Determination of carcinogenic tobacco-specific nitrosamines in mainstream smoke from US-brand and non-US-brand cigarettes from 14 countries

Tobacco-specific nitrosamines (TSNAs) comprise one of the major classes of carcinogenic compounds in mainstream cigarette smoke. As part of collaborative efforts between the World Health Organization and the U.S. Centers for Disease Control and Prevention (CDC) to reduce tobacco use and resulting disease, the CDC examined carcinogenic TSNA levels from cigarettes obtained from selected countries around the world. Using a modern, high-throughput liquid chromatography/mass spectrometry/mass spectrometry method under stringent quality control protocols, we determined the carcinogenic TSNA levels in mainstream smoke from a globally marketed brand, Marlboro, and from local top-selling cigarette brands from 14 countries. The levels of carcinogenic TSNAs in mainstream smoke collected using a 35-ml puff volume, 60-s puff interval, and 2-s puff duration correlated well (R=0.79, p <.0001) with previously reported levels in the corresponding tobacco filler. Marlboro cigarettes purchased in 10 countries had significantly higher carcinogenic TSNA levels in mainstream smoke than did local-brand cigarettes from the same country. In only one country, Brazil, were the carcinogenic TSNA levels in mainstream smoke from Marlboro cigarettes significantly lower than in the locally popular brand. However, carcinogenic TSNA levels in mainstream smoke from Brazilian Marlboro cigarettes were usually lower than those in mainstream smoke from the Marlboros purchased in the other 13 countries, suggesting a reason for the difference. The wide range of mainstream smoke carcinogenic TSNA levels measured in the present study (8.7-312ng/cigarette) suggest that manufacturers can lower the carcinogenic TSNA levels and that, for similar filter ventilation, carcinogenic TSNA levels in the tobacco filler of a cigarette are a useful indicator of the corresponding levels in mainstream smoke.