{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T09:40:35Z","timestamp":1774777235281,"version":"3.50.1"},"reference-count":48,"publisher":"BMJ","issue":"3","funder":[{"name":"National Institutes of Health and the FDA Center for Tobacco Products"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,2,19]]},"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Tobacco use leads to increased mortality, the majority of which is attributed to cardiovascular disease. Despite this knowledge, the early cardiovascular impact of tobacco product use is not well understood. Tobacco use increases exposure to harmful and potentially harmful constituents including volatile organic compounds (VOCs) such as acrolein and crotonaldehyde, which may contribute to cardiovascular risk. The link between exposure patterns, risk profiles and demographic distribution of tobacco product users, particularly users of new and emerging products, are not well known. Therefore, we designed the Cardiovascular Injury due to Tobacco Use (CITU) study to assess population characteristics, demographic features, exposure patterns and cardiovascular risk in relation to tobacco.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>We present the design and methodology of the CITU study, a cross-sectional observational tobacco study conducted in Boston, Massachusetts and Louisville, Kentucky starting in 2014. Healthy participants 21\u201345 years of age who use tobacco products, including electronic nicotine devices, or who never used tobacco are being recruited. The study aims to recruit an evenly split cohort of African-Americans and Caucasians, that is, sex balanced for evaluation of self-reported tobacco exposure, VOC exposure and tobacco-induced injury profiling. Detailed information about participant\u2019s demographics, health status and lifestyle is also collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study protocol was approved institutional review boards at both participating universities. All study protocols will protect participant confidentiality. Results from the study will be disseminated via peer-reviewed journals and presented at scientific conferences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-019850","type":"journal-article","created":{"date-parts":[[2018,3,30]],"date-time":"2018-03-30T09:25:33Z","timestamp":1522401933000},"page":"e019850","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Protocol to assess the impact of tobacco-induced volatile organic compounds on cardiovascular risk in a cross- sectional cohort: Cardiovascular Injury due to Tobacco Use study"],"prefix":"10.1136","volume":"8","author":[{"given":"Rachel J","family":"Keith","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA"},{"name":"American Heart Association Tobacco Regulation and Addiction Center, University of Louisville"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica L","family":"Fetterman","sequence":"additional","affiliation":[{"name":"Vascular Biology Section, Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts, USA"},{"name":"American Heart Association Tobacco Regulation and Addiction Center, Boston University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel W","family":"Riggs","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA"},{"name":"American Heart Association Tobacco Regulation and Addiction Center, University of Louisville"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy","family":"O\u2019Toole","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA"},{"name":"American Heart Association Tobacco Regulation and Addiction Center, University of Louisville"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica L","family":"Nystoriak","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA"},{"name":"American Heart Association Tobacco Regulation and Addiction Center, University of Louisville"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika","family":"Holbrook","sequence":"additional","affiliation":[{"name":"Vascular Biology Section, Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts, USA"},{"name":"American Heart Association Tobacco Regulation and Addiction Center, Boston University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pawel","family":"Lorkiewicz","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA"},{"name":"American Heart Association Tobacco Regulation and Addiction Center, University of Louisville"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aruni","family":"Bhatnagar","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA"},{"name":"American Heart Association Tobacco Regulation and Addiction Center, University of Louisville"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew P","family":"DeFilippis","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA"},{"name":"American Heart Association Tobacco Regulation and Addiction Center, University of Louisville"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naomi M","family":"Hamburg","sequence":"additional","affiliation":[{"name":"Vascular Biology Section, Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts, USA"},{"name":"American Heart Association Tobacco Regulation and Addiction Center, Boston University"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,3,30]]},"reference":[{"key":"2025121515211154000_8.3.e019850.1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/nts120"},{"key":"2025121515211154000_8.3.e019850.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.07.037"},{"key":"2025121515211154000_8.3.e019850.3","doi-asserted-by":"publisher","DOI":"10.1021\/tx200536w"},{"key":"2025121515211154000_8.3.e019850.4","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4612-2550-8_2"},{"key":"2025121515211154000_8.3.e019850.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.chroma.2003.08.104"},{"key":"2025121515211154000_8.3.e019850.6","doi-asserted-by":"publisher","DOI":"10.1080\/14622200802443544"},{"key":"2025121515211154000_8.3.e019850.7","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.taap.2006.08.008","article-title":"Acrolein induces vasodilatation of rodent mesenteric bed via an EDHF-dependent mechanism","volume":"217","author":"Awe","year":"2006","journal-title":"Toxicol Appl Pharmacol"},{"key":"2025121515211154000_8.3.e019850.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.taap.2009.12.010"},{"key":"2025121515211154000_8.3.e019850.