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ILSE HOFFMANN AND DIETRICH HOFFMANN 59 Development of highly sensitive analytical methods, as well as reproducible shortterm <strong>and</strong> long-term assays, has led to the identification of 69 carcinogens in cigarette smoke (Table 4.4). Of these, 11 are known human carcinogens (Group I), 7 are probably carcinogenic in humans (Group 2A), <strong>and</strong> 49 of the animal carcinogens are possibly carcinogenic to humans (Group 2B). This classification of the carcinogens is according to the International Agency for Research on Cancer (IARC) (1983, 1984, 1986b, 1988, 1990, 1991, 1992, 1994a, b, c, d, 1995a, b, 1996, 1999a, b). Two suspected carcinogens have, so far, not been evaluated by the IARC. Table 4.4 Carcinogens in cigarette smoke Agent Conc./nonfilter IARC evaluation of cigarette carcinogenicity in lab animals in humans Group a PAH Benz(a)anthracene 20–70 ng Sufficient 2A Benzo(b)fluoranthene 4–22 ng Sufficient 2B Benzo(j)fluoranthene 6–21 ng Sufficient 2B Benzo(k)fluoranthene 6–12 ng Sufficient 2B Benzo(a)pyrene 20–40 ng Sufficient Probable 2A Dibenz(a,h)anthracene 4 ng Sufficient 2A Dibenzo(a,l)pyrene 1.7–3.2 ng Sufficient 2B Dibenzo(a,e)pyrene Present Sufficient 2B Indeno(1,2,3-cd)pyrene 4–20 ng Sufficient 2B 5-Methylchrysene 0.6 ng Sufficient 2B Heterocyclic compounds Quinoline b 1–2 ng Dibenz(a,h)acridine 0.1 ng Sufficient 2B Dibenz(a,j)acridine 3–10 ng Sufficient 2B Dibenzo(c,g)carbazole 0.7 ng Sufficient 2B Benzo(b)furan Present Sufficient 2B Furan 18–37 ng Sufficient 2B N-Nitrosamines N-Nitrosodimethylamine 2–180 ng Sufficient 2A N-Nitrosoethylmethylamine 3–13 ng Sufficient 2B N-Nitrosodiethylamine ND–2.8 ng Sufficient 2A N-Nitroso-di-n-propylamine ND–1.0 ng Sufficient 2B
60 THE CHANGING CIGARETTE: CHEMICAL STUDIES AND BIOASSAYS Table 4.4 (continued) Carcinogens in cigarette smoke Agent Conc./nonfilter IARC evaluation of cigarette carcinogenicity in lab animals in humans Group a N-Nitroso-di-n-butylamine ND–30 ng Sufficient 2B N-Nitrosopyrrolidine 3–110 ng Sufficient 2B N-Nitrosopiperidine ND–9 ng Sufficient 2B N-Nitrosodiethanolamine ND–68 ng Sufficient 2B N-Nitrosonornicotine 120–3700 ng Sufficient 2B 4-(Methylnitrosamino)- 1-(3-pyridyl)-1-butanone 80–770 ng Sufficient 2B Aromatic amines 2-Toluidine 30–337 ng Sufficient 2B 2,6-Dimethylaniline 4–50 µg Sufficient 2B 2-Naphthylamine 1–334 ng Sufficient Sufficient 1 4-Aminobiphenyl 2–5.6 ng Sufficient Sufficient 1 N-Heterocyclic amines AaC 25–260 ng Sufficient 2B IQ 0.3 ng Sufficient 2B Trp-P-1 0.3–0.5 ng Sufficient 2B Trp-P-2 0.8–1.1 ng Sufficient 2B Glu-P-1 0.37–0.89 ng Sufficient 2B Glu-P-2 0.25–0.88 ng Sufficient 2B PhIP 11–23 ng Sufficient Possible 2A Aldehydes Formaldehyde 70–100 µg Sufficient Limited 2A Acetaldehyde 500–1400 µg Sufficient Insufficient 2B Volatile hydrocarbons 1,3-Butadiene 20–75 µg Sufficient Insufficient 2B Isoprene 450–1000 µg Sufficient 2B Benzene 20–70 µg Sufficient Sufficient 1 Styrene 10 µg Limited 2B Misc. organic compounds c Acetamide 38–56 µg Sufficient 2B Acrylamide Present Sufficient 2B
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Tobacco and Public Health: Science
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Tobacco and Public Health: Science
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Preface Tobacco: The public health
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PREFACE vii The cigarette companies
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dramatically. Once more, I am not s
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it impairs quality of life for year
