than the never users, and 2.4 (95% CI 1.8-3.1, P<.001) times higher compared to former smokers who now use ST. The IRR among the ST group relative to never users was 1.4 (95% CI 1.1-1.9, P=.02). The IRR between former smokers who now use ST and those who quit was 1.4 (95% CI 1.0-2.1, P=.08). Findings from this population-based study with a large number of oral cancer cases support significantly high oral cancer incidence among adults who smoke and a lower risk of oral cancer incidence among never users, quitters, users of ST, and former smokers who now use ST compared to cigarettes. Future studies with detailed control of tobacco history and other relevant confounders are needed to confirm these findings.

The Tax Incidence and Tax Pass-Through of Smokeless Tobacco in the US

Background: States adopt different tax bases for smokeless tobacco (SLT), making tax incidence on SLT not directly comparable across states. In addition, how taxes are passed through to SLT prices among states that impose specific taxes, and whether the pass-through rates for SLT are affected by the uptake and evolution of e-cigarettes, is unknown. Objective: This study will calculate the tax incidence on SLT and investigate how SLT taxes are passed to prices at the 25th, 50th, and 75th percentile levels, as well as whether these pass-through rates vary by e-cigarette uptake and evolution. Methods: We regressed SLT prices on specific taxes using ordinary least square regressions while controlling for state-, year-, and quarter-fixed effects. We then tested the difference in tax pass-through rates by different periods. Findings: The average tax incidence on chewing tobacco, moist snuff, dry snuff, and snus was 22%, 22%, 23%, and 20%, respectively. For moist snuff, taxes were fully passed to prices at the 25th and 50th percentiles (rate = 1.01, p &lt; 0.001) and overly passed to prices at the 75th percentile (rate = 1.25, p &lt; 0.001). The e-cigarette uptake and evolution significantly raised taxes by 13 cents and 14 cents per ounce, respectively, for moist snuff at the 75th percentile prices (p &lt; 0.05). Conclusions: If harm is considered a criterion for taxing tobacco products, the tax incidence on SLT could be further increased. Considering that lower-priced SLT have lower tax pass-through rates, price promotion restrictions and minimum pricing laws may be needed to increase the cost of lower-priced products. Additionally, we observed that tobacco companies tended to increase tax pass-through for premium SLT products as e-cigarettes gained popularity, which may indicate a strategic response to shifting consumer preferences.

Estimating the weight of consumed tobacco product waste in various Indian states: a novel method to assess the potential burden of tobacco product waste

IntroductionThe direct morbidity and mortality caused by tobacco are well documented, but such products also contribute to a range of environmental pollutants resulting from tobacco product waste. No previous studies...

The more smoking the more cataract: A study on smoking, snus use and cataract in a Swedish population.

To examine the prevalence of self-reported cataract and cataract surgery, and the incidence of cataract surgery, in relation to smoking and use of the moist smokeless tobacco product snus. In 2014/2015, individuals born in 1951 (n = 18 055) in the Västra Götaland County, Sweden, were invited to participate. Of these, 9743 (54%) accepted participation and 9316 (52%) remained after exclusion criteria were applied. Participants answered a questionnaire with items about eye conditions, smoking, snus, gender, education, asthma, chronic obstructive pulmonary disease, corticosteroid use, diabetes mellitus, weight and height. Prevalence ratios (PRs) for self-reported cataract and cataract surgery were calculated. The incidence of cataract surgery was assessed, and hazard ratios (HRs) were presented. Having ever smoked was associated with a higher prevalence ratio of self-reported cataract (PR 1.19, 95% confidence interval [CI] 1.04-1.35) and cataract surgery (PR 1.27, 95% CI 1.06-1.53), compared to those who had never been daily smokers. Currently, a smoker was associated with a higher HR of cataract surgery (HR 1.34, 95% CI 1.04-1.74), as well as having been a former smoker (HR 1.27, 95% CI 1.03-1.56). Total years of smoking were associated with an increased risk for cataract surgery (HR 1.05, 95% CI 1.02-1.08 for 5 years of smoking). Snus use was not associated with an increased prevalence of cataract or incidence of cataract surgery, except among women who were current snus users (HR for cataract surgery 2.04, 95% CI 1.16-3.60 n = 108). Smoking is associated with a higher prevalence of cataracts, and a higher incidence of cataract surgery, indicating a dose-response relationship. However, there was no firm association between snus use and cataract.

