Problems with the use of risk-assessment approaches to estimate differences in health risks from various smoking products

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John H. Lauterbach, john@lauterbachandassociates.com, Lauterbach & Associates, LLC, 211 Old Club Court, Macon, GA 31210-4708
Cigarette smoking has been associated with lung cancer, other cancers and nonneoplastic diseases of the pulmonary and cardiovascular systems. Toxicological risk assessment approaches have been used to identify the likely species in mainstream cigarette smoke (MSS) that cause neoplastic and nonneoplastic diseases (i.e., Fowles and Dybing, Tob. Control 2003;12:424-30) and have also been used to compare smoking products (i.e., Laugesen and Fowles, Tob. Control 2006;15:430-5; Pankow et al., Cancer Epidemiol. Biomarkers Prev. 2007;16:584-92). However, such approaches have used only commonly measured MSS analytes (so-called Hoffmann analytes) and have not included correlations with bioassay and epidemiological data. Consequently, a study was conducted to compare and contrast the conclusions from published risk assessments with those obtained when additional smoke analytes and bioassays are included. This study showed that additional analytes and bioassays are necessary to obtain a better perspective on differences among types of smoking products.