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documents and through litigation by
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PREFACE xv it will not succeed. Now
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Stratton, K., Shetty, P., Wallace,
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Contents Preface v C. Everett Koop
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27 Tobacco and pancreas cancer 479
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Contributors Amanda Amos Reader in
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Stephen S. Hecht University of Minn
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Cecily S. Ray Project Assistant Epi
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Abbreviations AAA Abdominal aortic
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Introduction The publication of thi
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Part 1 Tobacco: History
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Introduction Chapter 1 Evolution of
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RICHARD DOLL 5 However, little atte
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RICHARD DOLL 7 lung’ (Doll and Hi
Page 42 and 43: Table 1.1 Principal diseases caused
Page 44 and 45: Table 1.4 Manufactured cigarette co
Page 46 and 47: in 1995 was approaching the maximum
Page 48 and 49: References Adler, I. (1912). Primar
Page 50 and 51: Introduction Chapter 2 The great st
Page 52 and 53: MICHAEL J. THUN AND JANE HENLEY 19
Page 54 and 55: it seems likely that some of this v
Page 56 and 57: steady increase in lung cancer occu
Page 58 and 59: cigarette smoking in deaths from co
Page 60 and 61: the effects of smoking and smoking
Page 64 and 65: Lung cancer death rate (per 100,000
Page 68 and 69: Lickint, F. (1929). Zeitschrift fur
Page 70 and 71: Chapter 3 Dealing with health fears
Page 72 and 73: LYNN T. KOZLOWSKI AND RICHARD J. O
Page 78 and 79: Table 3.3 Selected cigarette advert
Page 84 and 85: Part 2 Tobacco: Composition
Page 86 and 87: Introduction Chapter 4 The changing
Page 88 and 89: ILSE HOFFMANN AND DIETRICH HOFFMANN
Page 94 and 95: Table 4.4 (continued) Carcinogens i
Page 96 and 97: Table 4.5 Standard conditions for m
Page 100 and 101: Table 4.7 Comparison of experimenta
Page 114 and 115: the lung in rats treated with NNK (
Page 116 and 117: serve as the scientific basis in su
Page 124 and 125: Senkus, M. (ed.) (1976). Leaf compo
Page 126 and 127: Introduction Chapter 5 Tobacco smok
Page 128 and 129: STEPHEN S. HECHT 95 Established pul
Page 130 and 131: STEPHEN S. HECHT 97 magnitude lower
Page 132 and 133: STEPHEN S. HECHT 99 generally great
Page 134 and 135: Table 5.1 1-Hydroxypyrene in the ur
Page 136 and 137: Table 5.2 NNAL and its glucuronides
Page 138 and 139: STEPHEN S. HECHT 105 Table 5.2 (con
Page 140 and 141: Table 5.3 Representative DNA adduct
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G No (Wang et al. 2001a) N 2 CHCH 2
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STEPHEN S. HECHT 111 N-Nitrosopyrro
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(Kozack et al. 2000; Seo et al. 200
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the DNA adducts resulting from toba
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Culp, S. J., Gaylor, D. W., Sheldon
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STEPHEN S. HECHT 119 International
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STEPHEN S. HECHT 121 Melchior, W. B
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STEPHEN S. HECHT 123 Rivenso, A., H
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Wang, M., McIntee, E. J., Cheng, G.
