印度孟买市场上销售的无烟烟草制品致瘾和致癌潜力的差异:一项监测研究

IF 5 Q1 HEALTH CARE SCIENCES & SERVICES The Lancet regional health. Southeast Asia Pub Date : 2024-08-23 DOI:10.1016/j.lansea.2024.100457
Sampada S. Nikam , Vikram Gota , Prakash C. Gupta , Namrata Puntambekar , Arjun Singh , Pankaj Chaturvedi , Peter W. Villalta , Dorothy K. Hatsukami , Jasjit S. Ahluwalia , Saonli Basu , Samir S. Khariwala , Irina Stepanov
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引用次数: 0

摘要

背景印度是全球无烟烟草(SLT)相关口腔癌发病率最高的国家,占全球无烟烟草使用者总数的近 70%。尼古丁和烟草特异性 N-亚硝胺(TSNA)分别在无烟烟草产品的成瘾性和致癌性方面发挥着关键作用。我们的研究小组以前曾报告过印度一小部分 SLT 产品样本中尼古丁和 TSNA 含量的巨大差异,呼吁进行系统监测。我们分析了 2019 年 8 月至 9 月期间从印度孟买五个当地市场购买的 321 个样品,这些样品代表了八种流行的 SLT 制品的 57 个品牌。取样地点为孟买市中心、库尔勒、塔内、瓦什和艾罗利。孟买癌症治疗、研究和教育高级中心(ACTREC)对产品的pH值、水分含量、总尼古丁和非质子(生物可用)尼古丁以及TSNA水平进行了测量。非质子化尼古丁部分占尼古丁总含量的 0.1%-100%。N′-亚硝基烟碱(NNN)的致癌 TSNA 含量为 0.06-76 微克/克,4-(甲基亚硝基氨基)-1-(3-吡啶基)-1-丁酮(NNK)的致癌 TSNA 含量为 0.02-19.2 微克/克,4-(甲基亚硝基氨基)-1-(3-吡啶基)-1-丁醇(NNAL)的致癌 TSNA 含量为 0.01-6.51 微克/克。与我们之前的研究一致,我们观察到同一类型产品的不同品牌之间存在很大差异。解释 这是报告印度孟买市场上 SLT 产品中特定品牌尼古丁和 TSNA 含量的最广泛和首个国内研究。我们的研究结果表明,印度 SLT 产品的尼古丁和 TSNA 含量差异极大,许多产品的尼古丁和 TSNA 含量都非常高。加强公众教育,继续努力降低印度 SLT 的使用率,对于减轻 SLT 相关发病率和死亡率的全球负担至关重要。应考虑对 SLT 产品中的尼古丁和 TSNA 水平进行监管。LC-MS/MS 分析部分得到了印度政府原子能部 XII 计划项目资金的支持。
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Variability in addictive and carcinogenic potential of smokeless tobacco products marketed in Mumbai, India: a surveillance study

Background

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.

Methods

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.

Findings

Total nicotine content ranged from 0.45 to 35.1 mg/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.

Interpretation

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.

Funding

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.

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