Assessment of Mouth-Level Exposure to Tobacco Constituents in U.S. Snus Consumers

This is the authors' abstract. We don't add key points for this paper.

INTRODUCTION: When assessing the health risks associated with different tobacco product categories (e.g., combustible and noncombustible), it is important to understand exposure. Snus, a smokeless tobacco product with lower levels of most tobacco-related toxicants than cigarette smoke, has been recently introduced in the United States. The objective of this study was to evaluate the mouth-level exposure (MLE) to selected tobacco constituents from snus by adult consumers of Camel SNUS (CSNUS). METHODS: For 7 days, 53 adult CSNUS consumers used their usual brand styles ad libitum, collecting their snus pouches after use. The collected pouches and unused product were analyzed for nicotine, N'-nitrosonornicotine (NNN), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), N'-nitrosoanabasine (NAB), N'-nitrosoanatabine (NAT), benzo[a]pyrene (B[a]P), arsenic, cadmium, chromium, lead, and nickel. MLE was estimated using the difference between the constituent amounts in the used and unused snus products. RESULTS: CSNUS consumption averaged 3.3 pouches/day or approximately 1.98 g/day. Mean nicotine MLE was 2.8 mg/pouch or 9.4 mg/day. Mean MLE to total tobacco-specific nitrosamines (TSNAs: NNK, NNN, NAB, and NAT) was 171.5 ng/pouch or 527.7 ng/day. B[a]P MLE averaged 0.2 ng/pouch or 0.68 ng/day. CONCLUSIONS: This study is the first to report snus MLE under normal conditions of use in a group of adult, U.S. snus consumers. On average, approximately 60%-90% of the amounts of nicotine, TSNAs, and B[a]P initially present in a snus pouch remained in the pouch after use by snus consumers in this study. The results from this study provide a preliminary assessment of exposure to constituents present in snus, which is potentially useful in risk assessment.