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Part 3 Nicotine and addiction
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Chapter 6 Pharmacology of nicotine
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JACK E. HENNINGFIELD AND NEAL L. BE
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Pickworth et al. 1995; Shiffman et
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American Caucasians and Hispanics (
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(US DHHS 2001). At doses delivered
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References JACK E. HENNINGFIELD AND
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Introduction Chapter 7 Behavioral p
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BRIDGETTE E. GARRETT ET AL. 151 How
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(Fischman and Foltin 1991). Another
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following repeated, infrequent and
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BRIDGETTE E. GARRETT ET AL. 157 oth
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BRIDGETTE E. GARRETT ET AL. 159 cli
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to tobacco product ingredients and
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BRIDGETTE E. GARRETT ET AL. 163 Gom
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BRIDGETTE E. GARRETT ET AL. 165 Ris
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Introduction Chapter 8 Cigarette sc
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JEFF FOWLES AND DENNIS SHUSTERMAN 1
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◆ The pressure drop of the filter
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Nitrosamines Nitrosamines are biolo
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Physical design features of cigaret
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Introduction Chapter 9 Nicotine dos
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world tobacco burden (World Health
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Table 9.2 The ranges of nicotine, n
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MIRJANA V. DJORDJEVIC 187 turing a
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Poland 19 1.4 n.a. n.a. 68−347 36
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MIRJANA V. DJORDJEVIC 191 cigarette
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MIRJANA V. DJORDJEVIC 193 Table 9.5
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MIRJANA V. DJORDJEVIC 195 MS wherea
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MIRJANA V. DJORDJEVIC 197 In recent
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MIRJANA V. DJORDJEVIC 199 Table 9.8
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MIRJANA V. DJORDJEVIC 201 Burns, D.
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International Agency for Research o
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Part 4 Tobacco use: Prevalence, tre
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Chapter 10 Tobacco in Great Britain
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Adult smoking PATTI WHITE 209 Since
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oys who were regular smokers report
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PATTI WHITE 213 cancer, and bringin
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Introduction Chapter 11 The epidemi
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since the late 1980s. In 2001, Phil
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YANG HONGHUAN 219 ◆ Among males,
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Table 11.1 Smoking among adolescent
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(57%) was higher than in males (45%
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20 cigarettes a day had double the
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Chapter 12 Patterns of smoking in R
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DAVID ZARIDZE 229 Ignatova et al. (
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DAVID ZARIDZE 231 Tyumen, respectiv
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References DAVID ZARIDZE 233 Alexee
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Chapter 13 Tobacco smoking in centr
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WITOLD ZATOŃSKI 237 The developmen
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especially post-Soviet countries, w
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No. of Cigarettes 3000 2500 2000 15
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WITOLD ZATOŃSKI 243 young men and
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DEATHS / 100,000 DEATHS / 100,000 7
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WITOLD ZATOŃSKI 247 According to d
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Unfortunately, available data on th
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Kaczmarczyk-Chalas, K., Gdulewicz,
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Chapter 14 The epidemic in India Pr
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aniseed, and musk, also available a
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PRAKASH C. GUPTA AND CECILY S. RAY
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Prevalence among youth PRAKASH C. G
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treatment and premature death were
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Although tobacco control legislatio
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PRAKASH C. GUPTA AND CECILY S. RAY
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Chapter 15 Tobacco in Africa: More
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In assessing tobacco use in Africa
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YUSSUF SALOOJEE 271 plug the gap th
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Table 15.2 Cigarette taxes as perce
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YUSSUF SALOOJEE 275 In recent years
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World Bank (2001). Economics of Tob
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Part 5 Tobacco and health. Global b
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Chapter 16 The future worldwide hea
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RICHARD PETO AND ALAN D LOPEZ 283 a
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UK male death rate at ages 35-69 ha
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Overview Chapter 17 Passive smoking
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evidence have proved to be effectiv
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JONATHAN M. SAMET 291 a thousand de