Molecular and cell phenotype programs in oral epithelial cells directed by co-exposure to arsenic and smokeless tobacco.

Chronic arsenic exposure can lead to various health issues, including cancer. Concerns have been mounting about the enhancement of arsenic toxicity through co-exposure to various prevalent lifestyle habits. Smokeless tobacco products are commonly consumed in South Asian countries, where their use frequently co-occurs with exposure to arsenic from contaminated groundwater. To decipher the in vitro molecular and cellular responses to arsenic and/or smokeless tobacco, we performed temporal multi-omics analysis of the transcriptome and DNA methylome remodelling in exposed hTERT-immortalized human normal oral keratinocytes (NOK), as well as arsenic and/or smokeless tobacco genotoxicity and mutagenicity investigations in NOK cells and in human p53 knock-in murine embryonic fibroblasts (Hupki MEF). RNAseq results from acute exposures to arsenic alone and in combination with smokeless tobacco extract revealed upregulation of genes with roles in cell cycle changes, apoptosis and inflammation responses. This was in keeping with global DNA hypomethylation affecting genes involved in the same processes in response to chronic treatment in NOK cells. At the phenotypic level, we observed a dose-dependent decrease in NOK cell viability, induction of DNA damage, cell cycle changes and increased apoptosis, with the most pronounced effects observed under arsenic and SLT co-exposure conditions. Live-cell imaging experiments indicated that the DNA damage likely resulted from induction of apoptosis, an observation validated by a lack of exome-wide mutagenesis in response to chronic exposure to arsenic and/or smokeless tobacco. In sum, our integrative omics study provides novel insights into the acute and chronic responses to arsenic and smokeless tobacco (co-)exposure, with both types of responses converging on several key mechanisms associated with cancer hallmark processes. The generated rich catalogue of molecular programs in oral cells regulated by arsenic and smokeless tobacco (co-)exposure may provide bases for future development of biomarkers for use in molecular epidemiology studies of exposed populations at risk of developing oral cancer.

Association between Exposure to Smokeless Tobacco Consumption and Carcinoma of Cervix

Background: Cervical cancer is the most destabilizing cancer that grows increasingly prevalent worldwide. The Southeast Asia region has the greatest incidence and mortality rates due to widespread use of smokeless tobacco (SLT) products, a lack of screening programmes, and immunization against cervical cancer. Objective: To assess the association between smokeless tobacco consumption and carcinoma of cervix. Methodology: A case-control study was conducted with 272 women aged 18-49 years, conveniently selected from both outpatient and inpatient settings at the National Institute of Cancer Research and Hospital (NICRH) in Dhaka, Bangladesh. The selection of NICRH was purposive. Participants underwent interviews using a pre-tested, semi-structured questionnaire between January and December 2019. Results: The mean age of cases was 49.8±8.8 years, while the mean age of controls was 48.5±9.3 years. In comparison to controls (52.2%), the majority of patients (65.4%) consumed SLT throughout their entire lives. A significant relationship was found between SLT use and the development of cervical cancer (p&lt;0.05). Those who have consumed any SLT in their lives are 1.7 times more likely to develop cervical cancer than those who have not taken any SLT. Cases (22.8%) used betel quid with jorda &gt;5 times, compared to controls (14.7%), and intensity of Gul used ≤5 among cases (9.6%) than controls (2.9%). Compared to controls (56.3%), the majority of cases (76.4%) had been using SLT for more than 10 years, with a statistically significant difference (p&lt;0.05). Cases used SLT for a longer time (19.2±10.3) compared to controls (15.6±11.1), with a significant association (p&lt;0.05). Conclusion: The study revealed a significant association between the risk of cervical cancer and the extent and duration of exposure to SLT. To minimize the risk of cervical cancer, contemplate restricting SLT production and utilization. Journal of Monno Medical College June, 2024; 10 (1):17-22

