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Review Article
11 2024
:36;
103484
doi:
10.1016/j.jksus.2024.103484

Review of toxic metals in tobacco cigarette brands and risk assessment

,
 Department of Mathematics, Physics and Informatics, Mkwawa University College of Education, University of Dar es Salaam, P.O. Box 2513 Iringa, Tanzania

⁎Corresponding author. amos.ntarisa@udsm.ac.tz (Amos Vincent Ntarisa)

Received: , Accepted: ,
© The Author(s) 2024
Disclaimer:
This article was originally published by Elsevier and was migrated to Scientific Scholar after the change of Publisher.

Abstract

The act of tobacco smoking cigarettes is linked to the development of lung cancer, which accounts for around 90 % of lung cancers in the world. This paper reviewed 76 articles on harmful heavy metals in tobacco cigarette brands and associated health risk assessment. This comprehensive examination involved searching targeted databases across multiple search engines, such as Scopus, Web of Science, Google Scholar, Science Direct, PubMed and Research Gate, published in English from 2000 to September 2024. The mean heavy metals concentrations are 2.9, 10.5, 4.5, 7.9 and 3.5 mg/kg for Cd, Pb, Cr, As and Hg, respectively. Related mean hazard quotient (HQ ) for non-carcinogenic ingestion and inhalation were determined. HQ for ingestion and inhalation were < 1 and > 1, respectively. HQ > 1 for all metal inhalation, which signifies considerable health risk. The risk of cancer for ingestion of all metals is in the acceptable limit below 1E-04, while the risk of cancer for inhalation of all metals is in the unacceptable range. Additional research on toxic heavy metals in tobacco cigarette brands from diverse countries is necessary to arrive at conclusive mean risks for each specific toxic heavy metal.

Keywords

Heavy metals
Smoking
Tobacco
Cigarette brands
Lung cancer, carcinogenic and non-carcinogenic
1

1 Introduction

Excessive levels of heavy metals pose a significant human toxicity risk as they are extensively distributed throughout the environment. While these metals are naturally present, in addition to by-products which contain some heavy metals, human activities such as mining, agriculture, industries activities, etc, that discharge them into the air, soil, water, and food can elevate exposure levels (Ntarisa, 2024; Sebiawu et al., 2014). Heavy metals are grouped into two main categories: essential and toxic heavy metals. Essential heavy metals play an important role in the daily lives of humans, plants, and other living beings but are toxic at higher concentrations. On the other hand, toxic heavy metals have no biological function in humans, plants, and other living beings. Even at low concentrations, these metals are highly hazardous. The highly toxic heavy metals are lead (Pb), mercury (Hg), arsenic (As), cadmium (Cd), and chromium (Cr). In contrast, the essential heavy metals in trace amounts include metals such as manganese (Mn), zinc (Zn), iron (Fe), copper (Cu), etc. (Asati et al., 2016; Mohamed et al., 2016; Pinto et al., 2017; Velusamy et al., 2022; Ziyae Aldin Samsam Shariat et al., 2019).

Certain plants, like tobacco, possess the capacity to accumulate heavy metals. Tobacco plants absorb metal ions and compounds from the soil through their roots, and they are further transported from the roots to the leaves (Özcan et al., 2019) Tiny leaf accumulations of heavy metals transfer to cigarette smoke during tobacco processing. The pH level, soluble organic matter, soil type, and presence of organic or metal ions are vital factors that affect the speciation, adsorption, and distribution of heavy metals in soil (Eneji et al., 2013; Ziarati et al., 2016). Consequently, the contamination of heavy metals varies in each country and each place where tobacco plants are cultivated and processed (Ziarati et al., 2016).

