{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:26:29Z","timestamp":1790313989438,"version":"4.1.0"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T00:00:00Z","timestamp":1746576000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010628","name":"Center for Tobacco Products","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010628","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Cancer survivors who continue to use tobacco products may have negative impacts on their long-term health outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims and Methods<\/jats:title>\n                    <jats:p>Data were drawn from the Population Assessment of Tobacco and Health Study Wave 5 (n\u2005=\u20056946). Geometric mean concentrations of biomarkers from four classes of harmful and potentially harmful constituents, along with a biomarker of oxidative stress, were compared between cancer survivors and non-cancer adults using weighted linear regressions adjusted for demographic factors. Among cancer survivors, comparisons were also made across current cigarette smoking and e-cigarette use statuses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared to non-cancer adults (n\u2005=\u20056441), cancer survivors (n\u2005=\u2005505) exhibited higher mean concentrations of 4-(methylnitrosoamino)-1-(3-pyridyl)-1-butanol (NNAL, 10.9 vs. 6.7 pg\/mg creatinine), cadmium (0.3 vs. 0.2\u00a0ng\/mg creatinine), lead (0.4 vs. 0.3\u00a0ng\/mg creatinine), n-Acetyl-s-(2-carboxyethyl)-l-cysteine (CEMA, 156.6 vs. 128.3\u00a0ng\/mg creatinine), and 8-isoprostane (521.6 vs. 441.5 pg\/mg creatinine) in the unadjusted analyses. Among cancer survivors, both exclusive cigarette smokers and dual users had higher mean concentrations of urine nicotine metabolites (ie, nicotine equivalents [TNE2], and cotinine), NNAL, cadmium, volatile organic compounds, and 8-isoprostane than non-tobacco users. Exclusive e-cigarette users also had higher mean concentrations of nicotine metabolites (TNE2, 4.1 vs. 0.01, p\u2005&amp;lt;\u2005.0001; cotinine, 288.1 vs. 0.4, p\u2005&amp;lt;\u2005.0001), NNAL (5.6 vs. 1.7, p\u2005=\u2005.03), cadmium (0.4 vs. 0.3, p\u2005=\u2005.01), and 8-isoprostane (594.2 vs. 482.5, p\u2005=\u2005.03) than non-tobacco users.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both exclusive smoking and dual-use pose elevated risks of exposure to tobacco-related toxicants to cancer survivors. Exclusive e-cigarette use also increases the risk of nicotine addiction and oxidative stress. Abstinence from all tobacco use among cancer survivors is needed to improve health outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications<\/jats:title>\n                    <jats:p>Cancer survivors represent a high-risk group for tobacco use. This study offers important insights into differences in biomarkers of tobacco-related toxicant exposure between cancer survivors and non-cancer adults and provides evidence of the health impacts associated with cigarette smoking and e-cigarette use. The findings emphasize the need for clinical monitoring and targeted public health interventions to encourage tobacco cessation, including addressing dual-use of cigarettes and e-cigarettes, in order to enhance long-term health outcomes and quality of life for cancer survivors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ntr\/ntaf099","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T08:51:34Z","timestamp":1746175894000},"page":"404-411","source":"Crossref","is-referenced-by-count":2,"title":["Biomarkers of Exposure to Tobacco-Related Toxicants and Oxidative Stress Among Cancer Survivors"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1395-7904","authenticated-orcid":false,"given":"Hongying Daisy","family":"Dai","sequence":"first","affiliation":[{"name":"Department of Biostatistics, College of Public Health, University of Nebraska Medical Center , Omaha, NE ,","place":["USA"]},{"name":"Department 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