Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction (2001)
Chapter: Index
Index
A
Abortion,
see Spontaneous abortions
Accidents
automobile, 42–44 (passim), 46, 50, 56
Acetylcholine (Ach), 161, 244–245, 252, 254, 266, 269, 347, 568
Action on Smoking and Health, 126
Activated charcoal filters,
see Charcoal filters
Added ingredients,
see Additives
Addiction, vii, 1, 5, 25, 28, 29, 35, 40, 41, 161, 162, 201, 601
see also Alcohol and drug abuse;
Relapse
adolescents, 261
advertising and, 66
African Americans, 407
dose-response relationship, 255–256, 264, 266
FDA attempt to regulate tobacco, 126, 127, 129, 258, 604
genetic predisposition to, 161, 256, 347–348
nicotine pharmacology, 161, 243, 244, 245, 248, 254–260 (passim), 263–267 (passim)
psychological and behavioral aspects, 41, 118, 161, 254, 256–257, 259
risk perception, 68
Surgeon General’s report, 24, 600
drug treatments, 96, 101, 104–114 (passim), 123
nicotine pharmacology, 161, 244, 245, 248, 254–260 (passim), 263–267 (passim)
Additives, 82, 86, 90–91, 432, 571, 598, 601
blending processes, viii, 26, 82, 85, 87, 94, 128, 209, 287
menthol, 62, 64, 72, 73, 77, 86–87, 98, 183, 319, 406–407, 438, 439
PREP risk assessment, 144, 149, 165, 212
regulation, 128, 149, 209, 210, 212, 224–225
smokeless tobacco, 299–300
Adolescents, 67, 235, 320–321, 602
see also Schools
addiction, 261
gender factors, 74, 172, 543, 545, 552
sexual behavior, 44–46, 50, 51
National Youth Tobacco Survey, 185–187
pregnancy, 44, 172, 543, 545, 552
prevalence of tobacco use, 1, 22, 38, 319
risk perception, 41, 68, 72, 73–74, 112, 185
sexual behavior, 44–46, 50, 51;
see also “pregnancy” supra
smokeless tobacco, 302
state laws banning sales to, 120, 125, 202, 604
Surgeon General’s reports, 24, 125, 598, 601
Youth Risk Behavior Survey, 93, 185–187, 261, 320–321
Adrenal hormones, 105, 107, 108, 109, 110, 244, 245, 252, 253, 480, 549
Adult Use of Tobacco Surveys (AUTS), 69, 76
Advertising, 7, 8, 26, 32, 72, 86
see also Labeling;
Marketing
antismoking, 125
children and adolescents, 24
cigarette-like products, 94
historical perspectives, 60–66, 72–73, 74, 76, 120, 125–126, 595, 597, 602, 603
regulation of, 7, 10, 120, 125–126, 127, 128, 141, 203, 206, 207, 208, 211, 216–221, 222, 229, 232, 595, 597, 602, 603
smokeless tobacco, 93
cigarette-like products, 93–94
nicotine inhalers, 97–98
birthweight, 548
mentholated cigarettes, 72, 73, 86, 406–407
nicotine metabolism, 250
Age factors
see also Adolescents;
Birthweight;
Children;
Reproductive and developmental effects
addiction, 261
body weight, 569
cancer, 389, 390, 405, 410–413, 420, 421, 424, 425
cardiovascular disease, 472, 473, 474–475, 482
chronic obstructive pulmonary (COPD), 503, 508, 509–511, 513, 515
dementia, 564
dose-response relationship, 164
environmental tobacco smoke (ETS), 424, 509–511
influenza and pneumonia, 526
initiation of smoking, 73–74, 185, 191, 319, 331, 381, 395, 405, 425, 508, 543, 601
nicotine metabolism, 250
ocular disease, 566
orthopedic disease, 565
PREPs, 76, 161, 164, 319, 321, 331
reproductive and developmental effects, 547
teenage pregnancy, 44, 172, 543, 545, 552
risk assessment, general, 67, 145, 186, 321
smokeless tobacco use, 93, 302
surveillance, 185, 186, 191, 192, 194, 321
Agency for Healthcare Research and Quality, 172
Air pollutants, 44, 54, 225, 296, 333, 390, 505, 508–509, 519
occupational toxins, 33, 140, 151, 164, 166, 180, 195, 298, 329, 332, 350, 375, 377, 390, 408, 419, 420, 431, 433, 508, 599
Alcohol and drug abuse
auto accidents, 42, 43, 44, 46, 50, 56
behavioral treatments, 118–119
dementia, 564
measures of, 255, 257–266 (passim)
methadone, 42, 48, 49–50, 51, 52, 55, 114
naltrexone, 108
National Household Survey on Drug Abuse, 50, 92–93, 185–187, 260, 261
psychological mechanisms, 41
surveillance, 195
synergistic effects, 342, 415–416, 418, 426, 428
Alzheimer’s disease, 254, 564–565
American Cancer Society
Cancer Prevention Study (CPS) I/II, 67, 75, 76, 167, 170, 400, 487, 512–513, 530, 531
American Indians, 22, 543, 603
American Legacy Foundation Survey, 320–321
Animal models, 12–13, 15, 17, 34, 141, 149, 175, 287, 291, 293
addiction, 258, 263–264, 265–266
cardiovascular disease, 149, 479, 486
cancer, 13, 293–295, 367, 374, 376, 383, 384–387, 422, 429, 432–433, 434, 435
cost of, 383
dose-response relationship, 16, 145, 163, 165
fetal lung development, 511
infectious diseases, 296–297
nicotine antibodies, 107–108
nicotine pharmacology, 244, 253, 258, 268
PREP risk assessment, 144, 145, 147, 148–149, 162, 163, 165, 208, 212–213, 303, 350, 351, 384–386
regulatory principles, 10, 208, 212–213, 215
reproductive and developmental effects, 550
transgenic animals, 298–299, 385, 391
Antagonists, 4, 106–108, 110, 116, 244
Antibodies, 107–108, 297, 330–331
lymphocytes, 156, 296–297, 314, 338, 346, 376, 399, 417, 436, 518, 519
see also Bupropion;
Zyban
nortriptyline, 4, 104, 106, 124
Aromatic amines, 148, 374, 377–378, 379, 420–421
Arthritis,
see Rheumatoid arthritis
Asbestos, 89, 298, 408, 501, 599
Asians/Pacific Islanders, 22, 250, 406, 407, 543, 603
Japanese, 88–89, 261, 286, 342, 409
Asthma, 170, 500–501, 518–525, 527, 530–531, 551
Atherosclerosis, 157, 162, 169, 253, 270, 296, 313, 332, 339, 343, 471, 472, 476–477, 479–483 (passim), 485, 490, 492, 493
Attitudes and beliefs, 54
see also Depression;
Risk perception
desire to cease smoking, 22, 71, 74–76, 78, 122, 186, 476, 512, 514, 515
negative opinion of tobacco use, 124–125, 187, 319
pregnant women, 187–188
public understanding of PREP content, 60
surveillance of, 8, 10, 185–188 (passim), 192, 196, 197
toward unsafe behavior, negative attitudes, 43
Automobile safety, vii
regulation, 41–44, 50, 52, 53, 56
AUTS,
see Adult Use of Tobacco Surveys
B
Behavioral effects of tobacco use, 3, 118, 389
see also Inhalation depth and intensity;
Smoking topography
addiction, 41, 118, 161, 254, 256–257, 259
childhood cognitive/behavioral disorders, 268, 550
cigarettes smoked per day, 22, 74, 88–89, 102, 113, 115, 119, 120, 151, 163, 164, 167, 170, 173, 300, 319, 343, 349, 375, 391, 392, 395, 396, 398–399, 401, 404, 412, 419, 437, 474, 487, 488, 489, 512, 513–514, 515, 516, 530
compensatory smoking, 2, 26, 67, 88, 121, 164, 219, 266, 285, 322, 380, 402, 403, 405, 477, 517
desire to cease smoking, 22, 71, 74–76, 78, 186, 476, 512, 514, 515
Behavioral Risk Factor Surveillance System, 185–187, 320–321, 543
Behavioral treatments, 116–119, 121, 532
drug treatment, general, and, 118–119
nicotine replacement products and, 96, 115
Beliefs,
see Attitudes and beliefs
Benzene, 89, 95, 148, 287, 290, 374, 379
Benzo[a]pyrene (BaP), 86, 87, 94, 148, 319, 373–374, 375–376, 380, 391–392, 407, 544
Biologically effective dose, 150, 160, 309–315 (passim), 326–333, 348, 350, 351, 353
cancer, 151, 166, 313, 327–330, 332–333, 380, 381, 388, 433, 435, 437
Biomarkers, 11–12, 13, 16, 121, 142, 144, 145, 149–150, 162–163, 240, 309–317, 323–366
see also Cotinine;
In vitro assays;
Plasma markers;
Serum markers;
Surrogate markers;
Urine biomarkers
biologically effective dose, 150, 151, 160, 166, 309–315 (passim), 326–333, 348, 350, 351, 353, 380, 381, 388, 433, 435, 437
biopsies, 311, 323, 341, 414, 417, 437, 518
bronchoalveolar lavage, 13, 156, 295, 338–339, 343–344, 437, 517
carbon monoxide as, 313, 323, 324–325, 330–331
carcinogenesis, general, 150–151, 153, 154, 163–167 (passim), 333, 380, 381, 388, 422, 424, 433, 435–436, 437
see also “mutagenesis” infra
DNA adducts, 153, 292, 293, 313, 314, 327–335 (passim), 341, 346, 348, 353, 368–370 (passim), 375–378 (passim), 385–390 (passim), 399, 405, 409, 417, 420–424 (passim), 429, 435, 492
surrogate markers, 166, 327, 330, 435–436
urine, 326, 353–354, 376, 378, 407, 420–421, 422, 424, 429, 435, 437
cardiovascular disease, 12, 154, 156, 168, 169, 253, 313, 332, 336–337, 339, 343, 354, 483–486, 490–491
surrogate markers, 168, 483–486, 490
chronic obstructive pulmonary disease (COPD), 170, 502
cohort studies, 352–353, 354, 438
cost of techniques, 153, 315, 318, 322
environmental tobacco smoke (ETS), 317, 323, 329, 348, 422, 436, 491
enzymatic processes, 314, 327, 334, 342, 345–346, 389
epidemiology and, 142, 160, 161, 309, 339, 438
exposure, 145, 150–161, 237, 309–317, 323–355, 396–397
internal exposure, 150, 151, 160, 163–164, 309, 323, 349, 350, 351, 388, 396, 431, 435, 437
half-life, 152, 154, 156, 157, 158, 250, 297, 316, 323, 324, 328, 333, 376, 422
internal exposure, 150, 151, 160, 163–164, 309, 323, 349, 350, 351–352, 388, 396, 431, 435, 437
lipids, 12, 154, 169, 243, 253, 314, 330–331, 336–337, 343, 378–379, 471, 479, 482, 485, 486, 491–492
leukotrines, 156, 344, 388, 519–520, 563
mutagenesis, 313, 314, 323, 326, 327, 334, 340–342, 345, 346–347, 353;
see also “carcinogenesis” supra
nicotine, 323, 324–325, 326, 347
see also Cotinine
plasma markers, 99, 113, 250, 293
nonneoplastic respiratory disease, 170–171, 501–503, 506, 507, 512, 517, 527, 531, 532
urine, 503, 506, 523, 524, 525, 529, 531
oropharyngeal disease, 156, 333, 342, 338–339
platelet activation, 12, 156, 157, 168, 169, 252, 253, 296, 337–339, 343, 354, 479, 480, 481, 483–486, 490, 491, 492, 493, 561
PREP risk assessment, 142, 144, 145, 150–161, 162–163, 165, 237, 309–317, 323–352, 388, 435–436, 553
regulatory issues, 10, 11–12, 207–208, 211, 220, 348–349
reproductive and developmental effects, 174, 191, 545, 548, 553, 570, 572
research recommendations, 352–355, 438, 491
saliva, 209, 267, 300, 311, 323, 325, 422, 428, 523, 525
standards, 348–349
surveillance, 182, 184–185, 190–191, 196
vascular activation, 12, 157, 169, 337, 490–491
