Assessment of Mouth-Level Exposure to Tobacco Constituents in U.S. Snus Consumers

When assessing the health risks associated with different tobacco product categories (e.g., combustible and noncombustible), it is important to understand exposure. Snus, a smokeless tobacco product with lower levels of most tobacco-related toxicants than cigarette smoke, has been recently introduced in the United States. The objective of this study was to evaluate the mouth-level exposure (MLE) to selected tobacco constituents from snus by adult consumers of Camel SNUS (CSNUS). For 7 days, 53 adult CSNUS consumers used their usual brand styles ad libitum, collecting their snus pouches after use. The collected pouches and unused product were analyzed for nicotine, N-nitrosonornicotine (NNN), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), N-nitrosoanabasine (NAB), N-nitrosoanatabine (NAT), benzo[a]pyrene (B[a]P), arsenic, cadmium, chromium, lead, and nickel. MLE was estimated using the difference between the constituent amounts in the used and unused snus products. CSNUS consumption averaged 3.3 pouches/day or approximately 1.98g/day. Mean nicotine MLE was 2.8mg/pouch or 9.4mg/day. Mean MLE to total tobacco-specific nitrosamines (TSNAs: NNK, NNN, NAB, and NAT) was 171.5ng/pouch or 527.7ng/day. B[a]P MLE averaged 0.2ng/pouch or 0.68ng/day. This study is the first to report snus MLE under normal conditions of use in a group of adult, U.S. snus consumers. On average, approximately 60%90% of the amounts of nicotine, TSNAs, and B[a]P initially present in a snus pouch remained in the pouch after use by snus consumers in this study. The results from this study provide a preliminary assessment of exposure to constituents present in snus, which is potentially useful in risk assessment.