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.taap.2006.09.009"},{"key":"2025121515211154000_8.3.e019850.10","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00867.2008"},{"key":"2025121515211154000_8.3.e019850.11","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00120.2011"},{"key":"2025121515211154000_8.3.e019850.12","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.110.222679"},{"key":"2025121515211154000_8.3.e019850.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.taap.2009.01.024"},{"key":"2025121515211154000_8.3.e019850.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.taap.2010.07.013"},{"key":"2025121515211154000_8.3.e019850.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2011.01.001"},{"key":"2025121515211154000_8.3.e019850.16","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00269.2003"},{"key":"2025121515211154000_8.3.e019850.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.yjmcc.2008.03.020"},{"key":"2025121515211154000_8.3.e019850.18","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.111.227124"},{"key":"2025121515211154000_8.3.e019850.19","unstructured":"WHO study group on tobacco product regulation. Report on the scientific basic of tobacco product regulation: fourth report of a WHO study group. World Health Organ Tech Rep Ser 2012:1\u201383."},{"key":"2025121515211154000_8.3.e019850.20","unstructured":"De Woskin R , Greenberg M , Pepelko W , et al . Toxicological review of acrolein (cas no. 107-02-08) in support of summary information on the integrated risk information system (Iris). Washington, DC: US Environmental Protection Agency, 2003."},{"key":"2025121515211154000_8.3.e019850.21","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntu078"},{"key":"2025121515211154000_8.3.e019850.22","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2012-050859"},{"key":"2025121515211154000_8.3.e019850.23","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0169811","article-title":"A device-independent evaluation of carbonyl emissions from heated electronic cigarette solvents","volume":"12","author":"Wang","year":"2017","journal-title":"PLoS One"},{"key":"2025121515211154000_8.3.e019850.24","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa022287"},{"key":"2025121515211154000_8.3.e019850.25","unstructured":"Parsons VL , Moriarity C , Jonas K , et al . Design and estimation for the national health interview survey, 2006-2015. Vital Health Stat 2 2014:1\u201353."},{"issue":"Pt 1","key":"2025121515211154000_8.3.e019850.26","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1016\/j.envpol.2017.08.065","article-title":"Evaluation of VOC concentrations in indoor and outdoor microenvironments at near-road schools","volume":"231","author":"Raysoni","year":"2017","journal-title":"Environ Pollut"},{"key":"2025121515211154000_8.3.e019850.27","doi-asserted-by":"crossref","first-page":"376","DOI":"10.3390\/ijerph13040376","article-title":"Assessment of exposure to VOCs among Pregnant Women in the National Children\u2019s Study","volume":"13","author":"Boyle","year":"2016","journal-title":"Int J Environ Res Public Health"},{"key":"2025121515211154000_8.3.e019850.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.etap.2015.07.018"},{"key":"2025121515211154000_8.3.e019850.29","doi-asserted-by":"publisher","DOI":"10.1016\/j.etap.2013.03.001"},{"key":"2025121515211154000_8.3.e019850.30","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1993.27"},{"key":"2025121515211154000_8.3.e019850.31","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-05-0647"},{"key":"2025121515211154000_8.3.e019850.32","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.114.000934","article-title":"Acrolein exposure is associated with increased cardiovascular disease risk","volume":"3","author":"DeJarnett","year":"2014","journal-title":"J Am Heart Assoc"},{"key":"2025121515211154000_8.3.e019850.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.aca.2012.04.009"},{"key":"2025121515211154000_8.3.e019850.34","doi-asserted-by":"publisher","DOI":"10.1161\/hh1301.093953"},{"key":"2025121515211154000_8.3.e019850.35","doi-asserted-by":"publisher","DOI":"10.1161\/01.ATV.0000198239.41189.5d"},{"key":"2025121515211154000_8.3.e019850.36","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.115.305724"},{"key":"2025121515211154000_8.3.e019850.37","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1177\/000331979905000304","article-title":"Smoking is associated with dose-related increase of intima-media thickness and endothelial dysfunction","volume":"50","author":"Poredos","year":"1999","journal-title":"Angiology"},{"key":"2025121515211154000_8.3.e019850.38","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.01.040"},{"key":"2025121515211154000_8.3.e019850.39","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.093245"},{"key":"2025121515211154000_8.3.e019850.40","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000112565.60887.1E"},{"key":"2025121515211154000_8.3.e019850.41","doi-asserted-by":"publisher","DOI":"10.1016\/S0076-6879(02)59183-7"},{"key":"2025121515211154000_8.3.e019850.42","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.667733"},{"key":"2025121515211154000_8.3.e019850.43","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.104.2.151"},{"key":"2025121515211154000_8.3.e019850.44","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntr072"},{"key":"2025121515211154000_8.3.e019850.45","unstructured":"Schoenborn CA , Gindi RM . Electronic cigarette use among adults: United States, 2014. NCHS Data Brief 2015:1\u20138."},{"key":"2025121515211154000_8.3.e019850.46","doi-asserted-by":"publisher","DOI":"10.1080\/14622200500056259"},{"key":"2025121515211154000_8.3.e019850.47","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.94.2.269"},{"key":"2025121515211154000_8.3.e019850.48","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2004.025684"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-019850","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T23:21:20Z","timestamp":1765840880000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-019850"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3]]},"references-count":48,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2018,3,30]]},"published-print":{"date-parts":[[2018,3]]}},"alternative-id":["10.1136\/bmjopen-2017-019850"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-019850","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3]]}}}