Biopsies, 311, 323, 341, 414, 417, 437, 518
Birthweight, 11, 23, 24, 149, 172, 173–174, 188, 193, 212, 267, 340–341, 344, 529, 543, 547–549, 550, 551, 552, 554, 596
Black persons,
see African Americans
Black vs blond tobacco
bladder cancer, 419
hemoglobin adducts, 332
lung cancer, 401–402
oropharnygeal cancer, 416
Bladder cancer, 24, 333, 355, 368, 377–378, 380, 388, 390, 418–421, 428
Blending processes, viii, 26, 82, 85, 87, 94, 128, 209, 287
see also Black vs blond tobacco
Blond tobacco,
see Black vs blond tobacco
Blood pressure, 154, 336–337, 343, 479, 482, 491
hypertension, 252, 319, 477, 479, 481, 547, 548, 568
antihypertensive drugs, 4, 107, 108–109, 124
Body weight, 340–341, 343, 344, 422, 482, 565, 569–570
age factors, 569
birthweight, 11, 23, 24, 149, 172, 173–174, 188, 193, 212, 267, 340–341, 344, 529, 543, 547–549, 550, 551, 552, 554, 596
nicotine effects, 126, 158–159, 162, 255, 267, 270, 568–569
ventilation and, 286
Bone,
see Orthopedic effects
Bradford Hill criteria, 381, 382
British American Tobacco Company, 65
Bronchi, 24, 156, 500, 505, 514, 520, 522, 526, 551
bronchitis, 21, 295, 338, 502, 503, 505, 510, 525, 529, 551
cancer and carcinogenesis, 285, 298, 375, 376, 391, 392, 393, 437, 518
epithelium, 298, 375, 376, 393
Bronchoalveolar lavage, 13, 156, 295, 338–339, 343–344, 437, 517
Bronchoscopy, 157, 171, 339, 392, 502–503, 517, 531
Brown & Williamson, 21, 61, 92, 184, 204, 228, 584, 601
Bupropion, 4, 98, 104, 105–106, 115, 231, 233–234, 347
see also Zyban
FDA actions, 123–124, 172, 552–553
pregnant women, 172, 174, 552–553, 554
Buspirone, 109
C
Canada, 219
Cancer and carcinogens, 1, 4, 23, 147–148, 163–167, 174, 367–469
additives, 90–91
adenocarcinomas (AD), 392, 393, 404
African Americans, 406–407, 416
age factors, 389, 390, 405, 410–413, 420, 421, 424, 425
animal models, 13, 293–295, 367, 374, 376, 383, 384–387, 422, 429, 432–433, 434, 435
aromatic amines, 148, 374, 377–378, 379, 420–421
benzene, 89, 95, 148, 287, 290, 374, 379
benzo[a]pyrene (BaP), 86, 87, 94, 148, 319, 373–374, 375–376, 380, 391–392, 407, 544
biologically effective dose, 151, 166, 313, 327–330, 332–333, 380, 381, 388, 433, 435, 437
biomarkers, 150–151, 153, 154, 163–167 (passim), 333, 380, 381, 388, 422, 424, 433, 435–436, 437
adducts, 153, 292, 293, 313, 314, 327–335 (passim), 341, 346, 348, 353, 368–370 (passim), 375–378 (passim), 386–390 (passim), 399, 405, 409, 417, 420–424 (passim), 429, 435, 492
surrogate markers, 166, 327, 330, 435–436
urine, 326, 353–354, 376, 378, 407, 420–421, 422, 424, 429, 435, 437
biopsies, 311, 323, 341, 414, 417, 437, 518
bladder, 24, 333, 355, 368, 377–378, 380, 388, 390, 418–421, 428
bronchial, 285, 298, 375, 376, 391, 392, 393, 437, 518
cervical, 24
clinical research, 165, 383, 414, 433, 437
cohort studies, 377, 395, 396–397, 400–403, 405, 411–413, 420
colonic, 394
definition of carcinogen, 368
dietary factors, 164, 166, 375, 376, 390, 404, 406, 408, 409, 414, 431, 433
dose-response relationship, 163–165, 167, 334–340, 381, 395–397, 415, 416, 419, 421, 431;
see also “biologically effective dose” supra
environmental tobacco smoke, 53, 390, 396, 398, 408, 422–424, 434, 439, 604
enzymatic processes, 368, 369, 370, 376, 377, 389, 394, 433, 436
epidemiology, 165, 166, 367, 383, 418, 420, 424
epithelial cells, 375, 376, 393, 394, 416, 420–421
esophagus, 1, 23, 24, 232, 372, 377, 425, 429, 597
exposure, 383–384, 390, 395–397, 398–399, 401, 404, 412, 419, 420, 437;
see also “dose-response relationship” supra
filtered cigarettes, 91, 164, 332, 399–400, 402–404, 405, 416, 419–420, 431
gender factors, 389, 416, 418, 419, 421, 424, 426, 436
lung, 24, 401, 402–403, 404–406, 410, 411, 412, 413, 598, 599
head and neck, 195, 301, 372, 427, 428
historical perspectives, 21–26 (passim), 367, 594, 595, 597, 598, 600, 604;
see also Surgeon General
incidence, 367, 384, 392, 410, 411, 415, 418
inhalation depth and retention, 390, 392, 395, 420, 426
international perspectives, 88–89, 407–408, 418, 423, 424, 425
in vitro assays, 154, 165, 367, 376, 383–384, 385, 391–392, 432
large-cell carcinomas, 392, 393
liver, 376, 377, 378, 385, 386, 420, 430
low-yield products, general, 399–404
lung, viii, 21, 23, 24, 66, 67, 86, 88–89, 149, 166–167, 192, 193, 215, 293–295, 296–297, 302, 333, 342, 355, 368, 372, 385, 386, 388, 390, 391–415, 423, 425, 426, 431, 598
cohort studies, 395, 396–397, 400–403, 405, 411–413
metastasis, 297, 395, 418, 501
mortality, 392, 398, 400, 411–414, 415, 418, 419, 426, 434
nicotine as carcinogen, 167, 402, 403, 405
nitrosamines, 4, 67, 86, 87, 91–92, 93, 148, 151, 210, 215, 294, 300, 301, 319, 326–327, 328, 348, 373–374, 376–377, 379, 380, 403, 405, 429–430, 603, 604
environmental tobacco smoke, 424
racial/ethnic differences, 406, 407
smokeless tobacco, 4, 93, 428, 429
oncogenes, 294, 341–342, 371, 389, 391, 393
oropharyngeal, 23, 167, 301, 333, 342, 368, 372, 415–418, 425, 427–429, 597
pancreatic, 372
polycyclic aromatic hydrocarbons (PAHs), 86, 148, 149, 295, 322, 326–327, 328–331, 333, 348, 374, 375–376, 377, 379, 391–392, 418, 570
PREP risk assessment, 3, 150–151, 153, 154, 163–167, 208, 218, 222, 373, 374–375, 379–392, 421, 430–439
in vitro assays, 154, 167, 367, 383–384, 385
low-yield products, general, 399–404
lung cancer, 294–295, 395–399, 407–409
see also “biomarkers” supra
processing of tobacco, 85
race/ethnicity, 406–408, 416, 436
regulatory issues, 10, 208, 215
research methodology, 378, 379–394, 410, 434–439
research recommendations, 434–439
small-cell lung carcinomas (SCLC), 392, 393–394, 395, 402, 404
smokeless tobacco, 4, 93, 300–301, 426–429
socioeconomic factors, 407, 414;
see also “race/ethnicity” supra
squamous cell carcinomas (SCC), 67, 299, 301, 372, 392, 393, 404, 415, 418
surrogate markers, 166, 327, 330, 435–436
tumor suppressor genes (including p53), 155, 336, 341–342, 343, 371–372, 375, 376, 391–392, 393–394, 405, 409, 415, 417, 418–419, 420, 421, 428–429, 435
urine biomarkers, 326, 353–354, 376, 378, 407, 420–421, 422, 424, 429, 435, 437
volatile organic compounds, 89, 148, 374
Cancer Prevention Study (CPS) I/II, 67, 75, 76, 167, 170, 400, 487, 512–513, 530, 531
Carbon monoxide, 2, 24, 26, 86, 288, 517, 570, 597
see also Potential reduced-exposure products (PREPs)
behavioral treatments and reduction of, 117
as biomarker, 313, 323, 324–325, 330–331
cardiovascular disease, 168, 481, 487
cigarette-like products, 94, 95
drug treatments and reduction of, 110, 113, 114
reproductive and developmental effects, 172, 173–174, 549, 550, 552, 554
smoker knowledge of, 72–73
surveillance, 184
yield assessments, 87, 88, 90, 92, 94, 95, 184, 210
Carcinogens,
see Cancer and carcinogens
Cardiovascular disease, 4, 24, 252–253, 302, 470–499
see also Blood pressure;
Extracardiac vascular disease
age factors, 472, 473, 474–475, 482
atherosclerosis, 157, 162, 169, 253, 270, 296, 313, 332, 339, 343, 471, 472, 476–477, 479–483 (passim), 485, 490, 492, 493
biomarkers, 12, 154, 156, 168, 313, 332, 336–337, 339, 343, 354
cholesterol levels, 289, 296, 477, 482
platelet activation, 12, 156, 157, 168, 169, 252, 253, 296, 337–339, 343, 354, 479, 480, 481, 483–486, 490–491, 492, 493, 561
surrogate markers, 168, 483–486, 490
carbon monoxide, 168, 481, 487
cholesterol levels, 289, 296, 477, 482
clinical research, 168, 169–170, 212, 491
coronary heart disease, viii, 1, 21, 23, 67, 157, 195, 208, 212, 222, 252–253, 347, 470, 471–481, 483, 487, 488, 505, 599
dose-response relationship, 167–168, 169, 471, 472, 473, 477, 483, 486–487
endothelial function, 479, 480, 481, 484–485, 486, 490, 491, 492
environmental tobacco smoke (ETS), 169, 470, 478, 491
see also “dose-response relationship” supra
filtered cigarettes, 168
gender factors, 168, 472, 473, 477, 481, 482
genetic factors, 478, 490, 492
incidence, 167, 470, 471, 472, 473, 479, 487
inflammation, 168, 252, 253, 270, 291, 482–483, 485, 490, 491, 492
lipids and lipoproteins, 12, 154, 169, 253, 314, 330, 336–337, 343, 471, 479, 482, 485, 486, 491–492
mortality, 470, 472, 473, 477, 487
nicotine replacement therapy (NRT), 98–99, 112, 115, 252–253, 471
platelet activation, 12, 156, 157, 168, 169, 252, 253, 296, 337–339, 343, 354, 479, 480, 481, 483–486, 490–491, 492, 493, 561
pregnant smokers, children of, 545, 548, 552
regulatory issues, 10, 208, 212
research recommendations, 491–493
risk assessment, 149, 154, 162, 167–170, 174, 208, 212, 222, 470–499, 598, 599
risk perception, 68
stroke, 24, 168, 470, 473, 476, 487, 489, 600
surrogate markers, 168, 483–486, 490
synergistic effects of toxins, 477–478
thrombosis, 154, 157, 336–337, 339, 356, 481, 485–486, 491
vascular activation, 12, 157, 169, 337, 490–491, 493
Caucasians, 73, 86, 250, 406, 407, 416, 513, 543, 548
Cell cultures,
see In vitro assay
Centers for Disease Control and Prevention (CDC), 207, 221
smokeless tobacco, 93
surveillance, general, 180, 184, 185
Youth Risk Behavior Survey, 93, 185–187, 261, 320–321
Cerebrovascular disease,
see Stroke
Cessation programs, vii, x, 24, 41, 116–119, 352
see also Behavioral treatments;
Chewing gum;
Drug treatments Oral/nasal sprays;
Patches;
Psychotrophic drugs;
School-based prevention/cessation programs
Charcoal filters, 88, 89, 92, 94, 286, 287, 406, 603
Chewing gum, vii, 4, 5, 14, 91, 96, 98, 99, 101, 103, 113–114, 115, 129, 253, 266–267, 599
cardiovascular disease, 471
Chewing tobacco, 83, 84, 247–248, 426, 428
Children, 320–321
see also Adolescents;
Birthweight;
Reproductive and developmental disorders;
Schools
advertising, 24
asthma, 501, 518–525 (passim), 530, 551