Global burden of oral cancer in 2022 attributable to smokeless tobacco and areca nut consumption: a population attributable fraction analysis

Consuming products that contain smokeless tobacco or areca nut increases the risk of oral cancer. We aimed to estimate the burden of oral cancer attributable to smokeless tobacco or areca nut consumption globally and by type of smokeless tobacco or areca nut product in four major consuming countries. We calculated population attributable fractions (PAFs) using prevalence of current use of smokeless tobacco or areca nut products from national surveys and corresponding risks of oral cancer from the literature. We applied PAFs to national estimates of oral cancer incidence in 2022 from the Global Cancer Observatory's Cancer Today database to obtain cases attributable to smokeless tobacco or areca nut consumption. We modelled 95% uncertainty intervals (UIs) using Monte Carlo simulations. Globally, an estimated 120 200 (95% UI 115 300-124 300) cases of oral cancer diagnosed in 2022 were attributable to smokeless tobacco or areca nut consumption, accounting for 30·8% (95% UI 29·6-31·9) of all oral cancer cases (120 200 of 389 800). An estimated 77% of attributable cases were among male patients (92 600 cases, 95% UI 88 000-96 500) and 23% were among female patients (27 600 cases, 26 000-29 000). Regions with the highest PAFs were Melanesia, Micronesia, and Polynesia (78·6%, 95% UI 74·4-80·5), southcentral Asia (57·5%, 54·8-59·5), and southeastern Asia (19·8%, 19·0-20·6). Lower-middle-income countries represented 90·2% of the world total attributable cases (108 400 cases, 95% UI 103 400-112 200). Our findings suggest that one in three cases of oral cancer globally are attributable to smokeless tobacco or areca nut consumption, and could be prevented through smokeless tobacco and areca nut control. Global cancer control efforts must incorporate further measures to reduce smokeless tobacco and areca nut consumption in populations with the largest attributable burden. French National Cancer Institute.

Understanding addictive behaviour of a group of slum dwelling female SLT users on the basis of PRIME theory: A case study in Odisha, India

ABSTRACT Context: Tobacco addiction is an important public health problem. Among several theories of addiction proposed, PRIME theory of motivation is found to be a comprehensive one to synthesise prevention strategies. Aims: This case study was conducted on the basis of PRIME theory to explain smokeless tobacco (SLT) addiction patterns among slum dwelling female residents of Cuttack district, Odisha. Settings and Design: Cuttack district of Odisha state and Qualitative synthesis. Methods and Material: Qualitative semistructured face-to-face interviews and framework analysis techniques were employed. The study was conducted over a period of 2 months between February 2020 and March 2020. Face-to-face interviews of 26 participants of Dasha Sahi slum using a semistructured questionnaire assessing responses based on five main themes including P, Plans; R, Responses; I, Impulses And Inhibitory Forces; M, Motives; and E, Evaluations of the said theory. Statistical Analysis Used: Verbatim transcripts were analysed using thematic framework analysis. Results: A majority of the participants were multiple SLT product users, and they did not have an immediate plan to quit. Most of the participants showed strong emotional attachment with these products and considered them the only source of pleasure (want) in a life full of miseries. The words “Tobacco” and “Nicotine” were medical jargons for them. Though they were aware of the harmful effects, they had a positive evaluative belief about its use because of cognitive dissonance. Most of them were habitual users living in an environment full of physical and social cues. Conclusions: This case study is well in line with the PRIME theory in explaining the addictive behaviour; a comprehensive multi-strategic approach was formulated for inculcating quitting behaviour among this disadvantaged section of the population as suggested by the proposer of this theory.

