A Method for Comparing the Impact on Carcinogenicity of Tobacco Products: A Case Study on Heated Tobacco Versus Cigarettes

被引:18
作者
Slob, Wout [1 ]
Soeteman-Hernandez, Lya G. [1 ]
Bil, Wieneke [1 ]
Staal, Yvonne C. M. [1 ]
Stephens, W. Edryd [2 ]
Talhout, Reinskje [1 ]
机构
[1] Natl Inst Publ Hlth & Environm RIVM, Bilthoven, Netherlands
[2] Univ St Andrews, Sch Earth & Environm Sci, St Andrews, Fife, Scotland
关键词
Carcinogenicity; cumulative exposure; heated tobacco; relative potency; tobacco products; NOT-BURN TOBACCO; GENETIC TOXICOLOGY; RISK-ASSESSMENT; CHEMICAL-CONSTITUENTS; EMPIRICAL-ANALYSIS; MAINSTREAM SMOKE; BMD METRICS; IN-VIVO; EXPOSURE; RATS;
D O I
10.1111/risa.13482
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Comparing the harmful health effects related to two different tobacco products by applying common risk assessment methods to each individual compound is problematic. We developed a method that circumvents some of these problems by focusing on the change in cumulative exposure (CCE) of the compounds emitted by the two products considered. The method consists of six steps. The first three steps encompass dose-response analysis of cancer data, resulting in relative potency factors with confidence intervals. The fourth step evaluates emission data, resulting in confidence intervals for the expected emission of each compound. The fifth step calculates the change in CCE, probabilistically, resulting in an uncertainty range for the CCE. The sixth step estimates the associated health impact by combining the CCE with relevant dose-response information. As an illustrative case study, we applied the method to eight carcinogens occurring both in the emissions of heated tobacco products (HTPs), a novel class of tobacco products, and tobacco smoke. The CCE was estimated to be 10- to 25-fold lower when using HTPs instead of cigarettes. Such a change indicates a substantially smaller reduction in expected life span, based on available dose-response information in smokers. However, this is a preliminary conclusion, as only eight carcinogens were considered so far. Furthermore, an unfavorable health impact related to HTPs remains as compared to complete abstinence. Our method results in useful information that may help policy makers in better understanding the potential health impact of new tobacco and related products. A similar approach can be used to compare the carcinogenicity of other mixtures.
引用
收藏
页码:1355 / 1366
页数:12
相关论文
共 46 条
  • [1] [Anonymous], 11 WHOIPCS
  • [2] [Anonymous], 2014, The health consequences of smoking: 50 years of progress
  • [3] [Anonymous], 2012, BENCHM DOS TECHN GUI
  • [4] [Anonymous], 1994, ASS HUM HLTH RISKS C
  • [5] Heat-Not-Burn Tobacco Cigarettes: Smoke by Any Other Name
    Auer, Reto
    Concha-Lozano, Nicolas
    Jacot-Sadowski, Isabelle
    Cornuz, Jacques
    Berthet, Aurelie
    [J]. JAMA INTERNAL MEDICINE, 2017, 177 (07) : 1050 - 1052
  • [6] Bekki Kanae, 2017, Journal of UOEH, V39, P201, DOI 10.7888/juoeh.39.201
  • [7] Comparison of in vitro and in vivo clastogenic potency based on benchmark dose analysis of flow cytometric micronucleus data
    Bemis, Jeffrey C.
    Wills, John W.
    Bryce, Steven M.
    Torous, Dorothea K.
    Dertinger, Stephen D.
    Slob, Wout
    [J]. MUTAGENESIS, 2016, 31 (03) : 277 - 285
  • [8] Deriving a data-based interspecies assessment factor using the NOAEL and the benchmark dose approach
    Bokkers, Bas G. H.
    Slob, Wout
    [J]. CRITICAL REVIEWS IN TOXICOLOGY, 2007, 37 (05) : 355 - 373
  • [9] Is current risk assessment of non-genotoxic carcinogens protective?
    Braakhuis, Hedwig M.
    Slob, Wout
    Olthof, Evelyn D.
    Wolterink, Gerrit
    Zwart, Edwin P.
    Gremmer, Eric R.
    Rorije, Emiel
    van Benthem, Jan
    Woutersen, Ruud
    van der Laan, Jan Willem
    Luijten, Mirjam
    [J]. CRITICAL REVIEWS IN TOXICOLOGY, 2018, 48 (06) : 500 - 511
  • [10] Mandated lowering of toxicants in cigarette smoke: a description of the World Health Organization TobReg proposal
    Burns, D. M.
    Dybing, E.
    Gray, N.
    Hecht, S.
    Anderson, C.
    Sanner, T.
    O'Connor, R.
    Djordjevic, M.
    Dresler, C.
    Hainaut, P.
    Jarvis, M.
    Opperhuizen, A.
    Straif, K.
    [J]. TOBACCO CONTROL, 2008, 17 (02) : 132 - 141