Evidence map›Paper›PMID 41848048›Full record

ArticleNicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco2026

Stable isotope labeling reveals that sugars are direct precursors to several toxicants and flavorings in cigarette smoke.

Wouter F Visser, Walther N M Klerx, Hans W J M Cremers, Daan G W Lensen, Liesbeth Dings, Roelina Hoving, Wilbert J de Ruijter, Karin Boer, Naömi Weibolt, Max J van Alphen and 2 more

Abstract read
In one paragraph

Article in Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Wouter F VisserCentre for Health Protection, National Institute for Public Health and the Environment, Postbus 1, 3720 BA, Bilthoven, The Netherlands.ORCID 0000-0003-1129-262X
Walther N M KlerxCentre for Health Protection, National Institute for Public Health and the Environment, Postbus 1, 3720 BA, Bilthoven, The Netherlands.
Hans W J M CremersCentre for Health Protection, National Institute for Public Health and the Environment, Postbus 1, 3720 BA, Bilthoven, The Netherlands.
Daan G W LensenCentre for Health Protection, National Institute for Public Health and the Environment, Postbus 1, 3720 BA, Bilthoven, The Netherlands.
Liesbeth DingsCentre for Health Protection, National Institute for Public Health and the Environment, Postbus 1, 3720 BA, Bilthoven, The Netherlands.
Roelina HovingCentre for Health Protection, National Institute for Public Health and the Environment, Postbus 1, 3720 BA, Bilthoven, The Netherlands.
Wilbert J de RuijterCentre for Health Protection, National Institute for Public Health and the Environment, Postbus 1, 3720 BA, Bilthoven, The Netherlands.
Karin BoerCentre for Health Protection, National Institute for Public Health and the Environment, Postbus 1, 3720 BA, Bilthoven, The Netherlands.
Naömi WeiboltCentre for Health Protection, National Institute for Public Health and the Environment, Postbus 1, 3720 BA, Bilthoven, The Netherlands.
Max J van AlphenCentre for Health Protection, National Institute for Public Health and the Environment, Postbus 1, 3720 BA, Bilthoven, The Netherlands.
Irina StepanovDivision of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN 55455, United States.ORCID 0000-0001-5140-8944
Reinskje TalhoutCentre for Health Protection, National Institute for Public Health and the Environment, Postbus 1, 3720 BA, Bilthoven, The Netherlands.ORCID 0000-0002-5310-9064

Funding

Impact of sugars on tobacco product toxicity and abuse liabilityR01DA051005 · NIDA · UNIVERSITY OF MINNESOTA · PI HATSUKAMI, DOROTHY K, STEPANOV, IRINA · 2020 to 2022
$1.3M
National Institute on Drug Abuse (NIDA) of the National Institutes of Health (NIH) P008078601National Institute on Drug Abuse (NIDA) of the National Institutes of Health (NIH) R01DA051005NIDA NIH HHS R01 DA051005
6 · The paper itself

Abstract

introductionsugars, added or naturally present in cigarette tobacco, have been reported to contribute to the harmful properties of cigarettes by enhancing smoke palatability, appeal, and potentially toxicity and addictiveness. In this study, 13C sugars were used to better understand the specific impact of added sugars on smoke composition.

methods[13C]-isotope-labeled sugars were added to cigarettes. Different concentrations, sugars (fructose, glucose, sucrose, and a mixture) were tested with 8 cigarette brands, with different design characteristics such as length, filter ventilation, and sugar content. Cigarettes were machine-smoked (using International Organization for Standardization and World Health Organization Intense regimes), and the resulting samples were subjected to untargeted and targeted analyses (for volatile organic compounds, polycyclic aromatic hydrocarbons (PAHs), aldehydes, tobacco-specific nitrosamines, and nicotine).

resultsThe presence of 13C in 5 furans, pyranone, and 1 compound of unknown chemical identity showed that additional amounts of these compounds were directly formed from the decomposition of sugars. Up to 58% of 5-hydroxymethylfuran originated from 13C sugars. Moreover, sugars were direct precursors of 4 out of the 5 aldehydes tested, although the 13C-labeled fraction of aldehydes was much smaller (up to 2%). No evidence for the direct formation of PAHs was found, but the addition of sugars was nevertheless found to impact the levels of unlabeled PAHs, TSNAs, and nicotine, presumably by altering the burning process of the experimental cigarettes.

conclusionsAdded sugars to cigarette tobacco contribute to the formation of harmful and flavored components in smoke, including furans and aldehydes. IMPLICATIONS: Based on our findings on sugars as precursors of harmful and flavored compounds, we propose to ban the addition of sugars to cigarettes and other combustible tobacco products. Imposing maximum allowable levels on sugars that are naturally present in tobacco could also be considered, as they also lead to harmful compounds and impart a flavor.This study adds to the body of evidence that sugars present in cigarette tobacco are precursors of harmful and flavored constituents of cigarette smoke. Regulation of sugars, such as banning added sugars and setting limits on natural sugars, may serve to protect public health.

Indexed as

Flavoring AgentsSmokeSugarsTobacco ProductsCarbon IsotopesIsotope LabelingCarbon IsotopesFlavoring AgentsSmokeSugarscomposition of mainstream smokeisotope labelingprecursorssugarstobacco

Identifiers

PMID41848048
PMCPMC13389535

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.