Noticing health warning labels and intentions to quit smokeless tobacco products: results from two Global Adult Tobacco Survey rounds, India

Introduction: Health warning labels (HWLs) are one of the key strategies for tobacco control. The current study assessed the individual characteristics affecting the noticeability of HWLs and the thought of quitting smokeless tobacco (SLT) on noticing HWLs. We further estimated the temporal changes in noticeability and thought of quitting after noticing HWLs over time in India. Methods: Data from two rounds (2009–2010 and 2016–2017) of GATS (Global Adult Tobacco Survey) from India were analysed to understand the pattern of SLT usage and estimate the relative changes in the noticeability of HWLs and the thought of quitting SLT among those who noticed HWLs. Sampling weights were used during the analysis. Multivariate binary logistic regression was used to explore the determinants for the noticeability of HWLs and encourage the intention to quit SLT after noticing the HWLs. Results: About 25.9% and 20.6% of participants consumed SLT daily or non-daily in two rounds of GATS. Overall, there was a 14% relative increase in noticing the HWLs and a 20% increase in the thought of quitting in GATS-2 compared with GATS-1. The adjusted odds ratio of observing HWLs among SLT users was 1.51 times (95% confidence interval (CI), 1.44–1.58) in round 2 compared with round 1, while the odds ratio concerning the thought of quitting SLT after noticing HWLs was 1.95 times (95% CI, 1.84–2.06) in round 2 compared with round 1. Conclusions: We observe a consistent increase in the noticeability of HWLs and intentions to quit in SLT users, with significant variations across socio-demographic characteristics calling for concerted efforts. SLT being the major form of tobacco usage in India and Asian countries, HWLs alone cannot bring down the consumption rates, and it needs to be supported by strict implementation of SLT legislation for long-lasting impact.

Lifestyle Differences in the Metabolic Comorbidity Score of Adult Population From South Asian Countries: A Cross-Sectional Study

BackgroundMetabolic comorbidities are involved in the development and progression of non-communicable diseases (NCDs). There is convincing evidence that lifestyles are important contributors to metabolic comorbidities. This study measured the metabolic comorbidity score of South Asian adults, and identified its relationship with lifestyles. MethodsWe studied five South Asian countries including Afghanistan, Bangladesh, Bhutan, Nepal, and Sri Lanka, using WHO's Stepwise approach to NCD risk factor surveillance data between 2014 and 2019. This was a nationally representative and cross-sectional survey on participants aged 15-69 years old. The sample size was 27,616. The outcome was metabolic comorbidity score, calculated based on total cholesterol, fasting plasma glucose, blood pressure, and abdominal obesity. Total metabolic comorbidity score of each participant varied between 0-8. It was then divided into three ranges – the lowest range (total metabolic comorbidity score <3), medium range (total metabolic comorbidity score ≥3 & ≤5), and the highest range (total metabolic comorbidity score ≥6). Based on the outcome of non-parametric receiver operating characteristics analysis, the medium and the highest range together was considered as higher metabolic comorbidity score. The lowest range was considered as lower metabolic comorbidity score. The higher metabolic comorbidity score was coded as “1”and the lower metabolic comorbidity score was coded as “0”. Thus, the outcome variable, metabolic comorbidity score, became a binary variable. Exposures included physical inactivity (<150 minutes of MVPS /week), high daily sedentary time (≥ 9 hours/day), use of tobacco (present or past smoking or daily use of smokeless tobacco products), and consumption of alcohol (at least once/month in the last one year). Binomial logistic regression model produced the odds ratios (OR) with corresponding 95% confidence intervals (CI). ResultsThe prevalence of higher metabolic comorbidity score was 34% among South Asian adults, 25% among the male respondents and 41% among the female respondents. Participants who were physically inactive (OR, 1.26; 95% CI, 1.17-1.36), had high sedentary time (OR, 1.24; 95% CI, 1.11-1.33), and consumed alcohol (OR, 1.40; 95% CI, 1.23-1.53) showed higher metabolic comorbidity score compared with the participants who were physically active, had low sedentary time and did not consume alcohol respectively. However, we found an inverse association (OR, 0.75; 95% CI, 0.71-0.81) between the use of tobacco and metabolic comorbidity score. ConclusionsOne third of South Asian adults had higher metabolic comorbidity score. Physical inactivity, daily sedentary hours and minimal alcohol consumption was associated with higher metabolic comorbidity score.