Accumulation of heavy metals from tobacco cigarette smoke occurs in tissues and fluids as a result of smoking (Ntarisa, 2024). As stated by the International Agency for Research on Cancer (IARC), inhaling smoke from tobacco cigarettes poses significant dangers and toxicity to human health (Massadeh et al., 2005). As per the World Health Organization (WHO), one person dies from the consequences of tobacco consumption every 4 s (St Claire et al., 2020). A prolonged intake of minimal quantities of heavy metals due to cigarette smoke over several years can lead to kidney damage and weakened bones, as certain heavy metals are primarily stored in the bone, liver, and kidneys (Karbon et al., 2015; Massadeh et al., 2005). Heavy metals can induce severe impacts on the brain, correlate with a decline in intelligence quotient (IQ) levels and the potential emergence of behavioural issues. Also, the act of smoking cigarettes is linked to the development of lung cancer, which accounts for around 90 % of lung cancers in the world (Felix and Ntarisa, 2024; Massadeh et al., 2005; Pelit et al., 2013).

Tobacco cigarette consumption and the prevalence of smokers have been on a consistent rise globally (Azeez et al., 2019; Hussain et al., 2024). Numerous companies worldwide engage in the manufacturing of tobacco cigarettes under various brand names. A significant portion of these cigarettes is available at affordable prices. If contaminated with various heavy metals, it can result in adverse health effects for the population. Because of this health risk problem, several researchers have devoted their efforts to conducting studies on heavy metals in tobacco cigarette brands worldwide, spanning various countries. Some early reviews regarding heavy metals in tobacco and tobacco products were carried out with titles: “Metals in Cigarette Smoke”, “Review on Cadmium Contamination in Soil and Bioaccumulation by Tobacco, its Source, Toxicity and Health Risk, and Metals in Cigarette Smoke” and”Toxic elements in tobacco and in cigarette smoke: inflammation and sensitization” presented by Bernhard et al (Bernhard et al., 2005), Iradukunda et (Iradukunda et al., 2021) and Steve Pappas (Pappas, 2011) respectively. Bernhard et al. examine how cigarette smoking delivers metals to the human body and explores the body's reactions to metals (Al, Cu, Cd, Hg, Pb, Ni, Zn, Cr, Se, Mn and V) exposure, while Iradukunda et al investigate tobacco plant's cadmium uptake, sources, toxicity, and health risks from soil accumulation also Steve Pappas Examine and consolidate existing evidence about specific health risks associated with exposure to metals or metalloids. Focus on those substances categorized as carcinogens by (IARC) or metals that demonstrate evidence of sensitization or inflammation due to exposure through smokeless tobacco products or cigarette smoke. This study reviews research on heavy metals in tobacco cigarette brands manufactured worldwide from 2000 to September 2024. It estimates the average amounts of toxic heavy metals (As, Cd, Cr, Hg, and Pb) in these cigarette brands and assesses the associated health risks to consumers.

2

2 Methods

2.1

2.1 Sources of data and search Method

A systematic review of heavy metal involved a comprehensive search of specific databases, spanning from early September 2023 to September 2024. The search targeted articles published in the English language between the years 2000 and September 2024. Various search platforms such as Google Scholar, Scopus, Science Direct, Web of Science, PubMed and Research Gate were the sources from which the data were retrieved. The approach employed for searching was heavy metals in tobacco cigarette brands, toxic metals in tobacco cigarette brands, trace metals in tobacco cigarette brands, metals in tobacco cigarette brands, assessment/analysis/measurements/evaluations of heavy metals in tobacco products and contamination of heavy metal in tobacco cigarette brands. Initially, 170 papers from diverse countries were randomly selected without specific considerations for the publication year or cigarette brands' sample size (N). Later, a more focused time frame of 2000 to September 2024 was chosen, and the selection criterion for N was established as N ≥ 3 for heavy metals. Upon reviewing the papers, redundant documents were eliminated. Finally, following the filtration process, eithty-one (81) articles sourced from diverse countries were identified for heavy metals in tobacco cigarette brands. After that, articles containing at least one toxic metal among As, Cd, Cr, Hg and Pb were chosen for quantitative analysis. Seventy-six(76) analysed articles had at least one element of these harmful metals. The tables for each toxic metal were created with information on manufacturer country, year, N, heavy metal concentration range, mean heavy metal concentrations, and reference. The range of concentrations for heavy metals, along with their arithmetic mean, was determined in m g / k g units. Any values not initially presented in ( m g / k g ) were converted into this unit.