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Table 17.2 Occupational ETS exposur
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Table 17.3 Nicotine concentrations
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portable piezobalance to sample aer
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JONATHAN M. SAMET 299 Fetal effects
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JONATHAN M. SAMET 301 Investigation
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Table 17.4 Summary of pooled random
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JONATHAN M. SAMET 305 also reported
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and involuntary exposure to tobacco
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Glantz, S. A. and Parmley, W. W. (1
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JONATHAN M. SAMET 311 O’Connor, G
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JONATHAN M. SAMET 313 US Department
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Introduction Chapter 18 Adolescent
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JOHN P. PIERCE ET AL. 317 would be
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JOHN P. PIERCE ET AL. 319 Indeed, t
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JOHN P. PIERCE ET AL. 321 reached i
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subsequent consumption. Most studie
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Burns, D., Garfinkel, L., and Samet
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JOHN P. PIERCE ET AL. 327 US Depart
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The epidemic Chapter 19 Tobacco and
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AMANDA AMOS AND JUDITH MACKAY 331 w
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AMANDA AMOS AND JUDITH MACKAY 333 T
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AMANDA AMOS AND JUDITH MACKAY 335 w
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AMANDA AMOS AND JUDITH MACKAY 337 p
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AMANDA AMOS AND JUDITH MACKAY 339 T
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AMANDA AMOS AND JUDITH MACKAY 341 o
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AMANDA AMOS AND JUDITH MACKAY 343 M
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such as Jewel and Madonna, who woul
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AMANDA AMOS AND JUDITH MACKAY 347 t
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particularly in developing countrie
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AMANDA AMOS AND JUDITH MACKAY 351 L
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Part 6 Tobacco and cancer
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Chapter 20 Cancer of the prostate F
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Table 20.1 Summary of results of ca
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Andersson et al. 1996 Sweden 256 ca
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Table 20.2 Summary of results of co
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cancer in younger or elderly men, w
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FABIO LEVI AND CARLO LA VECCHIA 365
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Summary Chapter 21 Laryngeal cancer
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12-year follow-up of the American C
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Hedberg et al. USA, 235, 81% P, 547
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cigarettes as compared to blond-tob
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of 3.78 and 11.47. An interpretatio
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Effect on survival In two studies f
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Cattaruzza, M. S., Maisonneuve, P.,
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USDHEW (1964). Laryngeal cancer. In
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Chapter 22 Smoking and cancer of th
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Table 22.1 Results from selected ca
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Asia Gao et al. 1994— Population
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EVA NEGRI 389 Ille-et-Vilaine, Fran
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Odds Ratio 2.5 2 1.5 1 0.5 0 0.30 2
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Garidou et al. 1996— Hospital ≤
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De Stefani, E., Barrios, E., and Fi
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Wynder, E. L. and Bross, I. J. (196
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Introduction Chapter 23 Tobacco use
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Table 23.1 Tobacco use and risk of
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Franceschi et al. Oral cavity, Oral
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Muscat et al. Oral cavity OR = 2.1
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Population-based case-control studi
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Lewin et al. Oral cavity, RR = 6.5
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TONGZHANG ZHENG ET AL. 411 the cont
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TONGZHANG ZHENG ET AL. 413 For smok
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TONGZHANG ZHENG ET AL. 415 per day
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TONGZHANG ZHENG ET AL. 417 than tha
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TONGZHANG ZHENG ET AL. 419 For exam
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TONGZHANG ZHENG ET AL. 421 decline
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Studies in India: Oral cancer is th
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carcinoma compared with other combi
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studies have demonstrated a positiv
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TONGZHANG ZHENG ET AL. 429 Garrote,
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TONGZHANG ZHENG ET AL. 431 Notani,
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Chapter 24 Smoking and stomach canc
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DAVID ZARIDZE 435 such as sex, age,
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DAVID ZARIDZE 437 (Kato et al. 1990
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DAVID ZARIDZE 439 respectively. The
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Gajalakshmi, C. K. and Shanta, V. (
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Pisani, P., Parkin, D. M., Bray, F.