Oral lesions in patients consuming different types of smokeless tobacco. A literature review.

Introduction: Smokeless tobacco (ST) is widely consumed around the world, with products such as gutkha and paan masala being particularly common. These products typically contain areca nut, which is known for its carcinogenic properties and negative effects on oral health. In addition, tobacco is a key ingredient in ST and has been linked to a range of general and dental health issues, particularly among younger populations. Objetive: The purpose of this study is to demonstrate the harmful effect of ST in the oral health. Method: A bibliographic search was conducted based on a sistematic review of articles published between January 2009 and March 2023, aided by PubMed, Scielo, and Google Scholar search engines. Results: Some studies have shown that ST and areca nut components can be particularly dangerous for people with cardiovascular disease and diabetes. Additionally, tobacco has a significant impact on periodontal and dental health, with pathological lesions that may lead to malignant disorders. Peer pressure and stress are common reasons for ST addiction. As such, promoting the intention to quit this habit should be repeatedly emphasized to avoid the negative consequences of these products. Conclusion: the consumption of tobacco has taken a huge toll around the world with its frequency and health consequences. The widespread of ST products such as gutkha and paan masala has affected all age groups. These are responsible for many repercussions that are harmful to health.

Variability in addictive and carcinogenic potential of smokeless tobacco products marketed in Mumbai, India: a surveillance study

India has the highest incidence worldwide of smokeless tobacco (SLT)-associated oral cancer, accounting for nearly 70% of all SLT users globally. Nicotine and tobacco-specific N-nitrosamines (TSNA) play critical roles in the addictive and carcinogenic potential, respectively, of SLT products. Our group has previously reported substantial variability in nicotine and TSNA levels across a small SLT product sample in India, calling for systematic surveillance. However, there is no information available on the current levels of these constituents in Indian SLT. We analysed 321 samples representing 57 brands of eight popular types of manufactured SLT products purchased from five local markets in Mumbai, India between August, and September 2019. The sampling locations were Mumbai Central, Kurla, Thane, Vashi, and Airoli. Product pH, moisture content, total and unprotonated (biologically available) nicotine, and TSNA levels were measured at the Advanced Centre for Treatment, Research, and Education in Cancer (ACTREC) in Mumbai. Total nicotine content ranged from 0.45 to 35.1mg/g across products. The unprotonated nicotine fraction contributed 0.1-100% of the total nicotine content. The carcinogenic TSNA levels ranged 0.06-76 ug/g for N'-nitrosonornicotine (NNN), 0.02-19.2 ug/g for 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), and 0.01-6.51 ug/g for 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL). Consistent with our previous study, we observed substantial variations across different brands of the same product type. This is the most extensive and the first within-country study to report brand-specific nicotine and TSNA levels in SLT products marketed in Mumbai, India. Our results show that levels of these constituents remain extremely variable across Indian SLT and are strikingly high in many products. Enhanced public education and continued efforts to reduce SLT use prevalence in India are critical for reducing the global burden of SLT-associated morbidity and mortality. Regulation of nicotine and TSNA levels in SLT products should be considered. This work was supported by the National Institutes of Health (USA) grant R01-TW010651 and, in part, by grants R01-CA180880 and R50-CA211256. The LC-MS/MS analysis was supported in part by XII Plan project funding from the Department of Atomic Energy, Government of India.

