Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026
Biomarkers of Exposure to Tobacco-Related Toxicants and Oxidative Stress Among Cancer Survivors.
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Dai Hongying Daisy, Hao Yi, Periera Mona, Michaud Tzeyu
Аннотация
INTRODUCTION: Cancer survivors who continue to use tobacco products may have negative impacts on their long-term health outcomes.
AIMS AND METHODS: Data were drawn from the Population Assessment of Tobacco and Health Study Wave 5 (n = 6946). Geometric mean concentrations of biomarkers from four classes of harmful and potentially harmful constituents, along with a biomarker of oxidative stress, were compared between cancer survivors and non-cancer adults using weighted linear regressions adjusted for demographic factors. Among cancer survivors, comparisons were also made across current cigarette smoking and e-cigarette use statuses.
RESULTS: Compared to non-cancer adults (n = 6441), cancer survivors (n = 505) exhibited higher mean concentrations of 4-(methylnitrosoamino)-1-(3-pyridyl)-1-butanol (NNAL, 10.9 vs. 6.7 pg/mg creatinine), cadmium (0.3 vs. 0.2 ng/mg creatinine), lead (0.4 vs. 0.3 ng/mg creatinine), n-Acetyl-s-(2-carboxyethyl)-l-cysteine (CEMA, 156.6 vs. 128.3 ng/mg creatinine), and 8-isoprostane (521.6 vs. 441.5 pg/mg creatinine) in the unadjusted analyses. Among cancer survivors, both exclusive cigarette smokers and dual users had higher mean concentrations of urine nicotine metabolites (ie, nicotine equivalents [TNE2], and cotinine), NNAL, cadmium, volatile organic compounds, and 8-isoprostane than non-tobacco users. Exclusive e-cigarette users also had higher mean concentrations of nicotine metabolites (TNE2, 4.1 vs. 0.01, p < .0001; cotinine, 288.1 vs. 0.4, p < .0001), NNAL (5.6 vs. 1.7, p = .03), cadmium (0.4 vs. 0.3, p = .01), and 8-isoprostane (594.2 vs. 482.5, p = .03) than non-tobacco users.
CONCLUSIONS: Both exclusive smoking and dual-use pose elevated risks of exposure to tobacco-related toxicants to cancer survivors. Exclusive e-cigarette use also increases the risk of nicotine addiction and oxidative stress. Abstinence from all tobacco use among cancer survivors is needed to improve health outcomes.
IMPLICATIONS: Cancer survivors represent a high-risk group for tobacco use. This study offers important insights into differences in biomarkers of tobacco-related toxicant exposure between cancer survivors and non-cancer adults and provides evidence of the health impacts associated with cigarette smoking and e-cigarette use. The findings emphasize the need for clinical monitoring and targeted public health interventions to encourage tobacco cessation, including addressing dual-use of cigarettes and e-cigarettes, in order to enhance long-term health outcomes and quality of life for cancer survivors.
AIMS AND METHODS: Data were drawn from the Population Assessment of Tobacco and Health Study Wave 5 (n = 6946). Geometric mean concentrations of biomarkers from four classes of harmful and potentially harmful constituents, along with a biomarker of oxidative stress, were compared between cancer survivors and non-cancer adults using weighted linear regressions adjusted for demographic factors. Among cancer survivors, comparisons were also made across current cigarette smoking and e-cigarette use statuses.
RESULTS: Compared to non-cancer adults (n = 6441), cancer survivors (n = 505) exhibited higher mean concentrations of 4-(methylnitrosoamino)-1-(3-pyridyl)-1-butanol (NNAL, 10.9 vs. 6.7 pg/mg creatinine), cadmium (0.3 vs. 0.2 ng/mg creatinine), lead (0.4 vs. 0.3 ng/mg creatinine), n-Acetyl-s-(2-carboxyethyl)-l-cysteine (CEMA, 156.6 vs. 128.3 ng/mg creatinine), and 8-isoprostane (521.6 vs. 441.5 pg/mg creatinine) in the unadjusted analyses. Among cancer survivors, both exclusive cigarette smokers and dual users had higher mean concentrations of urine nicotine metabolites (ie, nicotine equivalents [TNE2], and cotinine), NNAL, cadmium, volatile organic compounds, and 8-isoprostane than non-tobacco users. Exclusive e-cigarette users also had higher mean concentrations of nicotine metabolites (TNE2, 4.1 vs. 0.01, p < .0001; cotinine, 288.1 vs. 0.4, p < .0001), NNAL (5.6 vs. 1.7, p = .03), cadmium (0.4 vs. 0.3, p = .01), and 8-isoprostane (594.2 vs. 482.5, p = .03) than non-tobacco users.
CONCLUSIONS: Both exclusive smoking and dual-use pose elevated risks of exposure to tobacco-related toxicants to cancer survivors. Exclusive e-cigarette use also increases the risk of nicotine addiction and oxidative stress. Abstinence from all tobacco use among cancer survivors is needed to improve health outcomes.
IMPLICATIONS: Cancer survivors represent a high-risk group for tobacco use. This study offers important insights into differences in biomarkers of tobacco-related toxicant exposure between cancer survivors and non-cancer adults and provides evidence of the health impacts associated with cigarette smoking and e-cigarette use. The findings emphasize the need for clinical monitoring and targeted public health interventions to encourage tobacco cessation, including addressing dual-use of cigarettes and e-cigarettes, in order to enhance long-term health outcomes and quality of life for cancer survivors.