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Introduction Chapter 25 Cigarette s
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attenuated in every study after con
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EDWARD GIOVANNUCCI 449 with a gener
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(Baron et al. 1994) of 352 colon ca
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(U.S. Dept. of Health Education and
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References EDWARD GIOVANNUCCI 455 A
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EDWARD GIOVANNUCCI 457 Kono, S., Ik
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Chapter 26 Smoking and cervical neo
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Tokuhata 1967* Williams 1977* Wigle
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Clarke 1985* Hellberg 1986* La Vecc
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ANNE SZAREWSKI AND JACK CUZICK 465
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case-control study nested in a scre
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five-fold risk of cervical cancer f
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(typically around two-fold), but be
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Introduction Chapter 27 Tobacco and
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Cigar, pipe, and chewing tobacco Wh
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Conclusion Overall, tobacco smoking
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Summary Chapter 28 Smoking and lung
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GRAHAM G. GILES AND PETER BOYLE 487
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quit for 20 years or more (Rogot an
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cancer and others where there is st
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Peto, R. (1986) Influence of dose a
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Chapter 29 Tobacco smoking and canc
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He further noted that case-control
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coefficients from the data in Table
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DIMITRIOS TRICHOPOULOS AND ARETI LA
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Epidemiology Chapter 30 Smoking and
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CRYSTAL N. HOLICK AND HARVEY A. RIS
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and at least the enteric variety of
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Chapter 31 Endometrial cancer Paul
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Table 31.1 Epidemiological studies
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studies (Terry et al. 1999, 2002a),
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Newcomer Population 740/2372 40-79
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PAUL D. TERRY ET AL. 531 levels, an
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Relative body weight Obesity is an
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Key et al. 1991 147 pre- and postme
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lood levels among current smokers,
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Table 31.7 Studies of cigarette smo
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of the association between cigarett
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Jensen, J., Christiansen, C., and R
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PAUL D. TERRY ET AL. 545 Weiderpass
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Part 7 Tobacco and heart disease
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citations of some of the best-known
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KONRAD JAMROZIK 553 because the dat
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KONRAD JAMROZIK 555 Fig. 32.2 Trend
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Table 32.3 Case-control studies of
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Table 32.5 Cohort studies of active
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Table 32.6 Effect of exclusion of p
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eadily addressed by cohort studies
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Specificity The entries in Table 32
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Table 32.8 Application of Bradford
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KONRAD JAMROZIK 569 arterial CVD re
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elationship goes beyond statistical
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Garland, C., Barrett-Connor, E., Su
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National Health and Medical Researc
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Part 8 Tobacco and respiratory dise
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Introduction Chapter 33 Chronic obs
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Many of the constituents in both th
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DAVID M. BURNS rate of growth in lu
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Death rates from COPD in smokers an
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Fraction of Excess Risk 1.20 1.00 0
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DAVID M. BURNS Higgins, M. W., Enri
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Part 9 Tobacco and other diseases
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Introduction Chapter 34 Smoking and
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ALLAN HACKSHAW 595 several mechanis
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Table 34.4 Studies that reported re
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Table 34.5 Cohort studies that repo
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than non-smokers; they have about h
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Table 34.8 Cohort studies that repo
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esults from cohort studies. There i
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ALLAN HACKSHAW 607 (DiFranza and Le
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Table 34.12 Cohort studies that rep
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Caries and tooth loss Because perio
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Table 34.16 Summary of disorders in
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References ALLAN HACKSHAW 615 Allar
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Johnsen, R., Forde, O. H., Straume,
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Seddon, J. M., Willett, W. C., Spei
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Part 10 Genetics, nicotine addictio
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Chapter 35 Genes, nicotine addictio
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Cotinine (ng/ml) 750 500 250 OXCHEC