Microbial community and functions involved in smokeless tobacco product: a metagenomic approach

Smokeless tobacco products (STPs) are attributed to oral cancer and oral pathologies in their users. STP-associated cancer induction is driven by carcinogenic compounds including tobacco-specific nitrosamines (TSNAs). The TSNAs synthesis could enhanced due to the metabolic activity (nitrate metabolism) of the microbial populations residing in STPs, but identifying microbial functions linked to the TSNAs synthesis remains unexplored. Here, we rendered the first report of shotgun metagenomic sequencing to comprehensively determine the genes of all microorganisms residing in the Indian STPs belonging to two commercial (Moist-snuff and Qiwam) and three loose (Mainpuri Kapoori, Dohra, and Gudakhu) STPs, specifically consumed in India. Further, the level of nicotine, TSNAs, mycotoxins, and toxic metals were determined to relate their presence with microbial activity. The microbial population majorly belongs to bacteria with three dominant phyla including Actinobacteria, Proteobacteria, and Firmicutes. Furthermore, the STP-linked microbiome displayed several functional genes associated with nitrogen metabolism and antibiotic resistance. The chemical analysis revealed that the Mainpuri Kapoori product contained a high concentration of ochratoxins-A whereas TSNAs and Zink (Zn) quantities were high in the Moist-snuff, Mainpuri Kapoori, and Gudakhu products. Hence, our observations will help in attributing the functional potential of STP-associated microbiome and in the implementation of cessation strategies against STPs.Key points•Smokeless tobacco contains microbes that can assist TSNA synthesis.•Antibiotic resistance genes present in smokeless tobacco-associated bacteria.•Pathogens in STPs can cause infections in smokeless tobacco users.

Trends in smokeless tobacco use and attributable mortality and morbidity in the South-East Asia Region: implications for policy

ObjectivesTo describe the prevalence of smokeless tobacco (SLT) use and number of users by year, in addition to trends in mortality and attributable disease burden in countries of the WHO...

Tobacco use among adults with disabilities in nine countries-Demographic and Health Survey, 2016-2021.

Few studies have investigated tobacco use among people with disabilities living in low- and middle-income countries (LMICs). We aimed to examine current tobacco use among men and women with disabilities using Demographic and Health Survey (DHS) data from 9 LMICs. We considered a respondent currently use tobacco products if they reported current use of any combustible/smoked tobacco products or smokeless tobacco products. We performed secondary analyses of DHS data from 2016-2021 collected in Haiti, Mali, Mauritania, Nigeria, Pakistan, Rwanda, South Africa, Timor-Leste, and Uganda. We examined marginal effects in logistic regression to calculate the adjusted prevalence and adjusted prevalence differences of tobacco use by disability status, controlling for selected sociodemographic characteristics. The adjusted prevalence of current use of tobacco products among women with a moderate/severe disability, mild disability, and no disability varied across countries, with medians of 1.9% (range = 0.1% [Mali] to 11.3% [Pakistan]), 3.2% (range = 0.9% [Nigeria] to 13.3% [South Africa]), and 2.3% (range = 0.5% [Nigeria] to 8.9% [South Africa]), respectively. For men with moderate/severe disability, the median adjusted prevalence for current use of tobacco products was 18.8% (range = 8.9% [Rwanda] to 55.0% [Timor-Leste]). The median prevalences of current use of tobacco products for men with mild disability and no disability were similar to those with moderate/severe disability, at 16.5% and 15.9%, respectively. Current tobacco product use among people with disabilities varied for countries included in our study; however, with few exceptions, current tobacco product use was similar across disability status groups. Additional research is warranted to determine whether our findings extend beyond the nine countries assessed here. It is important to consider the needs of people with disabilities in tobacco prevention, control, and cessation efforts so that this substantial population can benefit equitably from such programs, interventions, or policies.