cardiovascular disease, 482, 493
cognitive deficits, 268, 550–551
environmental tobacco smoke, 286, 348, 422, 500, 510–511, 521, 522–525, 528–530, 549;
see also Family/home factors
nonneoplastic respiratory diseases, 500, 501, 506, 508, 510–511, 518–526 (passim), 528–530, 551
prevalence of tobacco use, 1
respiratory infections, 501, 506, 526, 528–529, 551
sales of tobacco to, 120, 125, 202, 604
Cholesterol levels, 289, 296, 477, 482
Chromosomes, 152, 293, 313, 314, 333, 334–335, 340, 341, 342, 346, 368, 369, 372, 389, 391, 393, 406, 414–415, 417, 419, 420, 435, 545
see also Mutagenesis and mutagens
loss of heterozygosity, 152, 313, 314, 334, 340, 342, 391, 393, 414–415, 419, 435
Chronic obstructive pulmonary disease (COPD), 1, 21, 23, 149, 174, 302, 500, 503–518, 520, 527, 530–531, 532, 584, 598, 599
bronchitis, 21, 295, 338, 502, 503, 505, 510, 525, 529, 551
definition of, 503
epidemiology, 503–505, 509, 512
gender factors, 500, 509, 512, 514, 515, 516
mortality, 505, 508, 509, 512, 513–514
Surgeon General’s report, 24
synergistic effects of toxins, 508–509
Cigarette Labeling and Advertising Act, 125
Cigars, viii, 82, 83, 85, 243–244, 425–426, 473, 508, 597
Clinical research, 7, 13, 16, 17, 34, 115–116, 147, 175–176, 232, 238, 352, 584
see also Biomarkers
behavioral treatments, 116–118
body weight, 570
cancer, 165, 383, 414, 433, 437
cardiovascular disease, 168, 169–170, 212, 491
clonidine, 108–109
cytochrome P-450, 109–110
depression, 569
antidepressants, 105–106, 115–116
FDA drug approval criteria, 122, 215, 227
nicotine antagonists, 107
nicotine replacement products, 96, 101–103, 113–115, 533
nonneoplastic respiratory disease, 13, 171, 511–512, 514, 518, 522, 523–525, 529, 530, 532–533
regulatory issues, 122, 208, 209, 212, 213, 215, 227, 229
reproductive and developmental effects, 173–174, 547, 548, 554
subjects unwilling/unable to quit, 122
surveillance and, 183, 193, 197
tobacco industry product testing, 128
Coalition on Smoking and Health, 126
Cognitive effects
aging, 162
developmental disorders, 268, 550–551
nicotine, 254, 255, 259, 270, 564
Cohort studies, 174, 193, 196, 437–438, 482, 548, 567
chronic obstructive pulmonary disease (COPD), 511
diabetes, 567
lung cancer, 395, 396–397, 400–403, 405, 411–413
College of American Pathologists, 349
Colon
cancer, 394
inflammatory bowel disease, 174, 302, 560, 561–562, 574
Combustion, viii, 3, 4, 66, 210, 598
cigarette-like products, 93
fires and fire-safe cigarettes, 87, 571, 604
measurement, 284
nicotine pharmacology, 243
surveillance, 184
temperature factors, viii, 27, 210, 284
Compensatory smoking, 2, 26, 67, 88, 121, 164, 219, 266, 285, 322, 380, 402, 403, 405, 477, 517
Comprehensive Smokeless Tobacco Health Education Act, 125
Comprehensive Smoking Health Education Act, 125
Consumer Product Safety Act, 125
Contraceptives
devices, 45
Controlled Substances Act, 123, 125
COPD,
see Chronic obstructive pulmonary disease
Coronary heart disease, viii, 1, 21, 23, 67, 157, 195, 208, 212, 222, 252–253, 347, 470, 471–481, 483, 487, 488, 505, 599
Coronary vascular disease,
see Cardiovascular disease
Cost factors, monetary, 383
aggregating harm, 55
animal models, 383
auto accidents, 44
biomarkers, 153, 315, 318, 322
cigarettes, 119, 129, 187, 262
taxation, 119, 128, 202, 596, 603
drug treatments, 110
health insurance discounts, 598
in vitro studies, 149
nicotine replacement products, 101–102, 129, 554–555
Cotinine, 174, 184–185, 187, 293, 321, 323, 324, 325, 326, 348, 353
carcinogenesis, 407, 422, 424, 429
cardiovascular disease, 168, 487
nonneoplastic respiratory disease, 517, 523, 525, 526, 529, 530, 532
pharmacology of, 248, 249, 250, 265
Court cases,
see Litigation
Curing of tobacco, 8, 82, 83, 84, 91, 128, 189, 209, 299–300
Current Population Survey, 185–187
Cyanide, 72, 89, 291, 324–325, 401, 549, 561, 572
Cytochrome P-450, 109, 152, 248, 269, 298, 323, 327, 334, 342, 375, 377, 378, 385, 409, 417, 421, 570
D
Definitional issues, 27–28
see also Standards
biomarkers assessment, 150, 311
carcinogen, 368
chronic obstructive pulmonary (COPD), 503
cigar, 83
Diagnostic and Statistical Manual of Mental Disorders (DSM), 255, 257, 258–259, 260–262
hazard identification, 33–34
mutagen, 368
regulatory, 11, 27–28, 30, 124, 126, 205, 225–226
tobacco constituent, 368
Dementia, 174
Alzheimer’s disease, 254, 564–565
Demographic factors,
see Age factors;
Educational attainment;
Genderfactors;
Military personnel;
Race/ethnicity;
Socioeconomic status
Department of Justice, 603
Depression, 104, 174, 186, 256–257, 347, 568–569
antidepressants, 105–106, 115–116, 254, 256, 570
Dermatologic diseases, 158, 174, 193–194, 246, 301, 338–339, 385, 566
Developmental disorders,
see Reproductive and developmental disorders
Devices,
see Medical devices
Diagnostic and Statistical Manual of Mental Disorders (DSM), 255, 257, 258–259, 260–262
Dietary factors, 89, 151, 175, 206, 294, 296, 325, 329, 333, 508, 573
cancer, 164, 166, 375, 376, 390, 404, 406, 408, 409, 414, 431, 433
pregnancy, 547
DNA, 291–292, 294, 299, 313, 314–315, 342–343, 344–347, 353, 368–370, 372, 384, 385, 486, 492
adducts, 153, 292, 293, 313, 327–335 (passim), 341, 346, 348, 353, 368–370 (passim), 372, 375–378 (passim), 385–390 (passim), 398–399, 405, 409, 417, 420–424 (passim), 429, 435, 492
chromosomes, 152, 293, 313, 314, 333, 334–335, 340, 341, 342, 346, 368, 369, 372, 389, 391, 393, 406, 414–415, 417, 419, 420, 435, 545
loss of heterozygosity, 152, 313, 314, 334, 340, 342, 391, 393, 414–415, 419, 435
repair, 152, 315, 326, 332, 334, 342–347 (passim), 369–370, 372, 376, 377, 378, 388, 389, 390, 394, 399, 409 478
Dopamine, 105, 109, 110, 244, 245, 256, 257, 266, 347–348, 551, 568, 571, 572
Dose-response relationship, viii, ix, 9, 11, 14, 15, 16, 33, 34, 316, 326–333, 343
see also Biologically effective dose;
Exposure
age factors, 164
animal models, 16, 145, 163, 165
antidepressants, 105–106
cancer, 163–165, 167, 334–340, 381, 395–397, 415, 416, 419, 421, 431
cardiovascular disease, 167–168, 169, 471, 472, 473, 477, 483, 486–487
dermatologic conditions, 566
environmental tobacco smoke (ETS), 423–424, 436
exposure-to-adverse effect, ix, 140, 145, 166, 511, 530
gender factors, 164
historical perspectives, 23
nicotine replacement doses per day, 255–256, 264, 266
nonneoplastic respiratory disease, 170, 171, 510–514, 521, 523, 527–528, 531, 532
ocular disease, 565
oropharyngeal disease, 415
Parkinson’s disease, 571–572
PREP risk assessment, 14, 15, 33, 34, 140, 141, 144–147, 152, 154, 156, 158, 159, 160, 167, 237–238, 271, 310, 312, 325, 326, 352, 381, 395–396
renal disease, 567–568
rheumatoid arthritis, 562
reproductive and developmental effects, 172–173, 544, 545, 546, 548, 550, 554–555
time factors, ix, 140, 141, 145, 511
Drug abuse,
see also Alcohol and drug abuse;
Addiction
Drug interactions, 122, 269, 570
Drug treatments, 2, 9, 17, 25, 29–30, 82, 95–116, 121
see also Chewing gum;
Medical devices;
Nicotine replacement therapy;
Oral/nasal sprays;
Psychotrophic drugs;
Patches
antagonists, 4, 106–108, 110, 116, 244
antidepressants, 4, 104, 106, 124;
see also Bupropion
antihypertensive drugs, 107, 108–109
behavioral therapy and, 96, 115, 118–119
carbon monoxide, reduction of, 110, 113, 114
cardiovascular disease and, 110, 113, 114
committee charge, 3–4, 31–32, 33, 34, 142, 202–203, 205
cost of, 110
Food and Drug Administration, 29–30, 205, 226–228
bupropion, 123–124, 172, 552–553
Investigational New Drug, 122, 215
historical perspectives, 95
mortality reduction, 111, 112–113
nicotine receptors, 97, 103, 105, 106–107, 110
over-the-counter drugs, 31, 94, 96, 97, 102, 110, 120, 123, 263
pregnant women, 116
relapse into smoking, 111
withdrawal, 96, 101, 104–114 (passim), 123
DSM,
see Diagnostic and Statistical Manual of Mental Disorders
Dye exclusion tests, 292
E
Eclampsia,
see Preeclampsia
Eclipse, 4, 65, 94–95, 129, 215, 517–518, 602
Economic factors,
see Cost and cost-benefit factors;
Funding;
Socioeconomic status;
Taxation
Education,
see Labeling;
Public education
Educational attainment, 390, 425, 530, 543, 547, 564
Emphysema,
see Chronic obstructive pulmonary disease
Employment factors,
see Workplace
Endometrial cancer, 368, 421–422
Endothelial function, 161–162, 168, 169, 302, 354
cardiovascular disease, 479, 480, 481, 484–485, 486, 490, 491, 492
nicotine pharmacology, 252, 253, 268, 270
reproductive and developmental effects, 546, 548, 572
Enforcement, 11, 30, 40, 43–44, 48, 120, 125, 196, 207, 209, 226, 238, 239
Environmental interventions, 119–121, 256
public smoking restrictions, 120, 206, 225, 597, 599, 600, 601
workplace restrictions, 119–120, 422
Environmental tobacco smoke (ETS), vii, 5, 25, 35, 51, 53–54, 147–148, 201, 597, 604
see also “children” infra
asthma, 521–522
biomarkers, 317, 323, 329, 348, 422, 436, 491
cancer, 53, 390, 396, 398, 408, 422–424, 434, 439, 604
cardiovascular disease, 169, 470, 478, 491
children, 286, 348, 422, 500, 510–511, 521, 522–525, 528–530, 549;
see also “family…” and “reproductive…” infra
cigarette-like products, 94
dose-response relationship, 423–424, 436
epidemiology, 424, 509–510, 521
family/home factors, 120, 186, 319, 422, 510, 521, 523, 525, 528, 544, 597
gender factors, 424, 544, 545, 548, 551, 599
infants, 549
international perspectives, 423, 424
nitrosamines, 424
nonneoplastic respiratory diseases, 500, 509–511, 521–522, 528–530, 531, 551
regulatory factors, 225;
see also Environmental interventions
reproductive and developmental effects, 544, 545, 548, 549, 551
Surgeon General’s report, 24, 597, 600
surveillance, 194
