CEBP：雪茄或可促使吸烟者致癌

  一项发表于杂志Cancer Epidemiology，Biomarkers & Prevention上的研究报告中，来自美国FDA的流行病学家表示，相比吸烟者来讲，在吸雪茄者机体中许多毒性物质往往处于较高水平，而这些毒性物质中至少就有一种是潜在的致癌剂，因此吸雪茄或许比吸烟对人类机体的危害更大。

  本文研究揭示，相比非烟草消耗者而言，当前许多吸雪茄者机体中存在较高浓度的烟草生物标志物，而对于之前有吸烟历史的吸雪茄个体，其机体烟草生物标识物水平或更高，本文研究就与前期研究结果一直，前期研究中研究者发现抽烟个体或更易坠入吸雪茄个体的行列。

      研究者Jiping Chen表示，吸雪茄个体往往会使其暴露于多种有害物质中，而且有很多都是潜在的致癌因子。据美国CDC数据显示，从2000年至2011年雪茄的消耗两在美国至少翻了一番以上。研究者对文章中参与调查的25522名个体进行调查研究，分析了这些参与者机体中5种烟草暴露的生物标记物的情况，其中两种为烟草中特有的可替宁和亚硝胺4-(甲基亚硝胺)-1-(3-吡啶)-1-丁酮（NNAL），另外三种标志物为铅、镉和砷，这三种并不是烟草特有的，其来源于环境中。

  研究者发现，吸雪茄者，不论是否处于吸烟状态，其机体中的可替宁、NNAL、铅和镉的浓度要高于非吸烟者，而有吸烟历史的吸雪茄个体机体中的可替宁和NNAL水平明显高于没有吸烟经历的吸雪茄者；最终研究者表示，每日吸雪茄者机体中NNAL的浓度和每日吸烟者机体的NNAL水平是可比较的。

  因此，相比非吸烟人群，吸雪茄人群机体中往往具有较高水平的有害烟草组分，包括可替宁、NNAL及有毒金属；而NNAL作为一种强致癌剂或许应该引起各位吸烟者的注意。相关研究由美国FDA提供资助。（转化医学网360zhyx.com）

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Biomarkers of Exposure among U.S. Cigar Smokers: An Analysis of 1999–2012 National Health and Nutrition Examination Survey (NHANES) Data

Background: Cigar consumption is increasing in the United States, but little information is available about exposure to toxic constituents from cigar smoking.

Methods: We conducted a cross-sectional analysis of biomarkers of tobacco exposure among 25,522 participants from the National Health and Nutrition Examination Survey (NHANES, 1999–2012). The biomarkers analyzed were serum cotinine, urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), blood lead, blood cadmium, and urinary arsenic. We calculated geometric mean concentrations for each biomarker by tobacco use category and geometric mean ratios controlling for demographic factors.

Results: Cigar smokers had higher cotinine, NNAL, and lead concentrations than nontobacco users. The geometric mean concentration [95% confidence interval (CI)] of cotinine for primary cigar smokers (i.e., current cigar/never cigarette smokers) was 6.2 (4.2–9.2) ng/mL versus 0.045 (0.043–0.048) ng/mL for nontobacco users, and the NNAL concentration was 19.1 (10.6–34.3) pg/mg creatinine for primary cigar smokers versus 1.01 (0.95–1.07) pg/mg creatinine for nontobacco users. Secondary cigar smokers (i.e., current cigar/former cigarette smokers) and dual cigar/cigarette smokers had higher cadmium concentrations than nontobacco users. Cigar smoking was associated with significantly higher concentrations of cotinine, NNAL, cadmium, and lead, after adjusting for demographic factors. Secondary cigar smokers had significantly higher cotinine and NNAL concentrations than primary cigar smokers. The NNAL concentrations in daily cigar smokers were comparable with those in daily cigarette smokers.

Conclusions: Cigar smokers have higher concentrations of several toxic and carcinogenic substances than nontobacco users.