Tobacco Effects

A New Paradigm of Breast Cancer Causation and Prevention

Robert Hiatt, MD
This work takes a transdisciplinary approach to develop a model for breast cancer causation and etiology that takes into account multiple disciplinary perspectives from the biologic to the sociologic in order to provide common ground for understanding and to point up gaps in knowledge about breast cancer etiology that require further investigation. 

Acute Pulmonary Toxicity of E-Cigarettes

Jeffrey Gotts, MD, PhD
Since their introduction a decade ago, e-cigarettes (e-cigs), which use a heated coil to aerosolize nicotine-containing e-liquids, have been aggressively promoted by tobacco companies as safe alternatives to cigarettes. The use of these devices has increased at an alarming rate across all segments of society and especially among adolescents, with 13% of US high school students reporting recent use in 2014. Short-term effects of e-cig use include coughing and increased airway resistance, while longer-term health effects remain unknown. There is an urgent need to develop model exposure systems to test how these aerosols affect lung biology. Similarly, there is a compelling public health interest in translating scientific insights about toxicity into regulatory standards.

Cardiovascular Assessment of the Effects of Tobacco and Nicotine-Delivery Products

Peter Ganz, MD
Cigarette smoking continues to be a major cause of cardiovascular disease (CVD). In contrast, the cardiovascular risks of other tobacco products in common use (smokeless tobacco) and new tobacco products (e-cigarettes) are not adequately understood. The FDA will need information about the cardiovascular safety of these products to inform their regulatory decisions.

Cardiovascular Health Effects of Emerging Heat-Not-Burn Tobacco Products (2.0)

Matt Springer, PhD

Heat-not-burn (HNB) products, which heat a mixture of tobacco and other compounds to temperatures below those at which combustion occurs, deliver an inhalable aerosol containing nicotine and other chemicals. Although previous attempts by the tobacco industry to introduce such products have been largely unsuccessful, Philip Morris International’s iQOS is successfully being test marketed in several countries. In addition, Philip Morris Products S.A. has submitted modified risk tobacco product applications to the FDA to permit marketing iQOS in the United States.

Contamination of Tobacco by Endotoxins, and Cigarette Butt Disposal


Research scientific literature and tobacco industry documents related to contamination of tobacco by endotoxins and the tobacco industry’s attempts to remove the contamination. Research on the impact of cigarette butt disposal in the outdoor environment as toxic waste.  

Core D: Biomarker Core (2.0)

Neal Benowitz, MD

Exposure assessment is necessary for evaluating the health effects of tobacco use.

Effect of inhaled vapors gas dust and fumes on risk of COPD and autoimmune disease, taking into account cigarette smoking exposure

Paul Blanc, MD, MSPH

Environmental Effects of Marijuana Use

Suzaynn Schick, PhD

My lab studies the chemistry and toxicity of smoke, with a focus on tobacco and cannabis smoke. As part of the UCSF Human Exposure Laboratory, we perform controlled exposure studies that test the immediate health effects of cigarette smoke exposure in human beings.  We have shown that breathing secondhand cigarette smoke causes rapid increases in cardiovascular disease risk and in nasal congestion.  Our research on the chemistry and toxicity of cigarette smoke has helped define a new health risk from smoking: thirdhand cigarette smoke.

Impact of Cigarette Smoke Exposure on Acute Lung Injury

Carolyn Calfee, MD

We are studying the effects of both active smoking and secondhand smoke exposure on susceptibility to acute lung injury, a major cause of respiratory failure among critically ill patients.

Impact of Different E-Cigarette Characteristics on Acute Lung Injury (2.0)

Carolyn Calfee, MD, Michael Matthay, MD, Jeffrey Gotts, MD, PhD, Farzad Moazed, MD

Over the past decade, use of electronic cigarettes (e-cigarettes) has been rapidly growing. Because e-cigarettes are relatively new to the market, there is little biologic data on their health effects, particularly how these health effects are affected by specific product characteristics.

Interaction of Cannabis and Tobacco

Neal Benowitz, MD

Our group is working on the nature of the interaction between cannabis and tobacco. We use biomarkers to determine the concordance of usage of the two products in adolescents, and are conducting a laboratory study on the pharmacokinetics and pharmacodynamics of vaped cannabis vs vaped tobacco vs vaped cannabis + tobacco.  I am also interested the cardiovascular effects of cannabis use in people with heart disease.

Lung Cancer Stigma, Smoking Stigma, and Symptom Severity among Lung Cancer Patients


Dr. Cataldo is conducting research on a wide range of issues related to smokers who develop lung cancer.  Several studies have explored the severity of lung cancer stigma and its relationship with the severity of physical (i.e., appetite, fatigue, cough, dyspnea, hemoptysis, pain, sleep) and psycho-social (i.e., self-esteem, anxiety, depression) symptoms and Quality of Life. Dr. Cataldo developed the Cataldo Lung Cancer Stigma Scale (CLCSS), this scale has been translated into Norwegian and Korean and is currently being used in a national study of lung cancer stigma in Australia. 