toxicology, 283, 285, 287, 289–290
Enzymatic processes, 84, 152, 166, 253, 292, 505, 571, 570
biomarkers, 314, 327, 334, 342, 345–346, 389
carcinogenesis, 368, 369, 370, 376, 377, 389, 394, 433, 436
cardiovascular disease, 478, 484, 487
cytochrome P-450, 109, 152, 248, 269, 298, 323, 327, 334, 342, 375, 377, 378, 385, 409, 417, 421, 570
mitochondria, 154, 314, 336–337, 341, 394
Epidemiology, 15, 16, 17, 23, 26, 33, 34, 183, 193, 195, 197, 202, 594
see also Cohort studies;
Mortality;
Surveillance
biomarkers and, 142, 160, 161, 309, 339, 438
cancer, 165, 166, 367, 383, 418, 420, 424
cardiovascular disease, 471, 472, 473, 477
chronic obstructive pulmonary (COPD), 503–505, 509, 512
dose-response assessments, 140
environmental tobacco smoke (ETS), 424, 509–510, 521
orthopedic effects, 565
PREPs, 6, 7, 8, 10, 13–14, 141, 142, 147, 153, 160, 165, 193, 195, 197, 203, 206, 208, 221, 222, 229, 232, 236, 238, 437–438, 584
regulatory issues, 8, 10–11, 129, 203, 206, 207, 208, 221, 222, 229
smokeless tobacco, 301
Epithelial cells, 244–245, 295, 313, 316, 563
bladder cancer, 420–421
cancer, 375, 376, 393, 394, 416, 420–421
respiratory system, other than bronchi, 500, 519, 525–526
wound healing, 561
Erectile dysfunction, 545
Esophageal cancer, 1, 23, 24, 232, 372, 377, 425, 429, 597
Ethnicity,
see Race/ethnicity
ETS,
see Environmental tobacco smoke
Exposure, viii, 31, 33–34, 140, 141, 143, 145, 232, 583
see also Dose-response relationship;
Environmental interventions;
Environmental tobacco smoke;
Inhalation depth and retention;
Potential reduced-exposure products (PREPs);
Yield assessment
internal exposure, 150, 151, 160, 163–164, 309, 323, 349, 350, 351, 388, 396, 431, 435, 437
cancer risk, 383–384, 390, 395–397, 398–399, 401, 404, 412, 419, 420, 437
cardiovascular disease, 474, 477
cigarettes smoked per day, 22, 74, 88–89, 102, 113, 115, 119, 120, 151, 163, 164, 167, 170, 173, 300, 319, 343, 349, 375, 391, 392, 395, 396, 398–399, 401, 404, 412, 419, 437, 474, 487, 488, 489, 512, 513–514, 515, 516, 530
compensatory smoking, 2, 26, 67, 88, 121, 164, 219, 266, 285, 322, 380, 402, 403, 405, 477, 517
definitional issues, 2, 27–28, 311
duration of smoking, 67, 76, 151, 168, 390, 395, 396–397, 401, 402, 404, 419, 420, 471, 493, 508, 566, 572
duration of smoking cessation, 75, 115, 186, 409–415, 419, 438, 470, 473, 475, 476, 487, 490, 562
exposure-to-adverse effect, ix, 140, 145, 166, 511, 530
historical perspectives, vii, 26–27
nicotine replacement doses per day, 98, 105–106, 113, 248
PREPs, 31, 33, 34, 140, 141, 143, 145, 148, 150–161, 191, 237–238, 309, 310, 311, 323, 349, 350, 351
regulatory principles, 10, 204, 207–208, 215
research methodology, 309–366
snuff, daily consumption, 300
surveillance, 191
Extracardiac vascular disease, 470, 481, 545, 552, 561, 563, 565
placental, 545
stroke, 24, 168, 470, 473, 476, 487, 489, 600
Eyes,
see Ocular disease
F
Fagerström Tolerance Questionnaire, 260
Family/home factors, 120, 186, 319, 422, 510, 521, 523, 525, 528, 544, 597
see also Genetic factors
FDA,
see Food and Drug Administration
Federal Cigarette Labeling and Advertising Act, 595
Federal Communications Commission, 125
Federal government
see also Legislation;
Regulatory issues;
specific departments and agencies
national surveillance system, 8, 181, 207
national tobacco control program, 7, 35, 202, 206–207, 229, 232
Federal Trade Commission (FTC), 15, 30, 67, 207, 210, 600
PREPs, 2, 15, 26, 61, 67, 207, 210, 221, 227, 350
smoking machines, 2, 3, 26–27, 87–88, 90, 210–211, 226, 283–284, 317–319, 350, 352, 373, 380, 395, 404
surveillance, 183, 184, 189, 190
Females,
see Gender factors
Fetal lung development, 149, 298, 511, 551
FEV,
see Forced expiratory volume
Filters, 2, 26, 52, 56, 60, 64, 82, 88, 89–90, 91, 92, 121
see also Ventilation
cancer risk, 91, 164, 332, 399–400, 402–404, 405, 416, 419–420, 431
cardiovascular disease, 168
charcoal, 88, 89, 92, 94, 286, 287, 406, 603
cigars, 83
DNA adducts, 332
FDA regulation, 128
historical perspectives, 379, 594, 595, 601
international perspectives, 286
oropharyngeal disease, 416
regulatory issues, 128, 210, 225
risk assessment, 143, 164, 168, 399–400, 402–404
toxicological measures, 284, 287
ventilation, 26, 71, 87, 88, 89, 90, 121, 211, 286, 287, 317, 380, 399, 597
Fire-safe cigarettes, 87, 571, 604
Food and Drug Administration (FDA), 30, 207
bupropion, 123–124, 172, 552–553
clinical trial criteria, 122, 215, 227
committee charge, 3–4, 41, 205
definition of cigarette, 27, 126
devices, 30, 91, 124, 125–126, 127, 128, 129, 204, 205, 206, 228
drug treatments, 29–30, 205, 226–228;
see also “nicotine replacement…” infra
bupropion, 123–124, 172, 552–553
investigational new drug, 122, 215
filters, 128
labeling, 27, 122, 123, 128, 227
litigation, 21, 30, 124, 127–128, 204, 227, 228, 604
processing of tobacco, 128
nicotine replacement products, viii, 29, 91, 95–96, 123–124, 172, 204–205, 552–553
outline of drug approval process, 122–123
PREPs, 15, 122–124, 129–130, 141, 181, 204–205, 206, 209, 221, 226–227
see also “nicotine replacement products” supra
surveillance, 181
tobacco, 27, 124–130, 204, 205, 227, 228, 604
Food, Drug and Cosmetic Act, 30, 122, 124, 125–126, 128, 204, 205, 206, 214
Forced expiratory volume (FEV), 156, 171, 338, 343, 503, 506, 508–509, 514–515, 516, 520, 523, 532–533
Framework Convention on Tobacco Control, 25
Free radicals, 91, 253, 378, 389, 485, 486, 506, 561, 566, 572
FTC,
see Federal Trade Commission
G
Gastrointestinal tract
carcinogens, general, 372
Crohn’s disease, 561–562
esophageal cancer, 1, 23, 24, 232, 372, 377, 425, 429, 597
inflammatory bowel disease, 174, 302, 560, 561–562, 574
nicotine pharmacokinetics, 247–248
nicotine replacement therapy (NRT), 267, 270
peptic ulcers, 175, 560–561, 573
see also Pregnancy;
Reproductive and developmental effects
adolescents, 74, 172, 543, 545, 552
sexual behavior, 44–46, 50, 51
advertising, 74
cancer, 389, 416, 418, 419, 421, 424, 426, 436
lung, 24, 401, 402–403, 404–406, 410, 411, 412, 413, 598, 599
cardiovascular disease, 168, 472, 473, 477, 481, 482
chronic obstructive pulmonary (COPD), 500, 509, 512, 514, 515, 516
clonidine treatments, 108
contraceptives, 45, 477, 481, 544, 597
dermatologic conditions, 566
dose-response relationship, 164
environmental tobacco smoke (ETS), 424, 544, 545, 548, 551, 599
inflammatory bowel disease, 561–562
low-yield products, 74, 404–405
menthol cigarettes, 87
nicotine replacement therapy, 267–268
oropharyngeal disease, 416
osteoporosis, 565
prevalence of smoking, 22, 74, 87, 404
renal disease, 568
respiratory diseases, 416, 520
chronic obstructive pulmonary (COPD), 500, 509, 512, 514, 515, 516
lung cancer, 24, 401, 402–403, 404–406, 410, 411, 412, 413, 598, 599
rheumatoid arthritis, 562
risk assessment, general, 67, 145, 164, 168
sexual behavior, 44–46, 50, 51
smokeless tobacco use, 93
surveillance, 187
Genetic factors, 310
see also Cancer and carcinogens;
DNA;
Gender factors;
Mutagenesis and mutagens;
Reproductive and developmental effects
addiction, predisposition to, 161, 256, 347–348
animal models, 165
cardiovascular disease, 478, 490, 492
chromosomes, 152, 293, 313, 314, 333, 334–335, 340, 341, 342, 346, 368, 369, 372, 389, 391, 393, 406, 414–415, 417, 419, 420, 435, 545
loss of heterozygosity, 152, 313, 314, 334, 340, 342, 391, 393, 414–415, 419, 435
cytochrome P-450, 109, 152, 248, 269, 298, 323, 327, 334, 342, 375, 377, 378, 385, 409, 417, 421, 570
nicotine metabolism, 252, 270–271
nicotine replacement therapy, 270
nonneoplastic respiratory disease, 170, 501–502
oncogenes, 294, 341–342, 371, 389, 391, 393
polymorphisms, 252, 256, 314, 315, 345, 346, 347, 405–406, 409, 478, 526
RNA, 152, 153, 299, 314, 334, 353, 389
tobacco, genetically altered, 189
toxic effects, susceptibility, ix, 6, 13, 145, 153, 164, 166, 192, 233, 344–347, 390, 408–409, 416, 429, 436, 478, 490, 508
transgenic animals, 298–299, 385, 391
tumor suppressor genes (including p53), 155, 336, 341–342, 343, 371–372, 375, 376, 391–392, 393–394, 405, 409, 415, 417, 418–419, 420, 421, 428–429, 435
Genomics, 12–13, 154, 342, 370–371, 393, 490, 492, 503
GlaxoWellcome Pharmaceutical, 585
Growing Up Tobacco Free, 211, 219
Gum,
see Chewing gum
H
Health insurance discounts, 598
Heart disease,
see Coronary heart disease;
Cardiovascular disease
Hemoglobin, 156, 294, 314, 324, 338, 396, 398, 481, 561
adducts, 313, 330, 332, 333, 376, 378, 398, 399, 429
Hepatic system, 109, 248, 250, 269
cancer, 376, 377, 378, 385, 386, 420, 430
Heterocyclic amines, 148, 288, 374, 377, 379
Heterozygosity, loss of (LOH), 152, 313, 314, 334, 340, 342, 391, 393, 414–415, 419, 435
Historical perspectives, vii, 1, 2, 21–22, 23, 26–27, 60–81, 89–91, 573, 593–605
alcohol abuse reduction, 47
cancer risk, general, 21–26 (passim), 367, 594, 595, 597, 598, 600, 604
FDA approval of over-the-counter drugs, 123
filtered cigarettes, 379, 594, 595, 601
nicotine pharmacology, 243, 593–595, 597
nicotine replacement products, 113, 599, 601
nonneoplastic respiratory diseases, 500, 506, 598, 599
regulation of tobacco industry, 124–130, 595–604
Surgeon General’s reports, 21–26 (passim), 69, 125, 379, 380–381, 513, 595–603 (passim)
surveillance, 181
tar content of cigarettes, 379
HIV,
see AIDS
Home factors,
see Family/home factors
Hormonal effects, 179, 255, 268, 405, 406, 544, 551
adrenal, 105, 107, 108, 109, 110, 244, 245, 252, 253, 480, 549
androgens, 422
fertility, 544
progesterone, 405
Host susceptibility, ix, 6, 13, 145, 153, 164, 166, 192, 233, 344–347, 390, 408–409, 416, 429, 436, 478, 490, 508
