ArticleCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2025
Biomarkers of Exposure to Nicotine and Selected Toxicants in Individuals Who Use Alternative Tobacco Products Sold in Japan and Canada from 2018 to 2019.
Article in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
5 citing papers in PubMed.
- The effect of nicotine delivery system on blood protease levels: a randomized crossover study.Scientific reports · 2025Trial
- Recent Trends in Cigarette and HTP Use in Japan: A Scoping Review.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026Article
- Smoking as a persistent global health challenge: perspectives on heated tobacco products.Frontiers in public health · 2026Review
- Dual use of combustible and heated tobacco products associates persistent symptoms with a history of COVID-19: a JASTIS 2023 cross‑sectional study.Scientific reports · 2025Article
- Electronic Nicotine Delivery Systems (ENDS): Implications for the Clinician.Pulmonary therapy · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundComparisons of nicotine and toxicant exposures between people who use different alternative tobacco products remain underexplored.
methodsThis cross-sectional, multicountry study analyzed urinary metabolites of nicotine, tobacco-specific nitrosamines [4-methylnitrosamino-1-3-pyridyl-1-butanone (NNK)], and volatile organic compounds (acrolein, acrylamide, and acrylonitrile) among established users (n = 550) in Japan and Canada. Participants exclusively or concurrently used nicotine vaping products (NVP; Canada only), heated tobacco products (HTP; Japan only), and combustible cigarettes (CC; Japan and Canada) or abstained (Japan and Canada).
resultsAll product groups showed substantial nicotine exposure. Both HTPs and NVPs exposed exclusive users to lower toxicant levels than exclusive CC use. Canadian participants who exclusively used NVPs exhibited lower NNK and acrolein exposure but higher acrylamide exposure than Japanese participants who exclusively used HTPs. Concurrent use of CCs alongside alternative products exposed users to higher toxicant levels compared with exclusive use of either alternative product.
conclusionsExclusive use of alternative tobacco products results in significant nicotine exposure but substantially lower toxicant exposure compared with exclusive CC use. People who use HTPs in Japan may experience higher exposure to nicotine and certain toxicants (NNK and acrolein) than people who use NVPs in Canada. Concurrent use results suggest that partially substituting CCs with alternative products may reduce toxicant exposure but to a lesser extent than completely transitioning to alternative products. IMPACT: Exposure patterns between two popular alternative tobacco products differ. The overall toxicant exposure from these products is lower than from CCs, providing critical data for regulatory decisions and public health considerations.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.