Clearing the Smoke Assessing the Science Base for Tobacco Harm Reduction (2001) / Chapter Skim
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From page 607... ...
, 263267 (passim) Additives, 82, 86, 90-91, 432, 571, 598, 601 advertising, 72, 73-74 animal models, 90-91, 149 blending processes, viii, 26, 82, 85, 87, 94, 128, 209, 287 FDA regulation, 128, 224 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, 224225 risk perception, 72-74, 77 smokeless tobacco, 299-300 surveillance, 189, 196 Adolescents, 67, 235, 320-321, 602 see also Schools addiction, 261 drug treatments, 112,116
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From page 608... ...
, 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 AIDS, 23, 44, 45, 48, 52, 53 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)
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From page 609... ...
, 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, 124125, 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, 4144, 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, 398399, 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 PREPs, 7, 73-76, 185, 197, 315 surveillance, 183, 185-188, 191-192, 195, 197
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From page 610... ...
, 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, 163164, 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, 163164, 309, 323, 349, 350, 351-352, 388, 396, 431, 435, 437 lipids, 12, 154, 169, 243, 253, 314, 330331, 336-337, 343, 378-379, 471, 479, 482, 485, 486, 491492 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, 170171, 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, 483486, 490, 491, 492, 493, 561 PREP risk assessment, 142, 144, 145, 150-161, 162-163, 165, 237, 309317, 323-352, 388, 435436, 553
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From page 611... ...
pyrene (BaP) , 86, 87, 94,148, 319, 373-374, 375-376, 380, 391392, 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)
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From page 612... ...
, 399, 405, 409, 417, 420424 (passim) , 429, 435, 492 cotinine, 407, 422, 424, 429 serum, 333, 422 surrogate markers, 166, 327, 330, 435436 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 breast, 385, 395, 598 bronchial, 285, 298, 375, 376, 391, 392, 393, 437, 518 carbon monoxide, 294, 407 cervical, 24 clinical research, 165, 383, 414, 433, 437 cohort studies, 377, 395, 396-397, 400403, 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 endometrial, 368, 421-422 environmental tobacco smoke, 53, 390, 396, 398, 408, 422424, 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, 420421 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, 399400, 402-404, 405, 416, 419420, 431 gender factors, 389, 416, 418, 419, 421, 424, 426, 436 breast, 385, 395, 598 endometrial, 368, 421-422 lung, 24, 401, 402-403, 404406, 410, 411, 412, 413, 598, 599 head and neck, 195, 301, 372, 427, 428 historical perspectives, 21-26 (passim)
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From page 613... ...
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 cancer, 294, 407 cardiovascular disease, 168, 481, 487 cigarette-like products, 94, 95 613 drug treatments and reduction of, 110, 113, 114 regulatory issues, 210, 218 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, 470499 see also Blood pressure; Extracardiac vascular disease age factors, 472, 473, 474475, 482 aneurysms, 470, 481, 491 animal models, 149, 479, 486 atherosclerosis, 157, 162, 169, 253, 270, 296, 313, 332, 339, 343, 471, 472, 476-477, 479-483 (passim)
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From page 614... ...
, 207, 221 smokeless tobacco, 93 surveillance, general, 180, 184, 185 Youth Risk Behavior Survey, 93, 185187, 261, 320-321 Cerebrovascular disease, see Stroke INDEX Cessation programs, vii, x, 24, 41, 116-119, 352 see also Behavioral treatments; Chewing gum; Drug treatments Oral/ nasal sprays; Patches; Psychotrophic drugs; Schoolbased 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 Nicorete, 97, 123, 129 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)
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From page 615... ...