Human Genome Project, 503
Hypertension, 252, 319, 477, 479, 481, 547, 548, 568
I
Immune system, 24, 149, 182, 254, 269, 270, 291, 296–298, 563, 597
see also Infectious diseases;
Inflammation
leukocytes, 314, 492, 506–507, 527
leukotrines, 156, 344, 388, 519–520, 563
lymphocytes, 156, 296–297, 314, 338, 346, 376, 399, 417, 436, 518, 519
macrophages, 293, 296, 297, 344, 484, 506, 517, 518, 526, 561
neutrophils, 156, 338, 344, 485, 508, 517, 518, 561
nonneoplastic respiratory disease, 526, 527
particulates, 297–298
preeclampsia, 572
rheumatoid arthritis, 174, 562
susceptibility to toxic effects, ix, 6, 13, 145, 153, 164, 166, 192, 233, 344–347
Immunoglobulin, 296, 519, 526, 527, 562
Incidence of disease, general, vii, viii, 14, 66, 596
see also Epidemiology;
Risk assessment;
Surveillance
cancer, 367, 384, 392, 410, 411, 415, 418
cardiovascular disease, 167, 470, 471, 472, 473, 479, 487
nonneoplastic respiratory diseases, 500, 518, 519, 526
Infectious diseases
animal models, 296–297
bladder, 418
intrautrine, 547
oral, 563
placental, 546
respiratory, 170, 296, 297, 354, 500–501, 502, 506, 508, 516, 525–531, 532, 546, 547, 551
pneumonia, 501, 502, 526, 527–528, 529, 530, 551
Inflammations, 144, 162, 169, 291, 338–339
anti-inflammatory agents, 123, 561
cardiovascular disease, 168, 252, 253, 270, 291, 482–483, 485, 490, 491, 492
gingivitis, 563–564
pelvic inflammatory disease, 544–545
placental, 546
respiratory, 12, 13, 95, 113, 149, 156, 170–171, 295, 298, 302, 338, 343–344, 395, 502, 505, 506, 507, 516–518, 527, 531, 533
asthma, 170, 500–501, 518–525, 527, 530–531, 551
Inflammatory bowel disease, 174, 302, 560, 561–562, 574
Information dissemination,
see Advertising;
Labeling;
Marketing;
Public education
Inhalation depth and retention, 210, 219, 252, 322
cancer, 390, 392, 395, 420, 426
cardiovascular disease, 471, 473
compensatory smoking, 2, 26, 67, 88, 285, 322
Inhalers,
see Oral/nasal sprays
Innovative products,
see Potential reduced-exposure products (PREPs);
Technological innovation
International Agency for Research on Cancer (IARC), 293, 374
International Diagnostic Code, 257, 258–259
International perspectives
addiction, 261
bidis, 83
cancer, 88–89, 407–408, 418, 423, 424, 425
environmental tobacco smoke (ETS), 423, 424
filters, 286
label warnings, 219
oropharyngeal disease, 415, 416
prevalence of tobacco use, 23, 88–89
smokeless tobacco, 93, 300, 426–428
snus, 4, 14, 167, 204, 270, 300, 301, 302, 427, 428, 434
smoker knowledge of toxins, 72–73
International Standards Organization, 87, 283
International Workshop on Genotoxicity Test Procedures, 292
Internet
cigarette-like products, 94
marketing of tobacco, 190
smoke yields, 92
Investigational New Drug, 122, 215
In vitro assays, 160, 215, 291–292
cancer, 154, 165, 367, 376, 383–384, 385, 391–392, 432
cardiovascular disease, 168, 480
PREPs, 12, 34, 144, 148–149, 151, 152, 154, 156, 158, 160, 168, 208, 212, 215, 303, 350, 351
cancer, 154, 167, 367, 383–384, 385, 432
J
Japan, 88–89, 261, 286, 342, 409
K
Kidneys,
see Renal disease
L
Labeling, 7, 10, 17, 29, 203, 206, 207, 208, 211, 213, 216–221, 222, 229, 232
definition of cigarette, 27
FDA criteria, 27, 122, 123, 128, 227
health warnings, 125, 215–216, 219–221, 595, 599
historical perspective, 219, 595, 599
nicotine replacement products, 123
Legal issues, 207
see also Litigation;
Regulatory issues
Legislation
advertising, bans on, 120, 125, 597, 602
automobile safety belts, 42, 43
Cigarette Labeling and Advertising Act, 125
committee recommendations, 204, 205, 227, 228
Comprehensive Smokeless Tobacco Health Education Act, 125
Consumer Product Safety Act, 125
Controlled Substances Act, 123, 125
Federal Cigarette Labeling and Advertising Act , 595
fire-safe cigarettes, 87, 571, 604
Food, Drug and Cosmetic Act, 30, 122, 124, 125–126, 128, 204, 205, 206, 214
label warnings, 216–217, 219–221
minors, sales of tobacco to, 120, 125, 202, 604
Public Health Cigarette Smoking Act, 125
public smoking restrictions, 120, 206, 225, 597, 599, 600, 601
state tobacco laws, 125, 207, 571, 584, 601, 604
tobacco products regulation, committee recommendation, 204, 205
Toxic Substances Control Act, 125
see also Regulatory issues
Leukocytes, 314, 492, 506–507, 527
Leukoplakia, 415, 427, 429, 563
Leukotrines, 156, 344, 388, 519–520, 563
Life expectancy, 23
Light cigarettes,
see Low-yield products
Lipids and lipoproteins, 12, 154, 169, 243, 253, 314, 330–331, 336–337, 343, 378–379, 471, 479, 482, 485, 486, 491–492
leukotrines, 156, 344, 388, 519–520, 563
Litigation
additives, 90–91
FDA jurisdiction, 21, 30, 124, 127–128, 204, 227, 228, 604
smoke yield assessment, 211
tobacco companies, litigation against, 126, 595, 601–604
Liver,
see Hepatic system
Lorillard Tobacco Company, 184, 584
Loss of heterozygosity,
see Heterozygosity, loss of
Low-yield products, 4, 27, 28, 73–76, 89–90, 95, 116, 205, 319, 432, 532, 533, 584
see also Black vs blond tobacco;
Filters;
Ventilation
advertising, 26, 56, 61–66, 72, 73, 76
bladder cancer, 421
cardiovascular disease, 471, 477
chronic obstructive pulmonary disease (COPD), 517–518
compensatory smoking, 2, 26, 67, 88, 121, 164, 219, 266, 285, 322, 380, 402, 403, 405, 477, 517
historical perspectives, 3, 60, 61–66, 72–73, 121, 596–604 (passim)
lung cancer risk, 399–404
nitrosamines, 377
oropharyngeal disease, 416
relapse into smoking, 75
risk assessment, 143, 145, 164, 399–400
risk perception, 66–67, 68–71, 76–77
Lung Health Study, 232, 471, 505, 514–515, 532
Lungs,
see Respiratory system
Lymphocytes, 156, 296–297, 314, 338, 346, 376, 399, 417, 436, 518, 519
M
Macrophages, 293, 296, 297, 344, 484, 506, 517, 518, 526, 561
Magnesium nitrate, 90–91
Males,
see Gender factors
Marketing, viii, 7, 8, 10, 30, 31, 32, 64, 74, 237, 240
see also Advertising;
Federal Trade Commission;
Labeling;
Packaging
historical perspectives, 60–66
postmarket surveillance, x, 182, 184, 189, 190, 203, 207, 208, 213, 221–222, 270
regulation, general, 207, 208, 213, 215, 216–221, 222–223, 228, 229, 232
premarket testing/approval, x, 8, 129, 213–215, 217, 223, 224, 227–228
see also Advertising
Medical Device Amendments of 1976, 124
Medical devices, 111
see also Oral/nasal sprays
birth control, 45
burning temperature, 95
computerized, 118
regulatory issues, 30, 91, 124, 125–126, 127, 128, 129, 204, 205, 206, 209–210, 214, 225, 228
Men,
see Gender factors
Menthol-containing cigarettes, 62, 64, 72, 73, 77, 86–87, 98, 183, 319, 406–407, 438, 439
African Americans, 72, 73, 86, 406–407
Methadone, 42, 48, 49–50, 51, 52, 55, 114–115
Methodology,
see Research methodology
Methoxsalen, 110
Military personnel, 70, 76, 398
Minority groups,
see Race/ethnicity
Mitochondria, 154, 314, 336–337, 341, 394
Modified tobacco products, viii, ix-x, 2, 8, 17, 52, 231, 303, 596
see also Additives;
Low-yield products;
Potential reduced-exposure products (PREPs);
Technological innovation
committee charge and methodology, 3–4, 205, 206
genetically altered, 189
regulatory issues, 8, 10–11, 205, 206, 207, 209
Molecular biology, 207, 298–299
see also Biomarkers;
Genetic factors;
Pharmacology;
Receptors;
Toxicology
cytochrome P-450, 109, 152, 248, 269, 298, 323, 327, 334, 342, 375, 377, 378, 385, 409, 417, 421, 570
lipids, 12, 154, 169, 314, 330, 336–337, 343, 379, 471, 479, 482, 485, 486, 491–492
oropharyngeal disease, 417
proteomics, 12–13, 152, 314, 334, 353, 389, 492
Monitoring the Future, 185–187, 320–321
cancer, 392, 398, 400, 411–414, 415, 418, 419, 426, 434
cardiovascular disease, 470, 472, 473, 477, 487
chronic obstructive pulmonary (COPD), 505, 508, 509, 512, 513–514
cigar smokers, 426
dementia risk assessment and, 564
drug treatment to reduce, 111, 112–113
fires caused by smoking, 571
harm reduction defined, 2, 25, 40
historical perspectives, vii, 2, 23
international perspectives, 23, 25
lung cancer, 392, 398, 411–414
nonneoplastic respiratory disease, 170, 505, 508, 509, 512, 513–514, 528, 530
oropharyngeal cancer, 415
registries, 321
regulatory issues, 213, 215, 220
sudden infant death syndrome, 173, 268, 543, 546, 549, 552, 596
surveillance, 194
Musculoskeletal effects,
see Orthopedic effects;
Rheumatoid arthritis
Mutagenesis and mutagens, 144, 148, 154, 292, 367–370, 371, 373–379, 380, 384, 429–430
see also Cancer and carcinogens
biomarkers, 313, 314, 323, 326, 327, 334, 340–342, 345, 346–347, 353
defined, 368
DNA adducts, 153, 292, 293, 313, 314, 327–335 (passim), 341, 346, 348, 353, 368–370 (passim), 372, 375–378 (passim), 385–390 (passim), 399, 405, 409, 417, 420–424 (passim), 429, 435, 492
transgenic animals, 298–299, 385, 391
tumor suppressor genes (including p53), 155, 336, 341–342, 343, 371–372, 375, 376, 391–392, 393–394, 405, 409, 415, 417, 418–419, 420, 421, 428–429, 435
N
Naloxone, 108
Naltrexone, 108
Nasal sprays,
see Oral/nasal sprays
National Cancer Institute, 185, 211, 596
National Center for Environmental Health, 184, 185
National Committee for Clinical Laboratory Standards, 349
National Health and Nutrition Examination Survey (NHANES), 184–185, 190, 320–321, 413, 422, 565
National Health Interview Survey, 69, 185–187, 320–321, 544
National Highway Traffic Safety Administration, 42, 44
National Household Survey on Drug Abuse, 50, 92–93, 185–187, 260, 261
National Institutes of Health, 301
National Cancer Institute, 185, 211, 596
National Institute for Environmental Health Sciences, 604
National Survey of Family Growth, 187
National Toxicology Program, 53, 384
National Vital Statistics System, 188
National Youth Tobacco Survey, 185–187
Native Americans,
see American Indians