2.2

2.2 Human health risk assessment

The human health risks assessment for non-carcinogenic and carcinogenic components was conducted using different equations. Equations (1) and (2) were used to calculate the average daily dosage (ADD) for non-carcinogenic hazards for ingestion and inhalation, respectively. Equations (3) and (4) were used to calculate the hazard quotient (HQ) for assessing non-carcinogenic risks by inhalation and ingestion, respectively. Equations (5) to (8) were used to calculate the lifetime average daily dose (LADD), as well as the risk from ingesting and inhalation, to assess carcinogenic health risk (Ismail et al., 2017; Ntarisa, 2024; Taiwo and Awomeso, 2017)

(1)
ADD Ing = C × E F × E D × IR Ing AT × B W
(2)
ADD Inh = C × E F × E D × IR Inh AT × B W
(3)
F o r i n h a l a t i o n , H Q = ADD Inh RFC
(4)
F o r i n g e s t i o n , H Q = ADD Ing RFD
(5)
LADD Ing = C × E F × E D × IR Ing AT × B W
(6)
LADD Inh = C × E F × E D × IR Inh AT × B W
(7)
F o r i n g e s t i o n , R i s k = LADD Ing × C S F
(8)
F o r i n h a l a t i o n , R i s k = LADD Inh × U R F

In this context, C stands for the average concentration of heavy metals in mg/kg, EF is the exposure frequency with a unit of 365 days/year, IRIng is the ingestion rate which is equivalent to 50 mg/day, IRInh is the inhalation rate (20 m3/day), and ED refers to the exposure duration (30 years). AT is the average exposure period, with values of 10,950 days (ED × 365) for non-carcinogenic risks and 25,550 days, calculated as 70 years × 365 days for carcinogenic risks. BW refers to body weight, which is assumed to be 70 kg, RFD is the reference dose, RFC is the reference concentration, URF is the unit risk factor for inhalation, and CSF is the cancer slope factor for ingestion. If the hazard quotient (HQ) exceeds 1, it indicates a significant health risk concern (Ismail et al., 2017; Ntarisa, 2024; Taiwo and Awomeso, 2017). In carcinogenic assessments, a risk within the range of 1 × 10 - 6 to 1 × 10 - 4 is considered acceptable (Abedi Sarvestani and Aghasi, 2019; Benson et al., 2017; Ismail et al., 2017). The values used for calculating EF, IR, ED, AT, and BW are listed in Table 1, while the RFD, RFC, CSF, and URF values are provided in Table 2.

Table 1 The value of EF, IR, ED, AT, and BW used in this study.
Value Reference
EF 365 days/year (Ismail et al., 2017; Zhao et al., 2023)
IRIng 50 mg/day (Ismail et al., 2017)
IRInh 20 m3 /day (Ismail et al., 2017; Zhao et al., 2023)
ED 30 years (Benson et al., 2017; Ismail et al., 2017; Taiwo and Awomeso, 2017)
AT for non-carcinogenic 10950 days (Benson et al., 2017; Ismail et al., 2017; Zheng et al., 2010)
AT for carcinogenic 25,550 days (Ismail et al., 2017; Zheng et al., 2010)
BW 70 kg (Ismail et al., 2017; Zheng et al., 2010)
Table 2 The value of RFD, RFC, CSF and URF used in this study.
Heavy Metal RFD ( m g / k g - d ) Reference RFC ( m g / m 3 ) Reference CSF mg/kg-d Reference URF ( m g / m 3 - d ) Reference
Hg 0.0001 (USEPA, 2023) 0.0003 (Ismail et al., 2017; USEPA, 2023) * *
Pb 0.0036 (Abedi Sarvestani and Aghasi, 2019; Ismail et al., 2017; Naimabadi et al., 2021; Taiwo et al., 2019) 0.0352 (Naimabadi et al., 2021) 0.042 (Naimabadi et al., 2021) *
Cd 0.0001 (USEPA, 2023) 0.00001 (Ismail et al., 2017; USEPA, 2023) 1.5 (Ismail et al., 2017) 0.0018 (Ismail et al., 2017; USEPA, 2023)
As 0.0003 (Ismail et al., 2017; Taiwo and Awomeso, 2017) 0.000015 (Ismail et al., 2017; USEPA, 2023) 1.5 (Ismail et al., 2017; Lee et al., 2006; USEPA, 2023) 0.0043 (Ismail et al., 2017; USEPA, 2023)
Cr 0.003 (Naimabadi et al., 2021; Taiwo et al., 2019; USEPA, 2023) 0.0001 (Ismail et al., 2017; USEPA, 2023) 0.5 (Ismail et al., 2017; USEPA, 2023) 0.084 (Ismail et al., 2017; USEPA, 2023)
* = Not found in the literature.