INDEX bronchitis, 21, 295, 338, 502, 503, 505, 510, 525, 529, 551 clinical studies, 13,171 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 time factors, 503, 511-512 ventilation, 503, 510 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 addiction, 263, 264-266 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, 101103, 113-115, 533 nonneoplastic respiratory disease, 13, 171, 511-512, 514, 518, 522, 523525, 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 Clonidine, 4, 108-109, 124 Coalition on Smoking and Health, 126 Cognitive effects aging, 162 dementia, 174, 254, 564-565 developmental disorders, 268, 550-551 memory, 254, 319, 564 nicotine, 254, 255, 259, 270, 564 615 Cohort studies, 174, 193, 196, 437-438, 482, 548, 567 biomarkers, 352-353, 354, 438 bladder cancer, 377, 420 chronic obstructive pulmonary disease (COPD) , 511 diabetes, 567 lung cancer, 395, 396-397, 400403, 405, 411413 pregnant women, 173, 547 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 oral, 477, 481, 544, 597 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 funding, 49, 215, 218, 229
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, 255, 257, 258-259, 260-262 exposure, 1, 27-28, 311 harm reduction, 2, 25, 3840 hazard identification, 33-34 mutagen, 368 nicotine, 27, 126 PREPs, 3, 28, 205 regulatory, 11, 27-28, 30, 124, 126, 205, 225-226 safer cigarette, 2, 25 surveillance, 180, 181, 194 tobacco constituent, 368 INDEX Dementia, 174 Alzheimer's disease, 254, 564-565 Demographic factors, see Age factors; Educational attainment; Gender factors; Military personnel; Race/ethnicity; Socioeconomic status Department of Justice, 603 Depression, 104, 174, 186, 256-257, 347, 568569 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 Diabetes, 174, 482, 548, 567 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, 342343, 344-347, 353, 368-370, 372, 384, 385, 486, 492 adducts, 153, 292, 293, 313, 314, 327-335 (passim)
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From page 617... ...
, 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
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From page 618... ...
, 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 bronchial, 298, 375, 376, 393 cancer, 375, 376, 393, 394, 416, 420421 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 Estrogen, 346, 405, 422, 566 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)
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From page 619... ...
INDEX internal exposure, 150, 151, 160, 163164, 309, 323, 349, 350, 351, 388, 396, 431, 435, 437 cancer risk, 383-384, 390, 395-397, 398399, 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, 398399, 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 Fagerstrom 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, 125 619 Federal government see also Legislation; Regulatory issues; specific departments and agencies funding, 49, 215, 218, 229 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 marketing, 61, 211, 213 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 Fertility, 173, 544-545 Fetal lung development, 149, 298, 511, 551 FEV, see Forced expiratory volume Fibers, 89, 94, 165, 189, 225 Fibroblasts, 561, 563 Filters, 2, 26, 52, 56, 60, 64, 82, 88, 89-90, 91, 92, 121 see also Ventilation cancer risk, 91, 164, 332, 399400, 402404, 405, 416, 419420, 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, 399400, 402404 surveillance, 183, 189 toxicological measures, 284, 287 ventilation, 26, 71, 87, 88, 89, 90, 121, 211, 286, 287, 317, 380, 399, 597 Fires, vii, 570-571 Fire Safe Act, 87, 571 Fire-safe cigarettes, 87, 571, 604 Food and Drug Administration (FDA)
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From page 620... ...
, 424, 544, 545, 548, 551, 599 inflammatory bowel disease, 561-562 low-yield products, 74, 404405 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, 404406, 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
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From page 621... ...
, 152, 313, 314, 334, 340, 342, 391, 393, 414415, 419, 435 Hispanics, 321, 406, 543, 603 Historical perspectives, vii, 1, 2, 21-22, 23, 26-27, 60-81, 89-91, 573, 593-605 alcohol abuse reduction, 47 asthma, 519, 520, 521 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 label warnings, 219, 595, 599 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)
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From page 622... ...
, 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, 426428 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
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From page 623... ...
INDEX 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 Japan, 88-89, 261, 286, 342, 409 K Kidneys, see Renal disease Kreteks, 83, 321 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, 595 623 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 surveillance, 188, 197 tobacco products regulation, committee recommendation, 204, 205 Toxic Substances Control Act, 125 see also Regulatory issues Leptin, 268, 378-379 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, 491492 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)
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From page 624... ...
; Technological innovation committee charge and methodology, 34, 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, 491492 oropharyngeal disease, 417 proteomics, 12-13, 152, 314, 334, 353, 389, 492 Monitoring the Future, 185-187, 320-321 Mortality, 201, 434, 595, 598 auto accidents, 42, 43 bladder cancer, 418, 419 cancer, 392, 398, 400, 411414, 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
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From page 625... ...