Neurological diseases
depression, 104, 174, 186, 256–257, 347, 568–569
antidepressants, 105–106, 115–116, 254, 256, 570
Parkinson’s disease, 162, 270, 347, 571–572
schizophrenia, 162, 174, 244, 257, 268–269, 347, 568
Neurotransmitters, 105, 134, 161, 244, 245, 255, 256, 519, 550–551, 571
see also Receptors
acetylcholine (Ach), 161, 244–245, 252, 254, 266, 269, 347, 568
dopamine, 105, 109, 110, 244, 245, 256, 257, 266, 347–348, 551, 568, 571, 572
serotonin, 105, 109, 244, 347, 478, 551
Neutrophils, 156, 338, 344, 485, 508, 517, 518, 561
New products,
see Potential reduced-exposure products (PREPs);
Technological innovation
New Zealand, 261
Nicotine, vii, 25, 26, 28–29, 66, 67, 597
see also Addiction;
Filters;
Low-yield products;
Nicotine replacement therapy;
Pharmacology;
Potential reduced-exposure products (PREPs);
Ventilation
antagonists, 4, 106–108, 110, 116, 244
antibodies, 107–108
antidepressants, 105
biomarkers, 323, 324–325, 326, 347
see also Cotinine
plasma markers, 99, 113, 250, 293
body weight, 126, 158–159, 162, 255, 267, 270, 568–569
carcinogenesis, 167, 402, 403, 405
cardiovascular disease, 168, 470–471
nicotine replacement therapy (NRT), 98–99, 112, 115, 252–253, 471
cigarette-like products, 94, 95
cognitive effects, 254, 255, 259, 270, 564
compensatory smoking, 2, 26, 67, 88, 121, 164, 219, 266, 285, 322, 380, 402, 403, 405, 477, 517
dementia, 564
gender factors, 74
marketing factors, 61
metabolism, 109, 110, 116, 162, 248–252, 256, 269, 313, 422
processing of tobacco, 85
public understanding of content, 60
regulatory issues, 10, 207, 210, 211–212
drug treatments, 97, 103, 105, 106–107, 110
genetic predisposition to smoking, 347–348
pharmacology, 161, 245, 252, 254, 255, 257
reproductive and developmental effects, 172, 545, 550, 552, 554–555, 572
smoker knowledge of, 72–73
yield assessment, 88, 90, 184, 207, 210, 211–212, 317–319, 373
Nicotine replacement therapy (NRT), viii, 1, 3, 4, 29, 51–53, 95–104, 110–115, 161–162, 231, 233–234, 254, 263, 269, 270–271, 325, 326, 430, 533, 552–553, 554–555
see also Chewing gum;
Oral/nasal sprays;
Patches
addiction, 161
behavioral therapy and, 96, 115
cardiovascular disease, 98–99, 112, 115, 252–253, 471
clinical trials, 96, 101–103, 113–115, 533
cost of, 101–102, 129, 554–555
dose-response relationship, 255–256, 264, 266
doses per day, 98, 105–106, 113, 248
gastrointestinal system, 267, 270
gender factors, 267–268
genetic factors, 270
historical perspectives, 113, 599, 601
labeling, 123
relapse into smoking, 101, 111, 115
reproductive and developmental effects, 112, 116, 172–173, 267, 552–553, 554–555
research methodology, 101–103
research recommendations, 269–271
time factors,
blood concentrations, 99–101, 103
FDA approval, 123
Nicotrol Nasal Spray, 97, 124, 129
Nitrosamines, 4, 67, 86, 87, 91–92, 93, 148, 151, 210, 215, 294, 300, 301, 319, 326–327, 328, 348, 373–374, 376–377, 379, 380, 403, 405, 429–430, 603, 604
environmental tobacco smoke, 424
racial/ethnic differences, 406, 407
smokeless tobacco, 4, 93, 428, 429
Nonneoplastic respiratory diseases, 170–171, 500–542
see also Chronic obstructive pulmonary disease
asthma, 170, 500–501, 518–525, 527, 530–531, 551
biomarkers, general, 170–171, 501–503, 506, 507, 512, 517, 527, 531, 532
bronchi, 24, 156, 500, 505, 514, 520, 522, 526, 551
bronchitis, 21, 295, 338, 502, 503, 505, 510, 525, 529, 551
epithelium, 298, 375, 376, 393
children, 500, 501, 506, 508, 510–511, 518–526 (passim), 528–530, 551
clinical research, 13, 171, 511–512, 514, 518, 522, 523–525, 529, 530, 532–533
cotinine, 517, 523, 525, 526, 529, 530, 532
dose-response relationship, 170, 171, 510–514, 521, 523, 527–528, 531, 532
environmental tobacco smoke (ETS), 500, 509–511, 521–522, 528–530, 531, 551
historical perspectives, 500, 506, 598, 599
infections, 170, 296, 297, 354, 500–501, 502, 506, 508, 516, 525–530, 532, 546, 547
children, 501, 506, 526, 528–529, 551
pneumonia, 501, 502, 526, 527–528, 529, 530, 551
sputum, 12, 193–194, 313, 353–354, 391, 435, 437, 503, 505, 514, 515
Nortriptyline, 4, 104, 106, 124
Nurses’ Health Study, 168, 487, 567
O
Occupational factors,
see Workplace
Ocular disease, 174, 193, 565–566
Oncogenes, 294, 341–342, 371, 389, 391, 393
Oral/nasal sprays, vii, 4, 94, 97–101, 103, 124, 266
Oropharyngeal disease, 174, 563–564, 574
see also Smokeless tobacco
biomarkers, 156, 333, 338–339, 342
cancer, 23, 167, 301, 333, 342, 368, 372, 415–418, 425, 427–429, 597
gingivitis, 563–564
oral clefts, 549–550
Orthopedic effects, 565
osteoporosis, 158, 174, 176, 193, 338–339, 565, 574
rheumatoid arthritis, 174, 562
Over-the-counter drugs, 31, 94, 96, 97, 102, 110, 120, 263
FDA approval process, 123
P
Packaging, 27, 30–31, 70, 77, 124
see also Labeling
Palladium, 90–91
Pancreatic cancer, 372
Paper, 27, 85, 87, 88, 89, 91, 92, 128, 287, 571, 604
see also Ventilation
regulatory issues, 210, 224, 225
ventilation, 26, 71, 87, 88, 89, 90, 121, 211, 286, 287, 317, 380, 399, 595, 597
Parental factors,
see Family/home factors
Parkinson’s disease, 162, 270, 347, 571–572
Particulates, viii, 284–285, 286–287, 322
see also Aerosols
carcinogens and mutagens, 148, 374, 436
free radicals, 378
immune response, 297–298
smoke yields, 87
Passive smoking,
see Environmental tobacco smoke
Patches, vii, 3, 4, 29, 96, 97, 98, 99, 100, 101, 103, 104, 112, 113, 601
clonidine, 108
mecamylamine, 107
pharmacokinetics, 246
Peptic ulcers, 175, 560–561, 573
Periodontal disease,
see Oropharyngeal disease
Pharmaceutical products,
see Chewing gum;
Drug treatment;
Oral/nasal sprays;
Nicotine replacement therapy;
Psychotrophic drugs;
Patches
Pharmacology, 101, 161–163, 215, 243–282, 570, 583, 593
see also Addiction;
Receptors
animal models, 244, 253, 258, 268
cardiovascular effects, 471
risk assessment, 161–163
withdrawal, 161, 244, 245, 254–260 (passim), 263–267 (passim)
Pipe smoking, 85, 321, 473, 508, 597
Placental complications, 268, 545–547, 552
cotinine, 348
Platelet activation, 12, 156, 157, 168, 169, 252, 253, 296, 337–339, 343, 354, 479, 480, 481, 483–486, 490–491, 492, 493, 561
Pneumonia, 501, 502, 526, 527–528, 529, 530, 551
Policy, general, 7, 9, 38–39, 41–42, 51–56, 119–122, 176, 201–230
see also Automobile safety;
Regulatory issues
alcohol and drug abuse, 39–40, 46–50, 51, 52, 53, 55, 56, 601
automobile safety, vii, 41–44, 50, 52, 53, 56
surveillance, 197
taxation, 119, 128, 202, 596, 603
teen sexual behavior, 44
Political factors, 22
Polycyclic aromatic hydrocarbons (PAHs), 86, 148, 149, 295, 322, 326–327, 328–331, 333, 348, 374, 375–376, 377, 379, 391–392, 418, 570
Polymer chain reaction, 340, 391
Polymorphisms, 252, 256, 314, 315, 345, 346, 347, 405–406, 409, 478, 526
Potential reduced-exposure products (PREPs), 2, 3–17 (passim), 21, 53, 231, 232–240, 273, 574
see also Drug treatment;
Filters;
Low-yield products;
Modified tobacco products;
Nicotine replacement therapy;
Ventilation
age factors, 76, 161, 164, 319, 321, 331
animal models, 144, 145, 147, 148–149, 162, 163, 165, 208, 212–213, 303, 350, 351, 384–386
behavioral effects of availability, 7, 73–76, 185, 197, 315
biomarkers, 142, 144, 145, 150–161, 162–163, 165, 237, 309–317, 323–352, 388, 435–436, 553
committee charge and methodology, 3–5, 31–32, 33, 34, 142, 202–203, 205, 237
currently available and novel, 91–95
definitional issues, 3, 28, 205
dose-response relationship, 14, 15, 33, 34, 140, 141, 144–147, 152, 154, 156, 158, 159, 160, 167, 237–238, 271, 310, 312, 325, 326, 352, 381, 395–396
epidemiology, 6, 7, 8, 10, 13–14, 141, 142, 147, 153, 160, 165, 193, 195, 197, 203, 206, 208, 221, 222, 229, 232, 236, 238, 437–438, 584
FDA actions, 15, 122–124, 129–130, 141, 181, 204–205, 206, 209, 221, 226–227
Federal Trade Commission (FTC), 2, 15, 26, 61, 67, 207, 210, 221, 227, 350
historical perspectives, 24, 26, 55, 60–81, 88–91
incidence of disease, 5–6, 193
in vitro assays, 12, 34, 144, 148–149, 151, 152, 154, 156, 158, 160, 168, 208, 212, 215, 303, 350, 351
cancer, 154, 167, 367, 383–384, 385, 432
lung cancer, 294–295, 395–399, 407–409
marketing, 61–66
other harm reduction intervention compared, 50–53
policy, general, 202–204
postmarket surveillance, x, 182, 184, 189, 190, 203, 207, 208, 213, 221–222, 270
pregnant women, 173–174, 552–553, 554–555
prevalence of use, 67
product descriptions, 82–140
regulation, 5, 6, 7–11, 30–32, 33, 122–124, 129–130, 147, 202–229 (passim), 234–235, 236, 238
relapse into smoking, 75, 101, 111, 115, 141, 146
risk assessment, general, 140–179 (passim)
risk thresholds, 9, 164, 167, 222–224, 225–226, 431, 439, 480, 481, 487
risk perception, 26, 68–69, 77, 78
smokeless tobacco, 93
Surgeon General’s reports, 24
surveillance, x, xi, 7–8, 10, 13–14, 147, 162, 176, 181, 182, 183, 185, 189, 203, 208, 221–222, 225, 236, 237, 238, 269, 270, 573, 574
time requirements for evaluation, 5, 141, 146, 147, 232, 320
toxicology, 144, 145, 147–150, 204–205, 207, 208–209, 212–213, 228, 292, 302–303
see also Reproductive and developmental effects
biomarkers, 174, 191, 545, 548, 553, 570, 572
birthweight, 11, 23, 24, 149, 172, 173–174, 188, 193, 212, 267, 340–341, 344, 529, 543, 547–549, 550, 551, 552, 554, 596
bupropion, 172, 174, 552–553, 554
carbon monoxide, 172, 173–174, 549, 550, 552, 554
contraceptives, 45, 477, 481, 544, 597
diet, 547
drug treatments, 116
environmental tobacco smoke (ETS), 544, 545, 548, 549, 551
fetal lung development, 149, 298, 511, 551
nicotine, 172, 545, 550, 552, 554–555, 572
nicotine replacement therapy (NRT), 112, 116, 172–173, 267, 552–553, 554–555
placental complications, 268, 545–547, 552
PREPs, 173–174, 552–553, 554–555
