Toxicology Nicotine-Derived N-Nitrosamines (TSNA) and Their Relevance In Tobacco Carci nogenesis

crease has continued despite growing awareness by the public of the ill effects of tobacco use. It has been estimated that presently, in the U.S. alone, 30 percent of the cancer mortality in men and women is associated with the smoking and chewing of toba~co.~ Increasing trends in tobacco consumption and cancer incidence are seen in many industrialized countries and will likely also occur in other parts of the world unless we succeed in reducing the smoking epidemic. A major, dominating factor for the tobacco dependency is related to the pharmacologic effects of nicotine. The papers of this volume which were presented at the “Round Table Discussion” of the 15th World Cancer Congress have clearly demonstrated that nicotine and nomicotine are not only the chemicals primarily responsible for the tobacco dependency, but that the Nicotiana dkaloids are also precursors to powerful organ-specific carcinogens, the tobacco-specific N-nitrosamines (TSNA). In this presentation, we summarize the relevance of the TSNA as factors for the increased risk for cancer among smokers and chewers. This is followed by an outline of the need for future research to fully elucidate the potential of TSNA as human carcinogens. The overview is concluded with some thoughts on achieving reduction or elimination of the biological effects of the TSNA.

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