, 155, 336, 341-342, 343, 371372, 375, 376, 391-392, 393-394, 405, 409, 415, 417, 418419, 420, 421, 428-429, 435 N Naloxone, 108 Naltrexone, 108 Nasal sprays, see Oral/nasal sprays National Cancer Institute, 185, 211, 596 625 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, 185187, 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 dementia, 174, 254, 564-565 depression, 104, 174, 186, 256-257, 347, 568-569 antidepressants, 105-106, 115-116, 254, 256, 570 Parkinson's disease, 162, 270, 347, 571572 schizophrenia, 162, 174, 244, 257, 268269, 347, 568 Neurotransmitters, 105, 134, 161, 244, 245, 255, 256, 519, 550-551, 571 see also Receptors acetylcholine (Ach)
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From page 626... ...
, 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 definitional issues, 27, 126 dementia, 564 gender factors, 74 marketing factors, 61 mecamylamine, 107, 124, 266 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 receptors, 550, 564, 568 drug treatments, 97, 103, 105, 106107, 110 genetic predisposition to smoking, 347-348 pharmacology, 161, 245, 252, 254, 255, 257 reproductive and developmental effects, 172, 545, 550, 552, 554555, 572 smoker knowledge of, 72-73 surveillance, 184, 189 yield assessment, 88, 90, 184, 207, 210, 211-212, 317-319, 373 INDEX 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 risk perception, 110-111, 112 time factors, blood concentrations, 99-101, 103 FDA approval, 123 long-term use, 115, 121 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, 376377, 379, 380, 403, 405, 429430, 603, 604 environmental tobacco smoke, 424 racial/ethnic differences, 406, 407 smokeless tobacco, 4, 93, 428, 429 Nonneoplastic respiratory diseases, 170171, 500-542 see also Chronic obstructive pulmonary disease asthma, 170, 500-501, 518-525, 527, 530531, 551 biomarkers, general, 170-171, 501-503, 506, 507, 512, 517, 527, 531, 532 urine, 503, 506, 523, 524, 525, 529, 531
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From page 627... ...
, 500, 509-511, 521-522,528-530,531, 551 genetic factors, 170, 501-502 historical perspectives, 500, 506, 598, 599 immune system, 526, 527 incidence, 500, 518, 519, 526 infections, 170, 296, 297, 354, 500-501, 502, 506, 508, 516, 525-530, 532, 546, 547 children, 501, 506, 526, 528-529, 551 influenza, 297, 502, 526, 530 pneumonia, 501, 502, 526, 527-528, 529, 530, 551 surrogate markers, 507, 512 tuberculosis, 501, 526, 528 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, 427429, 597 gingivitis, 563-564 gum bleeding, 156, 338, 563 oral clefts, 549-550 Orthopedic effects, 565 osteoporosis, 158, 174, 176, 193, 338-339, 565, 574 627 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 cigarette defined, 82, 83 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 alcohol, 253, 570 animal models, 244, 253, 258, 268 cardiovascular effects, 471 cotinine, 248, 249, 250, 265 historical perspectives, 243, 593-595, 597 regulatory issues, 126, 127
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From page 628... ...
, 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, 221222, 270 pregnant women, 173-174, 552-553, 554555 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)
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From page 629... ...
, 112, 116, 172-173, 267, 552-553, 554-555 placental complications, 268, 545-547, 552 preeclampsia, 268, 560, 572 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, 596 629 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 Premier, 4, 93, 94, 600 PREPs, see Potential reduced-exposure products President's Cancer Committee, 211 Prevalence, 195, 262, 594, 603 see also Incidence adolescents, 1, 22, 38, 319 birthweight, low, 11, 23, 24, 149, 172, 173-174, 188, 193, 212, 267, 340341, 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, 9091, 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 addiction, 41, 118, 161, 254, 256-257, 259
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From page 630... ...