preterm delivery, 172, 543, 546–547, 552, 596
regulatory issues, 10–11, 208, 222
smokeless tobacco, 301–302, 551–552
spontaneous abortion, 11, 24, 268, 545, 554, 596
teenage, 44, 172, 543, 545, 552
surveillance, 187–188, 191, 193
teratogenic effects, 545, 554–555
Pregnancy Risk Assessment Monitoring System, 187–188
Premarket notification/testing/approval, x, 8, 129, 213–215, 217, 223–224, 227–228
PREPs,
see Potential reduced-exposure products
President’s Cancer Committee, 211
Prevalence, 195, 262, 594, 603
see also Incidence
birthweight, low, 11, 23, 24, 149, 172, 173–174, 188, 193, 212, 267, 340–341, 344, 529, 543, 547–549, 550, 551, 552, 554, 596
cigar smoking, 425
gender factors, 22, 74, 87, 404
harm reduction defined, 40
orthopedic effects, 565
PREP use, 67
respiratory infections, 529
smokeless tobacco use, 92–93, 427
smoking, general, viii, 1, 22, 23, 25, 74, 189, 191, 197, 414
antidepressants, 106
international perspectives, 23, 88–89
nicotine replacement drugs, clinical trials, 102–103
pregnant women, 543–544
Processing of tobacco, 66, 82, 84–87, 89, 90–91, 299–300, 597
see also Additives
blending, viii, 26, 82, 85, 87, 94, 128, 209, 287
curing, 8, 82, 83, 84, 91, 128, 189, 209, 300
FDA regulation, 128
regulation recommendations, 209
surveillance, 189
Proteomics, 12–13, 152, 314, 334, 353, 389, 492
Psychological factors, 118
see also Attitudes and beliefs;
Behavioral effects of tobacco use;
Behavioral treatments;
Dementia;
Depression;
Schizophrenia
adolescents, 74
anxiety, 109
depression, 104, 174, 186, 256–257, 347, 568–569
antidepressants, 105–106, 115–116, 254, 256, 570
menthol cigarettes, 73
nicotine mood enhancement, 245, 254
nicotine replacement therapy, addiction, 161
surveillance, 186
Psychotrophic drugs, vii, 268–269
FDA attempt to regulate tobacco, 126
Public education, x, 9, 203–204, 236, 603
see also Internet;
Schools
committee charge, 4–5
consumer information, 7, 231, 240
see also Labeling
regulatory framework, 204, 205, 225, 229
surveillance, 188
Public Health Cigarette Smoking Act, 125
Public Health Service, 102, 103, 109, 595
Public health, general, 4, 5, 6, 7, 14, 16, 25, 31, 33, 141, 142, 202, 235–237
see also Cessation programs;
Epidemiology;
Fires;
Policy, general;
Surveillance
restrictions on public smoking, 120, 206, 225, 597, 599, 600, 601
Pulmonary system,
see Respiratory system
R
Race/ethnicity, 73, 86, 233, 321, 543, 548
see also specific groups
birthweight, 548
dementia, 564
dose-response relationship, 164, 407
metabolic processes, 250, 270–271, 389
oropharyngeal disease, 416
Surgeon General’s reports, 24, 125, 603
Receptors, 108, 244, 482, 485–486, 550–551, 564, 568
see also Neurotransmitters
drug treatments, 97, 103, 105, 106–107, 110
genetic predispositions for smoking, 347–348
pharmacology, 161, 245, 252, 254, 255, 257
progesterone, 405
Regulatory issues, x, 6, 30–31, 201–229, 584
see also Enforcement;
Federal Trade
Commission;
Food and Drug Administration;
Labeling;
Legislation;
Standards
additives, 128, 149, 209, 210, 212, 224–225
advertising, 7, 10, 120, 125–126, 127, 128, 141, 203, 206, 207, 208, 211, 216–221, 222, 229, 232, 595, 597, 602, 603
animal models, 10, 208, 212–213, 215
automobile safety, vii, 41–44, 50, 52, 53, 56
biomarkers, 10, 11–12, 207–208, 211, 220, 348–349
clinical trials, 122, 208, 209, 212, 213, 215, 227, 229
committee charge and methodology, 4, 5, 31–32, 34, 202–203
consumer information, general, 204, 205, 225, 229
conventional tobacco, 124–130, 207, 209–229 (passim), 234–235
definitional issues, 11, 27–28, 30, 124, 126, 205, 225–226
enforcement, 11, 30, 40, 43–44, 48, 120, 125, 196, 207, 209, 226, 238, 239
epidemiology, 8, 10–11, 129, 203, 206, 207, 208, 221, 222, 229
exposure, general, 10, 204, 207–208, 215
historical perspectives, 124–130, 595–604
marketing, 207, 208, 213, 215, 216–221, 222–223, 228, 229, 232
see also “advertising” supra;
Labeling postmarket surveillance, x, 182, 184, 189, 190, 203, 207, 208, 213, 221–222, 270
premarket testing/approval, x, 8, 129, 213–215, 217, 223, 224, 227–228
medical devices, 30, 91, 124, 125–126, 127, 128, 129, 204, 205, 206, 209–210, 214, 225, 228
modified tobacco products, 8, 10–11, 205, 206, 207, 209
nicotine, 10, 207, 210, 211–212
PREPs, 5, 6, 7–11, 30–32, 33, 122–124, 129–130, 147, 202–229 (passim), 234–235, 236, 238
processing of tobacco, 189, 209
public smoking restrictions, 120, 206, 225, 597, 599, 600, 601
reproductive and developmental effects, 10–11, 208, 222
respiratory effects, 10, 208, 215, 222
smokeless tobacco products, 126, 128, 209
surveillance, 183, 184, 188, 189, 190, 197, 203, 204, 208, 221–222, 225
taxation, 119, 128, 202, 596, 603
toxicology, 9, 10–11, 128, 204–205, 207, 212–213, 222, 224–225, 228
yield assessment, 183, 184, 207–208, 210–212, 219
smoking machines, 2, 3, 26–27, 87–88, 90, 210–211, 226, 283–284, 317–319, 350, 352, 373, 380, 395, 404
alcohol abuse, 47
depression and, 104
drug treatment and, 111
low-yield cigarettes, 75
nicotine replacement products, 101, 111, 115
PREP risk assessment, 75, 101, 111, 115, 141, 146
risk perception and, 41
substance abusers, 49
Reproductive and developmental effects, 4, 24, 172–174, 268, 298, 302, 543–559, 598, 601
see also Age factors;
Genetic factors;
Pregnancy
behavioral/cognitive disorders, 268, 550–551
biomarkers, 174, 191, 545, 548, 553, 570, 572
birthweight, 11, 23, 24, 149, 172, 173–174, 188, 193, 212, 267, 340–341, 344, 529, 543, 547–549, 550, 551, 552, 554, 596
carbon monoxide, 172, 173–174, 549, 550, 552, 554
cervical cancer, 24
clinical research, 173–174, 547, 548, 554
cognitive and behavioral disorders, 268, 550–551
congenital malformations, 268, 545, 549–550
contraceptives, 45, 477, 481, 544, 597
environmental tobacco smoke (ETS), 544, 545, 548, 549, 551
menstrual cycle, 267
nicotine, 172, 545, 550, 552, 554–555, 572
nicotine replacement therapy (NRT), 112, 116, 172–173, 267, 552–553, 554–555
pelvic inflammatory disease, 544–545
PREP risk assessment, 172–174, 552–553, 554–555
regulatory issues, 10–11, 208, 222
research recommendations, 553–555
smokeless tobacco, 551–552
sudden infant death syndrome, 173, 268, 543, 546, 549, 552, 596
Research methodology, 55–56, 121–122, 438–439
see also Animal models;
Biomarkers;
Clinical research;
Cohort studies;
Epidemiology;
Internet;
In vitro assays;
Surveillance
addiction measures/models, 257–267
carcinogenesis, 378, 379–394, 410, 434–439
committee study at hand, 3–5, 16, 31–35, 142
dementia, 564–565
exposure, 309–366
see also “smoke yields” infra
forced expiratory volume (FEV), 156, 171, 338, 343, 503, 506, 508–509, 514–515, 516, 520, 523, 532–533
free radical carcinogens, 378
health impact research, 66–67
nicotine metabolism, 252
nicotine replacement drugs, 101–103
Parkinson’s disease, 572
quitting smoking, 76
respiratory infections, 529–530
risk perception, 68
smoking machines, 2, 3, 26–27, 87–88, 90, 210–211, 226, 283–284, 317–319, 350, 352, 373, 380, 395, 404
Research recommendations, 7–17, 33–35, 77–78, 203, 206–207, 232–233, 239–240, 573–574
cancer, 434–439
cardiovascular, 491–493
nicotine replacement therapy, 269–271
nonneoplastic respiratory diseases, 532–533
reproductive and developmental effects, 553–555
smokeless tobacco, 301–302
toxicology, 301–303
Respiratory system, 4, 156, 285–286, 343
see also Nonneoplastic respiratory diseases
bronchi, 24, 156, 500, 505, 514, 520, 522, 526, 551
bronchitis, 21, 295, 338, 502, 503, 505, 510, 525, 529, 551
cancer and carcinogenesis, 285, 298, 375, 376, 391, 392, 393, 437, 518
epithelium, 298, 375, 376, 393
bronchoalveolar lavage, 13, 156, 295, 338–339, 343–344, 437, 517
bronchoscopy, 157, 171, 339, 392, 502–503, 517, 531
epithelial function, 500, 519, 525–526
forced expiratory volume (FEV), 156, 171, 338, 343, 503, 506, 508–509, 514–515, 516, 520, 523, 532–533
chronic obstructive pulmonary (COPD), 500, 509, 512, 514, 515, 516
lung cancer, 24, 401, 402–403, 404–406, 410, 411, 412, 413, 598, 599
inflammation, 12, 13, 95, 113, 149, 156, 170–171, 295, 298, 302, 338, 343–344, 395, 502, 505, 506, 507, 516–518, 527, 531, 533
asthma, 170, 500–501, 518–525, 527, 530–531, 551
lung cancer, viii, 21, 23, 24, 66, 67, 86, 89, 149, 166–167, 192, 193, 215, 293–295, 296–297, 302, 333, 342, 355, 368, 372
nicotine pharmacology, 244–245, 246
regulatory issues, 10, 208, 215, 222
Rheumatoid arthritis, 174, 562
Risk assessment, general, ix-x, 14, 15, 33–35, 66–67, 239–240
see also Biomarkers;
Dose-response relationship;
Epidemiology;
Exposure;
Surveillance;
specific diseases and anatomical systems
age factors, 67, 145, 186, 321
committee charge, 3–4
definitional issues, 28
exposure-to-adverse effect, time, ix, 140, 145, 166, 511, 530
filters, 143, 164, 168, 399–400, 402–404
gender factors, 67, 145, 164, 168
genetic predisposition to toxic effects, ix, 6, 13, 145, 153, 164, 166, 192, 233, 344–347, 390, 408–409, 416, 429, 436, 478, 490, 508
low-yield products, 143, 145, 164, 399–400
modified tobacco products, viii
pharmacology, 161–163
PREPs, 140–179 (passim)
risk thresholds, 9, 164, 167, 222–224, 225–226, 431, 439, 480, 481, 487
tobacco, 141–144
Risk characterization, general, 14, 33–34, 140, 237–238, 239
Risk perception, 2, 6, 8, 10, 26, 28, 40–41, 42–43, 67–73, 76–77, 185–188 (passim), 212, 434, 584
addiction, 68
adolescents, 41, 68, 72, 73–74, 112, 185
carbon monoxide, 72–73
international perspectives, 72–73
negative attitudes toward unsafe behavior, general, 43
nicotine replacement products, 110–111, 112
R.J.Reynolds, 184, 585, 594, 595, 597, 600
Eclipse, 4, 65, 94–95, 129, 215, 517–518, 602
