Study of cardiovascular disease biomarkers among tobacco consumers. Part 3: evaluation and comparison with the US National Health and Nutrition Examination Survey
Kristin M Marano, Steven J Kathman, Bobbette A Jones, Brian K Nordskog, Buddy G Brown, Michael F Borgerding, Kristin M Marano, Steven J Kathman, Bobbette A Jones, Brian K Nordskog, Buddy G Brown, Michael F Borgerding
Abstract
Cardiovascular disease (CVD) biomarkers of biological effect (BoBE), including hematologic biomarkers, serum lipid-related biomarkers, other serum BoBE, and one physiological biomarker, were evaluated in adult cigarette smokers (SMK), smokeless tobacco consumers (STC), and non-consumers of tobacco (NTC). Data from adult males and females in the US National Health and Nutrition Examination Survey and a single site, cross-sectional study of healthy US males were analyzed and compared. Within normal clinical reference ranges, statistically significant differences were observed consistently for fibrinogen, C-reactive protein (CRP), hematocrit, mean cell volume, mean cell hemoglobin, hemoglobin, white blood cells, monocytes, lymphocytes, and neutrophils in comparisons between SMK and NTC; for CRP, white blood cells, monocytes, and lymphocytes in comparisons between SMK and STC; and for folate in comparisons with STC and NTC. Results provide evidence for differences in CVD BoBE associated with the use of different tobacco products, and provide evidence of a risk continuum among tobacco products and support for the concept of tobacco harm reduction.
Keywords: BoBE; CVD; NHANES; cigarettes; smokeless tobacco.
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References
- Agaku IT, King BA, Husten CG, et al. Tobacco product use among adults—United States, 2012–2013. MMWR Morb Mortal Wkly Rep. 2014;63:542–7.
- Bolinder G, Norén A, de Faire U, Wahren J. Smokeless tobacco use and atherosclerosis: an ultrasonographic investigation of carotid intima media thickness in healthy middle-aged men. Atherosclerosis. 1997a;132:95–103.
- Bolinder G, Norén A, Wahren J, de Faire U. Long-term use of smokeless tobacco and physical performance in middle-aged men. Eur J Clin Invest. 1997b;27:427–33.
- Calapai G, Caputi AP, Mannucci C, et al. Cardiovascular biomarkers in groups of established smokers after a decade of smoking. Basic Clin Pharmacol Toxicol. 2009;104:322–8.
- Campbell LR, Brown BG, Jones BA. Study of cardiovascular disease biomarkers among tobacco consumers, Part 1: Biomarkers of exposure. Inhal Toxicol 2015
- Centers for Disease Control and Prevention (CDC) National Health and Nutrition Examination Survey Data. 2010a Available from: [Last accessed 3 Aug 2012]
- Centers for Disease Control and Prevention (CDC) National Health and Nutrition Examination Survey Questionnaire (or Examination Protocol, or Laboratory Protocol). 2010b. 2010b Available from: [Last accessed 3 Aug 2012]
- Chao A, Thun MJ, Henley SJ, et al. Cigarette smoking, use of other tobacco products and stomach cancer mortality in US adults: the Cancer Prevention Study II. Int J Cancer. 2002;101:380–9.
- Eliasson M, Lundblad D, Hägg E. Cardiovascular risk factors in young snuff-users and cigarette smokers. J Intern Med. 1991;230:17–22.
- Eliasson M, Asplund K, Evrin PE, Lundblad D. Relationship of cigarette smoking and snuff dipping to plasma fibrinogen, fibrinolytic variables and serum insulin. The Northern Sweden MONICA Study. Atherosclerosis. 1995;113:41–53.
- Ernster VL, Grady DG, Greene JC, et al. Smokeless tobacco use and health effects among baseball players. JAMA. 1990;264:218–24.
- Frost-Pineda K, Liang Q, Liu J, et al. Biomarkers of potential harm among adult smokers and nonsmokers in the total exposure study. Nicotine Tob Res. 2011;13:182–93.
- Giraud DW, Martin HD, Driskell JA. Plasma and dietary vitamin C and E levels of tobacco chewers, smokers, and nonusers. J Am Diet Assoc. 1995;95:798–800.