3

3 Results

The analysis of toxic heavy metal encompassed 76 articles sourced from various continents, detailed in Supplementary Tables 2-6. From the review findings, 38 articles were identified from Asia, 12 from Europe, 3 from North America, 21 from Africa, and 2 from South America. Out of the total, 66 articles were accessible in full text, accounting for 86.8 %, while 10 were only available in abstract form, representing 13.2 %. Some investigations documented the presence of a single toxic heavy metal in cigarette brands, whereas other research findings indicated the existence of many toxic heavy metals in cigarette brands. The results show that atomic absorption spectrophotometry was mainly used to determine toxic heavy metals, followed by flame atomic absorption spectrophotometer in cigarette brands, as shown in Supplementary Table 1.

A total of 75, 60, 31, 14, and 9 studies, in that order, have presented findings on the concentrations of Cd, Pb, Cr, As, and Hg in various cigarette brands, as shown in Supplementary Tables 2-6. The average arithmetic mean concentration in mg/kg were 2.9, 10.5, 4.5, 7.9 and 3.5 for Cd, Pb, Cr, As and Hg, respectively. The primary element of interest was Cd, followed by Pb. Prolonged exposure to small amounts of Cd over an extended period may lead to kidney damage and weakened bones, as Cd accumulates primarily in bones, liver, and kidneys. Also, elevated levels of Pb have been linked to a reduction in intelligence quotient (IQ) and the potential emergence of behavioural issues (Massadeh et al., 2005).

Tables 3 to 7 estimate non-carcinogenic and carcinogenic health risks for Cd, Pb, Cr, As, and Hg, respectively. The mean average ADD for non-carcinogenic health risks through ingestion was 2.08, 7.48, 3.21, 5.60 and 2.47 × 10 - 6  mg/kg-day for Cd, Pb, Cr, As and Hg, respectively. The mean average ADD values for inhalation were 3.83, 25.33, 2.68, 6.9 and 8.13 mg/m3-day for Cd, Pb, Cr, As and Hg, respectively. The mean HQ values for non-carcinogenic risks through ingestion were 20.80, 2.08, 1.07, 18.75 and 24.71 × 10 - 3 for Cd, Pb, Cr, As and Hg, respectively. For inhalation, the mean HQ values were 382.23, 0.72, 26.81, 547.60 and 27.09 × 10 3 for Cd, Pb, Cr, As and Hg, respectively. Since HQ < 1 for all metals through ingestion indicates no significant health risk, Q > 1 for all metals through inhalation suggests a considerable health risk (Ismail et al., 2017; Ntarisa, 2024).

