Tobacco Effects

A New Paradigm of Breast Cancer Causation and Prevention

Robert A. Hiatt, MD, PhD
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.

Adverse Cardiovascular Effects from One Minute of Exposure to Marijuana Secondhand Smoke

Matthew Springer, PhD

We have demonstrated that even one minute of exposure to secondhand smoke from marijuana impairs vascular endothelial function, and we are studying how the extent and mechanism of impairment compares related to those from tobacco secondhand smoke exposure.

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

Peter Ganz
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)

Matthew 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.

Impact of Changing Tobacco Product Use on Healthcare Costs for General and Vulnerable Populations (2.0)

Wendy Max, PhD, Hai-Yen Sung, PhD, Tingting Yao, PhD

Healthcare costs play a central role in FDA regulatory impact analysis. Many factors contribute to tobacco- attributable healthcare costs, including changing tobacco product use patterns, sociodemographic characteristics, health status, and socioeconomic status (SES). The central goal of this project is to develop economic models that analyze the impact of new patterns of tobacco product use on healthcare costs for different populations including those that are particularly vulnerable.

Impact of Cigarette Smoke Exposure on Acute Lung Injury

Carolyn Calfee, MD, MAS

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, MAS, 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.

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

Janine Cataldo, RN, PhD, FAAN

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, MPH

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 A. Hiatt, MD, PhD

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).

Polytobacco Study

Pamela Ling, MD

This is a qualitative study of adults who use multiple tobacco products, followed over time, in order to better understand patterns of tobacco use, how they change, and what influences these changes. This study includes tobacco products, e-cigarettes and cannabis use.

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

Jeffrey Gotts, MD, PhD, Carolyn Calfee, MD, MAS

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

Matthew 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, MPH

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.

SF CAN - Commune Smokefree Social

Pamela Ling, MD

This project is part of the Helen Diller Comprehensive Cancer Center’s program to decrease cancer in San Francisco. The goal is to increase smoking cessation among young adults, as quitting before age 30 avoids almost all the health consequences of smoking. Commune Smokefree Social groups are advertised and held on Facebook for Bay Area young adults to support smoking cessation.

The Identification of Molecular Sub-phenotypes of Asthma and COPD

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