- Hatsukami DK, Kotlyar M, Allen S, et al. Effects of cigarette reduction on cardiovascular risk factors and subjective measures. Chest. 2005;128:2528–37.
- Hatsukami DK, Benowitz NL, Rennard SI, et al. Biomarkers to assess the utility of potential reduced exposure tobacco products. Nicotine Tob Res. 2006;8:600–22.
- Henley SJ, Thun MJ, Connell C, Calle EE. Two large prospective studies of mortality among men who use snuff or chewing tobacco (United States) Cancer Causes Contr. 2005;16:347–58.
- Mansoor MA, Hervig T, Stakkestad JA, et al. Serum folate is significantly correlated with plasma cysteine concentrations in healthy industry workers. Ann Nutr Metab. 2011;58:68–73.
- Mouhamed DH, Ezzaher A, Neffati F, et al. Effect of cigarette smoking on plasma homocysteine concentrations. Clin Chem Lab Med. 2011;49:479–83.
- Naufal ZS, Marano KM, Kathman SJ, Wilson CL. Differential exposure biomarker levels among cigarette smokers and smokeless tobacco consumers in the National Health and Nutrition Examination Survey 1999–2008. Biomarkers. 2011;16:222–35.
- National Cancer Institute (NCI) Health effects of exposure to environmental tobacco smoke. In: Smoking and tobacco control monograph no. 10. 1999 Available from: [Last accessed 3 Aug 2012]
- Norberg M, Stenlund H, Lindahl B, et al. Contribution of Swedish moist snuff to the metabolic syndrome: a wolf in sheep's clothing? Scand J Public Health. 2006;34:576–83.
- Nordskog BK, Brown BG, Marano KM. Study of cardiovascular disease biomarkers among tobacco consumers. Part 2: biomarkers of biological effect. Inhal Toxicol 2015
- Nutt DJ, Phillips LD, Balfour D, et al. Estimating the harms of nicotine-containing products using the MCDA approach. Eur Addict Res. 2014;20:218–25.
- Okumura K, Tsukamoto H. Folate in smokers. Clin Chim Acta. 2011;412:521–6.
- Piano MR, Benowitz NL, Fitzgerald GA, et al. Impact of smokeless tobacco products on cardiovascular disease: implications for policy, prevention, and treatment. A policy statement from the American Heart Association. Circulation. 2010;122:1520–44. American Heart Association Council on Cardiovascular Nursing.
- Siegel D, Benowitz N, Ernster VL, et al. Smokeless tobacco, cardiovascular risk factors, and nicotine and cotinine levels in professional baseball players. Am J Public Health. 1992;82:417–21.
- Silaste ML. Dietary effects on antioxidants, oxidised LDL and homocysteine. Dissertation Oulu University. 2003 Available from: [Last accessed 3 Aug 2012]
- Stratton K, Shetty P, Wallace R, Bondurant S. Clearing the smoke: the science base for tobacco harm reduction – executive summary. Tob Control. 2001;10:189–95.
- US Department of Health and Human Services (USDHHS) The health consequences of smoking: a report of the surgeon general. 2004 Available from: [Last accessed 3 Aug 2012]
- US Department of Health and Human Services (USDHHS)) How tobacco smoke causes disease: the biology and behavioral basis for smoking-attributable disease. 2010 Available from: [Last accessed 11 Nov 2014]
- Wallenfeldt K, Hulthe J, Bokemark L, et al. Carotid and femoral atherosclerosis, cardiovascular risk factors and C-reactive protein in relation to smokeless tobacco use or smoking in 58-year-old men. J Intern Med. 2001;250:492–501.
- Wennmalm A, Benthin G, Granström EF, et al. Relation between tobacco consumption and urinary excretion of thromboxane A2 and prostacyclin metabolites in 756 randomly sampled young men. In: Sameulsson B, Paoletti R, editors. Advances in prostaglandin, thromboxane, and leukotriene research. Vol. 21. New York: Raven Press Ltd; 1990. p. 615.
- Zeller M, Hatsukami D. The strategic dialogue on tobacco harm reduction: a vision and blueprint for action in the US. Tob Control. 2009;18:324–32. Strategic Dialogue on Tobacco Harm Reduction Group.
Source: PubMed