Table 3 Estimation of non-carcinogenic and carcinogenic health risks for Cd.
Manufactures country Year Reference Mean concentrations (mg/kg) Non-carcinogenic health risk Carcinogenic health risk
Ingestion Inhalation Ingestion Inhalation
ADD ( × 10 - 6 mg/kg-day) HQ × 10 - 3 ADD (mg/m3-day) HQ × 10 3 LADD ( × 10 - 6 mg/kg-day) Cancer risk × 10 - 6 LADD (mg/m3-day) Cancer risk × 10 - 3
Benin 2012 (Agbandji et al., 2013) 47.2 33.71 337.14 62.03 6203.42 14.45 21.67 26.59 47.86
Brazil 2011 (Viana et al., 2011) 0.7 0.50 5.00 0.92 92.00 0.21 0.32 0.39 0.71
Bulgaria 2023 (Peeva et al., 2023) 0.8 0.57 5.71 1.05 105.14 0.24 0.37 0.45 0.81
China 2017 (Ren et al., 2016) 0.1 0.07 0.71 0.13 13.14 0.03 0.05 0.06 0.10
China 2014 (O’Connor et al., 2014) 3.2 2.29 22.86 4.21 420.57 0.98 1.47 1.80 3.24
Egypt 2017 (Abd El-Samad and Hanafi, 2017) 4.4 3.14 31.43 5.78 578.29 1.35 2.02 2.48 4.46
Ethiopia 2016 (Engida, 2017) 2.5 1.79 17.86 3.29 328.57 0.77 1.15 1.41 2.54
France 2012 (Agbandji et al., 2013) 41 29.29 292.86 53.89 5388.57 12.55 18.83 23.09 41.57
Germany 2005 (Nnorom et al., 2005) 1.8 1.29 12.86 2.37 236.57 0.55 0.83 1.01 1.83
Hungary 2002 (Csalári and Szántai, 2002) 0.3 0.21 2.14 0.39 39.43 0.09 0.14 0.17 0.30
India 2009 (Dhaware et al., 2009) 0.4 0.29 2.86 0.53 52.57 0.12 0.18 0.23 0.41
India 2019 (Özcan et al., 2019) 0.6 0.43 4.29 0.79 78.86 0.18 0.28 0.34 0.61
India 2010 (Verma et al., 2010) 0.5 0.36 3.57 0.66 65.71 0.15 0.23 0.28 0.51
Iran 2016 (Ziarati et al., 2016) 0.6 0.43 4.29 0.79 78.86 0.18 0.28 0.34 0.61
Iran 2012 (Pourkhabbaz and Pourkhabbaz, 2012) 2.7 1.93 19.29 3.55 35.49 0.83 1.24 1.52 2.74
Iran 2019 (Ziyae Aldin Samsam Shariat et al., 2019) 1.6 1.14 11.43 2.10 210.29 0.49 0.73 0.90 1.62
Iran 2015 (Pashapour et al., 2015) 0.4 0.29 2.86 0.53 52.57 0.12 0.18 0.23 0.41
Iraq 2021 (Haleem and Amin, 2021) 0.4 0.29 2.86 0.53 52.57 0.12 0.18 0.23 0.41
Iraq 2019 (Haleem et al., 2020) 0.4 0.29 2.86 0.53 52.57 0.12 0.18 0.23 0.41
Iraq 2015 (Karbon et al., 2015) 0.57 0.41 4.07 0.75 74.91 0.17 0.26 0.32 0.58
Iraq 2022 (Joda and Alheloo, 2022) 1.6 1.14 11.43 2.10 210.29 0.49 0.73 0.90 1.62
Iraq 2015 (Al-Jeboori et al., 2015) 0.1 0.07 0.71 0.13 13.14 0.03 0.05 0.06 0.10
Ireland 2015 (Afridi et al., 2015) 0.4 0.29 2.86 0.53 52.57 0.12 0.18 0.23 0.41
Japan 2021 (Dinh et al., 2021) 0.9 0.64 6.43 1.18 118.29 0.28 0.41 0.51 0.91
