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Cancer Prevention Research
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Research Article

Evidence Supporting Product Standards for Carcinogens in Smokeless Tobacco Products

Dorothy K. Hatsukami, Irina Stepanov, Herb Severson, Joni A. Jensen, Bruce R. Lindgren, Kimberly Horn, Samir S. Khariwala, Julia Martin, Steven G. Carmella, Sharon E. Murphy and Stephen S. Hecht
Dorothy K. Hatsukami
1University of Minnesota, Masonic Cancer Center, Minneapolis, Minnesota.
2Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota.
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  • For correspondence: hatsu001@umn.edu
Irina Stepanov
1University of Minnesota, Masonic Cancer Center, Minneapolis, Minnesota.
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Herb Severson
3Oregon Research Institute, Eugene, Oregon.
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Joni A. Jensen
2Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota.
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Bruce R. Lindgren
1University of Minnesota, Masonic Cancer Center, Minneapolis, Minnesota.
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Kimberly Horn
4George Washington University, School of Public Health, Washington, District of Columbia.
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Samir S. Khariwala
5Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota.
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Julia Martin
3Oregon Research Institute, Eugene, Oregon.
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Steven G. Carmella
1University of Minnesota, Masonic Cancer Center, Minneapolis, Minnesota.
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Sharon E. Murphy
1University of Minnesota, Masonic Cancer Center, Minneapolis, Minnesota.
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Stephen S. Hecht
1University of Minnesota, Masonic Cancer Center, Minneapolis, Minnesota.
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DOI: 10.1158/1940-6207.CAPR-14-0250 Published January 2015
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Abstract

Smokeless tobacco products sold in the United States vary significantly in yields of nicotine and tobacco-specific nitrosamines (TSNA). With the passage of the Family Smoking Prevention and Tobacco Control Act, the Food and Drug Administration now has the authority to establish product standards. However, limited data exist determining the relative roles of pattern of smokeless tobacco use versus constituent levels in the smokeless tobacco product in exposure of users to carcinogens. In this study, smokeless tobacco users of brands varying in nicotine and TSNA content were recruited from three different regions in the U.S. Participants underwent two assessment sessions. During these sessions, demographic and smokeless tobacco use history information along with urine samples to assess biomarkers of exposure and effect were collected. During the time between data collection, smokeless tobacco users recorded the amount and duration of smokeless tobacco use on a daily basis using their diary cards. Results showed that independent of pattern of smokeless tobacco use and nicotine yields, levels of TSNA in smokeless tobacco products played a significant role in carcinogen exposure levels. Product standards for reducing levels of TSNA in smokeless tobacco products are necessary to decrease exposure to these toxicants and potentially to reduce risk for cancer. Cancer Prev Res; 8(1); 20–26. ©2014 AACR.

  • Received August 3, 2014.
  • Revision received October 6, 2014.
  • Accepted October 24, 2014.
  • ©2014 American Association for Cancer Research.
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Cancer Prevention Research: 8 (1)
January 2015
Volume 8, Issue 1
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Evidence Supporting Product Standards for Carcinogens in Smokeless Tobacco Products
Dorothy K. Hatsukami, Irina Stepanov, Herb Severson, Joni A. Jensen, Bruce R. Lindgren, Kimberly Horn, Samir S. Khariwala, Julia Martin, Steven G. Carmella, Sharon E. Murphy and Stephen S. Hecht
Cancer Prev Res January 1 2015 (8) (1) 20-26; DOI: 10.1158/1940-6207.CAPR-14-0250

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Evidence Supporting Product Standards for Carcinogens in Smokeless Tobacco Products
Dorothy K. Hatsukami, Irina Stepanov, Herb Severson, Joni A. Jensen, Bruce R. Lindgren, Kimberly Horn, Samir S. Khariwala, Julia Martin, Steven G. Carmella, Sharon E. Murphy and Stephen S. Hecht
Cancer Prev Res January 1 2015 (8) (1) 20-26; DOI: 10.1158/1940-6207.CAPR-14-0250
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