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Preventive medicine · Jan 2009
ReviewMonitoring the tobacco use epidemic II: The agent: Current and emerging tobacco products.
- Steven D Stellman and Mirjana V Djordjevic.
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, New York, USA. sds91@columbia.edu
- Prev Med. 2009 Jan 1; 48 (1 Suppl): S11S15S11-5.
ObjectiveThis Agent paper (II of V on monitoring the tobacco use epidemic) summarizes the findings and recommendations of the Agent (product) Working Group of the November, 2002, National Tobacco Monitoring, Research and Evaluation Workshop.MethodsThe Agent Working Group evaluated the need to develop new surveillance systems for quantifying ingredients and emissions of tobacco and tobacco smoke and to improve methods to assess uptake and metabolism of these constituents taking into account variability in human smoking behavior.ResultsThe toxic properties of numerous tobacco and tobacco smoke constituents are well known, yet systematic monitoring of tobacco products has historically been limited to tar, nicotine, and CO in mainstream cigarette smoke using a machine-smoking protocol that does not reflect human smoking behavior. Toxicity of smokeless tobacco products has not been regularly monitored. Tobacco products are constantly changing and untested products are introduced into the marketplace with great frequency, including potential reduced-exposure products (PREPs). The public health impact of new or modified tobacco products is unknown.ConclusionsSystematic surveillance is recommended for mainstream smoke constituents such as polycyclic aromatic hydrocarbons (PAH), tobacco-specific nitrosamines (TSNA), total and free-base nicotine, volatile organic compounds, aromatic amines, and metals; and design attributes including tobacco blend, additives, and filter ventilation. Research on smoking topography is recommended to help define machine-smoking protocols for monitoring emissions reflective of human smoking behavior. Recommendations are made for marketplace product sampling and for population monitoring of smoking topography, emissions of toxic constituents, biomarkers of exposure and, eventually, risk of tobacco-related diseases.
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