Impact of vanilla flavor on nicotine taste, choice, intake, and seeking behaviors.

Flavors can alter the orosensory properties of tobacco products. Specifically, flavors can serve as an oral cue for smokeless tobacco products. We aimed to investigate the impact of oral vanillin, the principal chemical of vanilla flavor in tobacco products, on nicotine's taste, and nicotine choice, intake, and seeking behaviors. Experiments were performed in young adult Sprague Dawley rats. We employed a two-bottle free-choice test (2BC) to measure the preference for different concentrations of vanillin and its effect on nicotine preference. To explore the long-term effects of early exposure to sweetened vanillin, we utilized a combined 2BC and intraoral self-administration (IOSA) model. We assessed the nicotine taking and seeking behaviors in the presence or absence of vanillin. We performed a taste reactivity test (TRT) to quantify liking (ingestive) and disliking (aversive) taste responses to oral nicotine with or without vanillin. In 2BC, female rats preferred vanillin containing solutions more than their male counterparts. In IOSA, vanillin alone and in combination with nicotine led to greater IOSA compared to water. Female rats self-administered vanillin plus nicotine more than male rats. Vanillin increased motivation to nicotine taking, but only in females. In TRT, vanillin increased nicotine's ingestive responses but blocked aversive responses in both sexes. These results indicate that vanilla flavor can increase oral nicotine intake. It can also increase liking and decrease disliking of nicotine's taste. Furthermore, the impact of vanilla flavor on nicotine taste and nicotine choice, intake, and seeking behaviors is concentration and sex dependent.

Evaluation of Dissolution Release Profiles of Nicotine and Three Distinct Flavor Markers in Loose Moist Smokeless Tobacco Products

Summary This study describes the dissolution release profiles of nicotine and flavor markers from three loose moist smoke-less tobacco (MST) products, same brand, each made with a distinct flavor. The US Pharmacopeia flow-through cell dissolution apparatus 4 (USP-4) was employed, following a previously published method that was validated to study the nicotine release from MST products. Herein, we expanded the scope of the analytical method by incorporating three flavor markers including methyl salicylate, ethyl salicylate, and glycyrrhizic acid to provide an understanding of the dissolution release profiles of not only nicotine but also of flavor markers. The dissolution release profiles of nicotine were found to be equivalent across all three tobacco products. In contrast, the release profiles of the studied flavor markers exhibited distinct differences, primarily influenced by their chemical properties, particularly polarity. Notably, glycyrrhizic acid demonstrated the most rapid release rate, while ethyl salicylate exhibited the slowest release rate. This study serves as a valuable resource for researchers, manufacturers, and regulatory bodies involved in the evaluation of MST products attributes and performance.

Development and validation of a ddPCR assay to detect and quantify tobacco DNA in smoke and smokeless tobacco and tobacco-free products

The last decade, smoke and smokeless products claiming to be tobacco-free, including herbal cigarettes and herbal shisha, became available on the European market and gained popularity. This study proposes a new digital droplet PCR (ddPCR) method, designed based on a previously developed real-time PCR (qPCR) method being currently used by the U.S. Food and Drug Administration (FDA) to specifically detect the presence of tobacco DNA in targeting a sequence from the Nicotiana tabacum nia-1 gene. To ensure a harmonized and reliable control by enforcement laboratories, both of these qPCR and ddPCR methods were then evaluated and validated for their compliance to an international standard. First, the performance of these PCR-based methods was successfully assessed as specific and sensitive, and in line with minimum performance requirements from international standard. Secondly, the transferability to external laboratory was confirmed for these PCR-based methods. Finally, the applicability of these PCR-based methods was demonstrated using 7 ground tobacco reference materials from the Tobacco Research Center (TRC) Toronto University as well as 6 commercial smokeless and tobacco-free smoke and smokeless products. Based on this study, the previously developed qPCR method was confirmed as complying with international standard, ensuring a efficient and harmonize use by enforcement laboratories for tobacco control on the European market. Moreover, this study proposed to enforcement laboratories the possibility to use a ddPCR method, enabling the simultaneous detection and absolute quantification of tobacco DNA as well as a limited impact of PCR inhibitors.