630 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 cancer, 406-408, 416, 436 dementia, 564 dose-response relationship, 164, 407 metabolic processes, 250, 270-271, 389 nitrosamines, 406, 407 oropharyngeal disease, 416 pregnant smokers, 543, 553 prevalence of smoking, 22, 24 Surgeon General's reports, 24, 125, 603 Radon, 195, 298, 408 Receptors, 108, 244, 482, 485486, 550-551, 564, 568 see also Neurotransmitters INDEX dopamine, 256, 266, 347-348 estrogen, 394, 405 nicotinic, 550, 564, 568 drug treatments, 97, 103, 105, 106107, 110 genetic predispositions for smoking, 347-348 pharmacology, 161, 245, 252, 254, 255, 257 progesterone, 405 Red Book, 14, 15, 33, 34, 141 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, 224225 advertising, 7, 10, 120, 125-126, 127, 128, 141, 203, 206, 207, 208, 211, 216221, 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 carbon monoxide, 210, 218 carcinogens, 10, 208, 215 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, 209229 (passim) , 234-235 definitional issues, 11, 27-28, 30, 124, 126, 205, 225-226 enforcement, 11, 30, 40, 4344, 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 filters, 128, 210, 225 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, 221222, 270
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From page 631... ...
, 544, 545, 548, 549, 551 fertility, 173, 267, 544-545 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 surveillance, 187-188, 193 teratogenic, 545, 554-555 Research methodology, 55-56, 121-122, 438439 see also Animal models; Biomarkers: Clinical research; Cohort studies; Epidemiology; Internet; In vitro assays; Surveillance addiction measures/models, 257-267 asthma studies, 520, 521 carcinogenesis, 378, 379-394, 410, 434439 committee study at hand, 3-5, 16, 31-35, 142 dementia, 564-565 exposure, 309-366 see also "smoke yields" infra
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From page 632... ...
, 156, 171, 338, 343, 503, 506, 508-509, 514-515, 516, 520, 523, 532-533 gender factors, 416, 520 chronic obstructive pulmonary (COPD) , 500, 509, 512, 514, 515, 516 INDEX lung cancer, 24, 401, 402-403, 404406, 410, 411, 412, 413, 598, 599 inflammation, 12, 13, 95, 113, 149, 156, 170-171, 295, 298, 302, 338, 343344, 395, 502, 505, 506, 507, 516518, 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, 399400, 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, 408409, 416, 429, 436, 478, 490, 508 low-yield products, 143, 145, 164, 399400 modified tobacco products, viii pharmacology, 161-163 PREPs, 140-179 (passim)
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From page 633... ...
, 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, 407408, 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 lung cancer, 407, 414 pregnant smokers, 543, 547 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
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From page 634... ...
, 183, 184, 189, 190 filters, 183, 189 gender factors, 187 national surveillance system, general, 8, 181, 207 pregnant women, 174, 553 postmarket surveillance, x, 182, 184, 189, 190, 203, 207, 208, 213, 221222, 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 time factors, 181, 194 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, 415416, 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)
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From page 635... ...
, 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, 255-256 635 nicotine replacement drugs, blood concentrations, 99-101, 103 FDA approval, 123 long-term use, 115, 121 population surveys, 320 PREP evaluation, 5, 141, 146, 147, 232, 320 reproductive effects, time to conception, 544 surveillance, 181, 194 thrombosis bleeding, 154, 336 withdrawal symptoms, 255 wound healing, 174, 175, 194, 561, 573 Tobacco Testing Laboratory, 600 Toluene, 89, 148, 290, 374 Toxicology, 26-28, 34, 121, 129, 147-148, 283-308, 553, 583 see also Animal models; Biomarkers; Carbon monoxide; Doseresponse relationship; Exposure; Synergistic effects; Tar; Yield assessment advertising and, 66 arsenic, 72, 148, 184, 374 asbestos, 89, 298, 408, 501, 599 cyanide, 72, 89, 291, 324-325, 401, 549, 561, 572 environmental tobacco smoke, 283, 285, 287, 289-290 filters, 284, 287 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, 111112, 173-174, 207, 270, 429430, 554 reproductive and developmental effects, 172, 545, 550, 552, 554555, 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 smoker knowledge of, 72-73, 77
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From page 636... ...
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 a' 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, 210212, 219 smoking machines, 2, 3, 26-27, 87-88, 90, 210-211, 226, 283-284, 317-319, 350, 352, 373, 380, 395, 404 surveillance, 182,183, 184 tar, 87, 90, 91, 92, 94, 184,210,211-212, 317-319, 373-374, 399401, 407 Youth Risk Behavior Survey, 93, 185-187, 261, 320-321 z Zyban, 30,104, 123-124 see also Bupropion
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