Tobacco-specific nitrosamines (TSNAs) comprise one of the most important groups of carcinogens in tobacco products, particularly cigarettes (traditional and electronic) and fermented dipping snuff.
Background
These nitrosamine carcinogens are formed from nicotine and related compounds by a nitrosation reaction that occurs during the curing and processing of tobacco.[1] Essentially the plant's natural alkaloids combine with nitrate forming the nitrosamines.[2]
They are called tobacco-specific nitrosamines because they are found only in tobacco products, and possibly in some other nicotine-containing products. The tobacco-specific nitrosamines are present in cigarette smoke and to a lesser degree in "smokeless" tobacco products such as dipping tobacco and chewing tobacco; additional information has shown that trace amounts of NNN and NNK have been detected in e-cigarettes.[3] They are present in trace amounts in snus. They are important carcinogens in cigarette smoke, along with combustion products and other carcinogens.[1]
Metabolism and chemical binding to DNA (adduct formation) are critical in cancer induction by NNK and NNN.
Human metabolism of NNK and NNN varies widely from individual to individual, and current research is attempting to identify those individuals who are particularly sensitive to the carcinogenic effects of these compounds. Such individuals would be at higher risk for cancer when they use tobacco products or are exposed to secondhand smoke. Identification of high-risk individuals could lead to improved methods of prevention of tobacco-related cancer, and improved risk valuation for insurers.