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- Title
5. Biomarkers of exposure, effect and susceptibility for assessing electronic nicotine delivery devices and heated tobacco products, and their possible prioritization.
- Authors
Stepanov, Irina; Hecht, Stephen S.
- Abstract
Biomarkers have been used extensively in studies of cigarettes and other conventional tobacco products, providing valuable data on harmful exposures, biological effects, and the disease susceptibility of users and non-users exposed to second-hand smoke. This report provides an evaluation of the published literature on use of such biomarkers in studies of electronic nicotine delivery systems (ENDS) and heated tobacco products (HTPs) and an assessment of the potential utility and limitations of biomarkers in tobacco control. The reviewed evidence indicates that switching from smoking conventional cigarettes to exclusive ENDS use is associated with reductions in biomarkers of exposure to several toxicants and carcinogens that play key roles in smoking-induced diseases. The levels of many such biomarkers are, however, higher in dual users (people who continue to use cigarettes and ENDS at the same time), which is much more common than switching completely. In addition, the health effects of the changes in exposure are not yet well understood, and biomarkers of biological effects suggest that ENDS pose certain risks to users – particularly dual users and when compared with non-use of any tobacco or nicotine product. The review of the published literature underscores the lack of independent, non-industry research on exposure and effects resulting from HTP use. The report proposes a panel of priority biomarkers for tobacco control, identifies relevant research gaps, notes the need for industry-independent research, and recommends regulatory priorities.
- Publication
WHO Technical Report Series, 2023, Issue 1047, p87
- ISSN
0512-3054
- Publication type
Article