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MICHAEL MURPHY ET AL. 627 of those
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MICHAEL MURPHY ET AL. risk associat
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Table 35.2 (continued) Gene map Chr
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MICHAEL MURPHY ET AL. pre-clinical
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Steps to carcinogenesis Exposure to
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DNA repair As previously alluded to
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MICHAEL MURPHY ET AL. Lichtenstein,
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Part 11 Tobacco and alcohol
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Table 36.1 Comparison of alcohol an
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Although gene therapy has rarely be
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20+ TABAC 5.1 10-19 0-9 3.4 12.3 0-
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Heavy drinking is known to cause ga
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Treatment issues and co-dependence
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ALBERT B. LOWENFELS AND PATRICK MAI
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Part 12 Tobacco control: Successes
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Introduction Chapter 37 Global toba
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NIGEL GRAY (sometimes at state leve
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NIGEL GRAY The first attempt to red
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per litre of smoke. Reduction of th
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Borland, R., Cappiello, M. and Owen
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Chapter 38 Lessons in tobacco contr
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entangling relationships with negot
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successful country advocates deeply
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Thus, when the opportunity arose, t
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Chapter 39 A brief history of legis
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Committee, mentioned above, little
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4. Tobacco and its related processi
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RUTH ROEMER 683 advertising and adv
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or shows, and distribution of free
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RUTH ROEMER 687 threat to the peopl
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RUTH ROEMER 689 The case was settle
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Another study by Harvard researcher
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At the end of 2003, 83 countries ha
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Chapter 40 Roles of tobacco litigat
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NGOs obtained sanctions against tob
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RICHARD A. DAYNARD 699 In a 1980s c
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RICHARD A. DAYNARD 701 Fourth, the
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even impossible. Such a statute pre
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RICHARD A. DAYNARD 705 Daynard, R.
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Introduction Chapter 41 Impact of s
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in this chapter, is evidence that s
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RON BORLAND AND CLAIRE DAVEY 711 Wh
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RON BORLAND AND CLAIRE DAVEY 713 On
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RON BORLAND AND CLAIRE DAVEY 715 ro
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you are subject, but this does not
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RON BORLAND AND CLAIRE DAVEY 719 to
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RON BORLAND AND CLAIRE DAVEY 721 fo
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RON BORLAND AND CLAIRE DAVEY 723 (E
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RON BORLAND AND CLAIRE DAVEY 725 th
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advanced. Although in countries lik
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RON BORLAND AND CLAIRE DAVEY 729 Da
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RON BORLAND AND CLAIRE DAVEY 731 Pr
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Introduction Chapter 42 Effective i
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PRABHAT JHA ET AL. 735 India (Gupta
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Average price or tax per pack (US$)
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PRABHAT JHA ET AL. 739 Bans on adve
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PRABHAT JHA ET AL. 741 Table 42.2 T
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PRABHAT JHA ET AL. 743 antismugglin
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Farrelly, M. C., Pechacek, T. F., a
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PRABHAT JHA ET AL. 747 Raw, M., Mc
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Part 13 Treatment of dependence
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Introduction Chapter 43 Treatment o
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Nocturnal sleep-disturbing nicotine
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MICHAEL KUNZE AND E. GROMAN 755 tob
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Fifteen different products were ide
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In summary, tobacco dependence amon
Page 794 and 795:
medications for OTC sale in 1996, t
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MICHAEL KUNZE AND E. GROMAN 763 US
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Chapter 44 Regulation of the cigare
Page 800 and 801:
as these correlate quite well with
Page 802 and 803:
NIGEL GRAY 769 within three major g
Page 804 and 805:
of carcinogens and toxins in its wa
Page 806 and 807:
Index abdominal aortic aneurysm see
Page 808 and 809:
aromatic amines 58, 60, 98 DNA addu
Page 810 and 811:
central and eastern Europe (CEE) (C
Page 812 and 813:
coronary thrombosis 5 see also myoc
Page 814 and 815:
epinephrine 169 epoxide hydrolase g
Page 816 and 817:
health professionals advice on smok
Page 818 and 819:
laryngeal cancer (Continued) animal
Page 820 and 821:
Morris, Philip 207 see also Philip
Page 822 and 823:
nursing home residents 718 nutritio
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Polish Central Statistical Office (
Page 826 and 827:
smoke, tobacco (including cigarette
Page 828 and 829:
Sweden female smoking rates 330-1 l
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United Nations agencies 680-1 Unite
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Tobacco and Public Health - TCSC Indonesia

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