A combined metagenome and disease enrichment analysis of nitrosamines present in smokeless tobacco, wiz using molecular docking and functional annotation approach

Smokeless tobacco products (SLTs) are a major concern due to the associated health risks of the carcinogens, toxins, dynamic microbial system and other harmful chemicals present in them. Procured tobacco leaves are sweetened, flavored and processed to yield the various noncombustible forms of SLTs. These SLTs contain a discrete microbial ecosystem which may contribute to the formation of tobacco specific nitrosamines (TSNAs), endotoxins and other pro inflammatory components. In the present study Whole Metagenome Sequencing was carried out for the exploration of microbial communities followed by their functional profiling. In addition to this, novel targets for TSNAs were predicted using the Swiss Target Prediction tool. Further, disease enrichment analysis of various TSNAs present in Wiz was done using Molecular Docking and functional annotation approach using David database. Bacterial, fungal and viral species were found in the sample where more than 50 % of total bacterial species were Proteobacteria followed by Actinobacteria, Firmicutes, Apicomplexa, Bacteroidetes, Basidiomycota and Cyanobacteria phyla. Total 22,766 genes with 64.9 % GC content were found, which were associated with nitrogen metabolism, antibiotic resistance, multidrug transportation, multitoxins, and pro-inflammation. The presence of phages in wiz showed the possibility of horizontal gene transfer. The pathway enrichment analysis of various TSNAs of wiz were found to be associated with numerous diseases, such as Parkinson's disease, schizophrenia, mental depression, Hypertension, male infertility, Acute Kidney disease and various kinds of cancers.This study will help to understand the possible role of microbiota, TSNAs and their genetic contribution to the overall product's effect on human health. The raw data was submitted to NCBI Short Read Archive (SRA) under Bio Project accession number PRJNA837388.

Comparison of Tobacco Product Prices at Fort Liberty Army Installation and Surrounding Community Areas, 2021.

High rates of tobacco use persist in the U.S. military, with 18.4% of service members smoking cigarettes in 2018. The Department of Defense's (DoD) 2017 policy required that tobacco retailers on military installations set tobacco product prices equal to the most common community price, including tax, but there is limited evidence confirming whether local retailers are adhering to this policy. We examined tobacco product pricing in tobacco retailers on- and off-post at the largest U.S. Army installation, Fort Liberty, and Cumberland County, North Carolina. Between June and August 2021, we collected data on tobacco product availability, price, and promotions from retailers on Fort Liberty (n = 14) and a random sample of off-post retailers within 10 miles of installation gates (n = 52). We calculated the mode, mean, and median price of each product, plus the difference in these prices at on- and off-post retailers. We used Welch's t-test to test differences in mean prices between on- versus off-post retailers. The mode, mean, and median prices of cigarette packs and cartons were lower on-post than off-post (eg, $0.51-$0.55 cheaper for Marlboro cigarette packs on-post). However, the mode, mean, and median prices of smokeless tobacco products and little cigars were higher on-post than off-post (eg, $0.82-$0.89 more costly for Swisher Sweets 2-packs on-post). Results highlight the need for continued enforcement to ensure compliance with the 2017 DoD policy. Comprehensive policy action to reduce tobacco price disparities on- and off-post is critical to reducing high rates of tobacco use among service members. Despite the implementation of the 2017 DoD pricing policy, some tobacco products remain cheaper at tobacco retailers on-post compared to off-post retailers. Our results highlight the need for greater routine surveillance to increase implementation of the policy-particularly for cigarettes-to reduce high rates of tobacco use among service members.