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Nearly all teens living in economically disadvantaged urban area exposed to tobacco smoke
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More than 90% of teenagers living in economically disadvantaged areas in and around San Francisco had 1-butanol urine screens that showed exposure to tobacco, according to findings recently published in Cancer, Epidemiology, Biomarkers and Prevention.
“Secondhand smoke exposure poses a signicant health risk to teenagers, particularly for respiratory problems and infections,” Neal Benowitz, MD, division of clinical pharmacology and experimental therapeutics at the University of California San Francisco, and colleagues wrote. “[Secondhand smoke] exposure also increases the likelihood of a nonsmoker becoming an active tobacco user.”
Researchers used receiver-operating characteristic and latent class analysis approaches to analyze 1-butanol levels of 466 adolescents’ urine who were pediatric well or urgent care patients at Zuckerburg San Francisco General Hospital during parts of 2013 and 2014. The level of 1-butanol was used to distinguish active cigarette smoking from secondhand smoke.
Benowitz and colleagues found that 94% of teenagers had “measurable levels” of 1-butanol. Cotinine levels from an earlier study were compared to the 1-butanol levels in the new study. Though the substances were strongly correlated, researchers wrote the correlation slopes were not the same for active vs. secondhand smoke-exposed teenagers. In addition, among nonsmokers, 1-butanol levels were signicantly higher in African-Americans (median, 3.3 pg/mL) vs. other ethnic groups (0.9–1.9 pg/mL).
Researchers wrote their results could be attributable to 1-butanol exposure for longer periods of time and thus would be suspected of being more sensitive to periodic exposure or because of changes in test sensitivity to a certain level of exposure.
“We suggest that routine biochemical screening be considered to identify and reduce exposure of such individuals,” researchers concluded. “Our data indicate that either cotinine or [1-butanol] would be suitable analytes for biochemical screening, although [1-butanol] would detect more exposed adolescents.” - by Janel Miller
Disclosure: Benowitz reports being a consultant/advisory board member for Pfizer, and has served as a paid expert witness in litigation against tobacco companies. No other relevant financial disclosures were reported.
Perspective
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Camille Ragin, PhD, MPH
This is a very important study. 4-(methylnitrosamino)-1-(3) pyridyl-1-butanol is indeed a biomarker that is sensitive enough to detect tobacco exposure in smokers and in secondhand smokers. Most importantly it is a specific tobacco metabolite, in that it is not a dietary component and is only found in the environment when there is tobacco smoke present. Tobacco is the highest contributor to cancer incidence. Furthermore, the incidences of many cancers is highest among African Americans compared with other racial groups. Higher levels of 1-butanol among African American adolescents and, more-so, African American nonsmokers reported in this study is striking. This aligns with the work that we are doing here at Fox Chase Cancer Center.
The findings from this study supports the need for further research in this area, as well as more focused attention to the implementation of public health initiatives to reduce tobacco exposure in African Americans.
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