RNA, 152, 153, 299, 314, 334, 353, 389
S
Saliva, 209, 267, 300, 311, 323, 325, 422, 428, 523, 525
Schizophrenia, 162, 174, 244, 257, 268–269, 347, 568
Schools
impacts of smoking on performance, 187
prevention/cessation programs, 24, 120, 598, 601
teen sexual behavior, 44–45
Youth Risk Behavior Survey, 93, 185–187, 261, 320–321
Secondary smoke,
see Environmental tobacco smoke
Serotonin, 105, 109, 244, 347, 478, 551
Sertraline, 105
Serum markers, 157, 174, 184–185, 187, 190, 300, 313, 314, 321, 323, 330, 335, 339, 353
cholesterol levels, 289, 296, 477, 482
diabetes, 567
environmental tobacco smoke, 348, 422
nonneoplastic respiratory diseases, 506, 517, 527, 532
reproductive and developmental effects, 548, 553, 570, 572
Sex differences,
see Gender factors
Sexual behavior, adolescents, 44–46, 50, 51
pregnancy, 44, 172, 543, 545, 552
Sidestream smoke,
see Environmental tobacco smoke
Skeletal system,
see Orthopedic effects
Skin diseases,
see Dermatologic diseases
Skin patches,
see Patches
Sleep disturbance, 105, 106, 254, 255
Smith Kline Beecham, 585
Smokeless tobacco products, 83, 85, 92–95, 99, 101, 149, 167, 255, 426–429, 563, 598, 600
see also Chewing tobacco;
Snuff
addiction, 266
additives, 299–300
adolescents, 302
advertising, 93
cancer, 4, 93, 300–301, 426–429
epidemiology, 301
international perspectives, 93, 300, 426–428
snus, 4, 14, 167, 204, 270, 300, 301, 302, 427, 428, 434
nitrosamines
research recommendations, 301–302
toxicology, 299–302
use surveys, 321
Smoking machines (Federal Trade Commission), 2, 3, 26–27, 87–88, 90, 210–211, 226, 283–284, 317–319, 350, 352, 373, 380, 395, 404
Smoking topography, 151, 182, 322, 323, 349, 352, 399, 405, 406, 407–408, 437
see also Inhalation depth and topography
compensatory smoking, 2, 26, 67, 88, 121, 164, 219, 266, 285, 322, 380, 402, 403, 405, 477, 517
Snuff, 83–84, 92–93, 100, 300, 301, 427, 593
DNA adducts, 332
snus, 4, 14, 167, 204, 270, 300, 301, 302, 427, 428, 434
Socioeconomic factors
asthma, 519
educational attainment, 390, 425, 530, 543, 547, 564
Spontaneous abortions, 11, 24, 268, 545, 554, 596
Sprays,
see Oral/nasal sprays
Sputum, 12, 193–194, 313, 353–354, 391, 435, 437, 503, 505, 514, 515
Standards, 11, 17, 30–31, 209, 225–226
see also Definitional issues;
Regulatory issues
addiction, 255, 257–262 (passim), 265
additives, 224–225
biomarkers, 348–349
Diagnostic and Statistical Manual of Mental Disorders (DSM), 255, 257, 258–259, 260–262
International Diagnostic Code, 257, 258–259
International Standards Organization, 87, 283
pregnant women, clinical guidelines, 172
risk thresholds, 9, 164, 167, 222–224, 225–226, 431, 439, 480, 481, 487
smoke yields, 87–88, 210–212, 283–284
smoking machines, 2, 3, 26–27, 87–88, 90, 210–211, 226, 283–284, 317–319, 350, 352, 373, 380, 395, 404
tobacco industry regulation, 128, 204
Star Scientific (Star Tobacco), 91–92, 585, 603, 604
Stroke, 24, 168, 470, 473, 476, 487, 489, 600
Sudden infant death syndrome, 173, 268, 543, 546, 549, 552, 596
Surgeon General, 21–26 (passim), 69, 125, 379, 380–381, 513, 595–603 (passim)
Surgery, 438
inflammatory bowel disease, 561–562
lung cancer, 395
Surgical wounds,
see Wound healing
Surrogate markers, 6, 11–12, 16, 31, 147, 153, 235, 270, 310, 314, 335, 339
cancer, 166, 327, 330, 435–436
cardiovascular disease, 168, 483–486, 490
nonneoplastic respiratory disease, 507, 512
regulatory issues, 220
Surveillance, 10, 17, 176, 180–200, 203, 208, 232, 573, 574
see also Centers for Disease Control and Prevention;
Epidemiology
age factors, 185, 186, 191, 192, 194, 321
attitudes and beliefs, 8, 10, 185–188 (passim), 192, 196, 197
behavioral effects of smoking, 183, 185–188, 191–192, 195, 197
carbon monoxide, 184
clinical research and, 183, 193, 197
dependence potential, 269
environmental tobacco smoke (ETS), 194
FDA, 181
Federal Trade Commission (FTC), 183, 184, 189, 190
gender factors, 187
national surveillance system, general, 8, 181, 207
postmarket surveillance, x, 182, 184, 189, 190, 203, 207, 208, 213, 221–222, 270
PREPs, x, xi, 7–8, 10, 13–14, 147, 162, 176, 181, 182, 183, 185, 189, 203, 208, 221–222, 225, 236, 237, 238, 269, 270, 573, 574
regulatory issues, 183, 184, 188, 189, 190, 197, 203, 204, 208, 221–222, 225
yield assessments, 182, 183, 184
Sweden, 4, 14, 93, 167, 204, 270, 300, 301, 302, 427, 428, 434, 548
Synergistic effects, 298, 342, 378, 387, 390, 570
see also Air pollutants
alcohol and tobacco, 342, 415–416, 418, 426, 428
asbestos, 89, 298, 408, 501, 599
bladder cancer, 420
chronic obstructive pulmonary disease (COPD), 508–509
cardiovascular disease, 477–478
drug interactions, 122, 269, 570
lung cancer, 408–409
oropharyngeal disease, 415–416, 418
pregnancy, 545
T
Tar, 2, 11, 24, 26, 66, 67, 70–71, 184, 584
see also Filters;
Low-yield products;
Potential reduced-exposure products (PREPs);
Ventilation
carcinogenesis, 373–374, 399–404, 407
cigarette-like products, 94
public understanding of content, 60
yield assessment, 87, 90, 91, 92, 94, 184, 210, 211–212, 317–319, 373–374, 399–401, 407
Taxation, 119, 128, 202, 596, 603
T cells,
see Lymphocytes
Technological innovations
see Drug treatments;
Filters;
Fire-safe cigarettes;
Modified tobacco products;
Potential reduced-exposure products (PREPs);
Ventilation
FTC smoking machine, 2, 3, 26–27, 87–88, 90, 210–211, 226, 283–284, 317–319, 350, 352, 373, 380, 395, 404
processing of tobacco, 66
Teenagers,
see Adolescents
Temperature factors, viii, 95, 210, 284
definition of cigarette, 27
Teratogenic effects, 545, 554–555
Thrombosis, 154, 157, 336–337, 339, 356, 481, 485–486, 491, 493
Time factors
addiction, 255–256, 260, 262, 263–264
adverse effects of treatment, 121
behavioral treatments, 117–118
biomarkers, half-life, 152, 154, 156, 157, 158, 250, 297, 316, 323, 324, 328, 333, 376, 422
burn rate, 87
chronic obstructive pulmonary (COPD), 503, 511–512
committee charge, 4
dose-response assessment, 140, 141
duration of smoking, lifetime, 67, 76, 151, 168, 390, 395, 396–397, 401, 402, 404, 419, 420, 471, 493, 508, 566, 572
duration of smoking cessation, 75, 115, 186, 409–415, 419, 438, 470, 473, 475, 476, 487, 490, 562
see also Relapse
exposure-to-adverse effect, ix, 140, 145, 166, 511, 530
FDA approval for medical devices, 124
legislation, 221
nicotine pharmacology, 246, 250, 251, 255–256
nicotine replacement drugs,
blood concentrations, 99–101, 103
FDA approval, 123
population surveys, 320
PREP evaluation, 5, 141, 146, 147, 232, 320
reproductive effects,
time to conception, 544
withdrawal symptoms, 255
wound healing, 174, 175, 194, 561, 573
Tobacco Testing Laboratory, 600
Toxicology, 26–28, 34, 121, 129, 147–148, 283–308, 553, 583
see also Animal models;
Biomarkers;
Carbon monoxide;
Dose-response relationship;
Exposure;
Synergistic effects;
Tar;
Yield assessment
advertising and, 66
asbestos, 89, 298, 408, 501, 599
cyanide, 72, 89, 291, 324–325, 401, 549, 561, 572
environmental tobacco smoke, 283, 285, 287, 289–290
genetic susceptibilities, ix, 6, 13, 145, 153, 164, 166, 192, 233, 344–347, 390, 408–409, 416, 429, 436, 478, 490, 508
nicotine-derived, 28–29, 86, 94–95, 111-112, 173–174, 207, 270, 429–430, 554
reproductive and developmental effects, 172, 545, 550, 552, 554–555, 572
PREP risk assessment, 144, 145, 147–150, 204–205, 207, 208–209, 212–213, 228, 292, 302–303
processing of tobacco, 85, 128
regulatory issues, 9, 10–11, 128, 204–205, 207, 212–213, 222, 224–225, 228
research recommendations, 301–303
susceptibility to toxic effects, ix, 6, 13, 145, 153, 164, 166, 192, 233, 344–347
smoking machines, 2, 3, 26–27, 87–88, 90, 210–211, 226, 283–284, 317–319, 350, 352, 373, 380, 395, 404
Toxic Substances Control Act, 125
U
Ulcers,
see Peptic ulcers
Urine biomarkers, 12, 106, 109, 156, 157, 171, 190, 250, 252, 295, 312, 313, 314, 325, 326, 336–337, 339, 343, 346
cancer, 326, 353–354, 376, 378, 407, 420–421, 422, 424, 429, 435, 437
cardiovascular disease, 485, 486
environmental tobacco smoke, 323, 348
nonneoplastic respiratory diseases, 503, 506, 523, 524, 525, 529, 531
reproductive and developmental effects, 174, 545, 548, 553, 548
V
Vapors, 27, 87, 88, 92, 94, 148, 284, 374
Vascular activation, 12, 157, 169, 269, 337, 480, 490–491, 493
Vascular disease,
see Cardiovascular disease;
Extracardiac vascular disease
Ventilation
asthma, 522
chronic obstructive pulmonary (COPD), 503, 510
cigarette paper, 26, 71, 87, 88, 89, 90, 121, 211, 286, 287, 317, 380, 399, 595, 597
respiratory infections, 526
Visual impairments,
see Ocular disease
Vitamin C, 486
Volatile organic compounds, 89, 148, 374
W
Weight,
see Birthweight;
Body weight
White persons,
see Caucasians
drug treatments, 96, 101, 104–114 (passim), 123
nicotine pharmacology, 161, 244, 245, 254–260 (passim), 263–267 (passim)
Women,
see Gender factors
Women’s Health Study, 544
Workplace
occupational toxins, 33, 140, 151, 164, 166, 180, 195, 298, 329, 332, 350, 375, 377, 390, 408, 419, 420, 431, 433, 508, 599
smoking restrictions, 119–120, 422
World Bank, 23
World Health Organization, 23, 25, 258, 470
World Wide Web,
see Internet
Wound healing, 174, 175, 194, 561, 573
Y
Yield assessment, 70–71, 87–88, 90, 92, 234, 284
see also Low-yield products
carbon monoxide, 87, 88, 90, 92, 94, 95, 184, 210
nitrosamines, 376
particulates, 87
regulatory issues, 183, 184, 207–208, 210–212, 219
smoking machines, 2, 3, 26–27, 87–88, 90, 210–211, 226, 283–284, 317–319, 350, 352, 373, 380, 395, 404
tar, 87, 90, 91, 92, 94, 184, 210, 211–212, 317–319, 373–374, 399–401, 407
Youth Risk Behavior Survey, 93, 185–187, 261, 320–321
Z
see also Bupropion