Mechanisms of Airway Inflammation and Remodeling in Lung Diseases

Prescott Woodruff, MD

These studies apply innovative methods for quantitative morphometry and gene expression analyses to human tissue samples obtained at fiberoptic bronchoscopy. In work to date, we have applied these methods to study mechanisms of disease in asthma, COPD and sarcoidosis. Ongoing work in this area is supported by the NIH (R01 HL-095372). Our approaches combine the application of gene expression profiling methods (microarrays, qPCR, laser capture microdissection) and design–based stereology (for quantitative measurement of tissue remodeling in human samples).

Personalized Medicine for Colorectal and Breast Cancer

Robert Hiatt, MD

Major goals: To use an integrated, interdisciplinary approach to obtain evidence about key aspects of the translation of genomic information for breast and colorectal cancer into clinical practice and health policy.

Pharmacologic Basis of Racial Difference in Nicotine Dependence

Neal Benowitz, MD, Gideon St Helen, PhD

AA and EA smokers undergo detailed monitoring of smoking behavior, receive known doses of nicotine to establish nicotine metabolic rate, undergo DNA testing, and have their responses to not smoking for several hours studied. Exposure to carcinogens and other tobacco smoke toxins is also measured.  It is hypothesized that there are racial differences in metabolism that may explain different patterns of smoking, and that this in turn influences the reasons why smokers continue to self-administer nicotine (i.e., continue to smoke).

Pharmacology of co-administration of cannabis and tobacco

Gideon St Helen, PhD

While co-administration of cannabis and tobacco is becoming increasingly common, the pharmacology of various modalities of co-administration is understudied.

Quantification and Biomarkers of Short-Term Pulmonary Effects of Tobacco Smoke Exposure: Infection-Related Acute Lung Injury

Jeffrey Gotts, MD, PhD, Carolyn Calfee, MD

The health consequences of smoking are primarily perceived to be cancer, cardiovascular disease, and chronic pulmonary disease, but acute pulmonary consequences of exposure to cigarette smoke are likely to be as or more important.  However, there has been little research on smoking and acute lung injury a common cause of acute respiratory failure in critically ill patients.

Rapid Vascular Effects of Secondhand Smoke

Matt Springer, PhD

We are assessing the dose- and time-response of vascular functional impairment caused by exposure to second hand smoke at very low levels and short exposure times in rats.  

Rate of Nicotine Metabolism and Withdrawal Symptoms in Adolescent Light Smokers


The goal of this study was to examine the associations between the rate of nicotine metabolism and cigarette consumption, addiction and withdrawal symptoms.

Sample Analysis and Support for Clinical Trials

Prescott Woodruff, MD

The Woodruff Laboratory supports sample analyses for clinical trials in asthma and COPD in both NIH and industry-supported studies. These sample analyses include measurement of changes in airway remodeling in response to specific therapeutic interventions, assessment of inflammation and the application of biomarkers to enhance the interpretation of clinical trials.

The Identification of Molecular Sub-phenotypes of Asthma and COPD

Prescott Woodruff, MD
These studies are funded by: 1) An R01 grant from the National Heart, Lung and Blood Institute at the National Institutes of Health.

Tobacco and cannabis use among people living with HIV

Richard Wang, MD
The prevalence of tobacco use is higher among people living with HIV than in the general population, and it is estimated that, among those receiving anti-retroviral therapy, combustible cigarette smoking may pose a greater threat to health than HIV itself. This research is determining the impact of the rapidly changing landscape of inhalational exposures, ranging from heated tobacco products to vaporized cannabis extracts, on the health of people living with HIV.

Toxicant Exposure and Cardiovascular Effects: Cannabis vs Tobacco

Gideon St Helen, PhD

Proposition 64 legalized adult recreational use of cannabis in California, and there are concerns it will lead to an increase in prevalence and intensity of cannabis use in the state. Further, electronic vaporizers, which heat but do not combust cannabis materials, are being introduced in the market for use with cannabis. Vaporizers are perceived as safer alternatives to smoking and are gaining popularity.

Understanding Tobacco-Based Injury to Blood Vessels and Lung at a Molecular Level

John Kane, MD, PhD
This project takes advantage of growing understanding of the molecular events underlying disease. There is increasing awareness that chemicals in tobacco smoke attack cells in the lungs and arteries leading to destructive pulmonary disease and to occlusion of blood vessels resulting in heart attacks, strokes and loss of circulation in the limbs. These chemicals increase the accumulation of damaged carriers (lipoproteins) of cholesterol in the arteries, leading to occlusion of the vessels. They also increase inflammatory proteins (cytokines) that accelerate this process and cause inflammation in lung tissue. We will assess the impact of tobacco smoking on of a large panel of cytokines. We also are discovering and measuring levels of lipoproteins which have roles in protecting arteries and lung cells. We will also assess the role of genetics in the context of smoking-induced injury. These insights could lead to protective interventions.