Daily Use of Smokeless Tobacco: Systemic Effects
- 15 July 1989
- journal article
- research article
- Published by American College of Physicians in Annals of Internal Medicine
- Vol. 111 (2) , 112-116
- https://doi.org/10.7326/0003-4819-111-2-112
Abstract
The study objective was to compare exposure to nicotine and related cardiovascular effects as well urinary mutagenicity (a potential marker of systemic absorption of carcinogenic compounds) during use of oral snuff, chewing tobacco, and cigarettes, as desired. The experimental design incorporated crossover sequential treatments, and balanced-order experimental studies in a clinical research center. Eight healthy men who regularly smoked cigarettes and had previous experience with the use of both oral snuff and chewing tobacco participated. There was a period of four 3- or 4-day blocks during which participants used oral snuff, chewing tocacco, and cigarettes as desired, or abstained from all tobacco. Concentrations of nicotine and cotinine (the primary metabolite of nicotine), cardiovascular effects, and uring sodium, catecholamine and mutagenicity were measured over 24 hours at the end of each treatment block. Circadian exposure to nicotine and cardiovascular effects, including urinary catecholamine excretion, were similar for all forms of tobacco use. Urine sodium excretion was greater while using smokeless tobacco than while smoking, probably due to absorption of sodium from the smokeless tobacco. Urine mutagenicity was markedly increased while smoking cigarettes and tended to be increased (P < 0.10) while chewing tobacco but not while using oral snuff. In conclusion, systemic absorption of nicotine, sodium, and carcinogenic chemicals from smokeless tobacco may cause or aggravate human illness in addition to the known adverse effects on the oral cavity.Keywords
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