Jordan 2005 (Massadeh et al., 2005) 2.6 1.86 18.57 3.41 341.71 0.80 1.19 1.46 2.64
Jordan 2003 (Jaradat et al., 2003) 0.3 0.21 2.14 0.39 39.43 0.091 0.14 0.17 0.30
Jordan 2004 (Massadeh et al., 2003) 2.6 1.86 18.57 3.41 341.71 0.80 1.19 1.46 2.64
Kenya 2015 (Omari et al., 2015) 0.08 0.06 0.57 0.11 10.51 0.02 0.04 0.05 0.081
Kenya 2020 (Peter et al., 2020) 0.1 0.07 0.71 0.13 13.142 0.03 0.05 0.06 0.10
Malaysia 2017 (Ismail et al., 2017) 0.9 0.64 6.43 1.18 118.29 0.28 0.41 0.51 0.91
Malaysia 2019 (Janaydeh et al., 2019) 0.8 0.57 5.71 1.05 105.14 0.24 0.37 0.45 0.81
Mexico 2008 (Martínez et al., 2008) 1.2 0.86 8.57 1.58 157.71 0.37 0.55 0.68 1.22
Nigeria 2013 (Eneji et al., 2013) 0.01 0.01 0.07 0.013 1.31 0.003 0.05 0.006 0.0101
Nigeria 2019 (Onojah et al., 2019) 1.4 1.00 10.00 1.84 184.00 0.43 0.64 0.79 1.42
Nigeria 2013 (IWUOHA et al., 2013) 0.6 0.43 4.29 0.79 78.86 0.18 0.28 0.34 0.61
Nigeria 2011 (Anhwange and Yiase, 2011) 1.4 1.00 10.00 1.84 184.00 0.43 0.64 0.79 1.42
Nigeria 2015 (Abudu et al., 2015) 0.13 0.09 0.93 0.17 17.09 0.04 0.06 0.074 0.13
Nigeria 2019 (Azeez et al., 2019) 1.4 1.00 10.00 1.84 184.00 0.43 0.64 0.79 1.42
Nigeria 2005 (Nnorom et al., 2005) 1.3 0.93 9.29 1.71 170.86 0.40 0.60 0.73 1.32
Nigeria 2011 (Yebpella et al., 2010) 0.7 0.50 5.00 0.92 92.00 0.21 0.32 0.39 0.71
Nigeria 2018 (Onojah et al., 2019) 1.4 1.00 10.00 1.84 184.00 0.43 0.64 0.79 1.42
Pakistan 2008 (Ajab et al., 2008) 0.5 0.36 3.57 0.66 65.71 0.15 0.23 0.28 0.51
Pakistan 2011 (Ahmad et al., 2011) 0.2 0.14 1.43 0.26 26.29 0.06 0.09 0.11 0.20
Pakistan 2019 (Mahmood et al., 2020) 0.5 0.36 3.57 0.66 65.71 0.151 0.23 0.28 0.51
Pakistan. 2017 (Asim et al., 2017) 0.10 0.07 0.71 0.13 13.14 0.03 0.05 0.06 0.10
Pakistan 2008 (Kazi et al., 2009) 0.6 0.43 4.29 0.79 78.86 0.184 0.28 0.34 0.61
Pakistan 2024 (Hussain et al., 2024) 0.4 0.28 2.86 0.53 52.57 0.12 0.18 0.22 4.06
Palestina 2015 (Abu-Obaid et al., 2015) 1.2 0.86 8.57 1.58 157.71 0.37 0.55 0.678 1.22
Philippines 2013 (Solidum, 2013) 0.01 0.01 0.07 0.013 1.31 0.003 0.005 0.006 0.0101
Poland 2008 (Galażyn-Sidorczuk et al., 2008) 0.8 0.57 5.71 1.05 105.14 0.24 0.37 0.45 0.81
Portugal 2014 (Pinto et al., 2017) 0.8 0.57 5.71 1.05 105.14 0.24 0.37 0.45 0.81
Romanian 2014 (AGOROAEI et al., 2014) 1.1 0.79 7.86 1.45 144.57 0.34 0.51 0.62 1.12
Romania 2018 (Strungaru et al., 2018) 0.7 0.50 5.00 0.92 92.00 0.21 0.32 0.39 0.71
Saudi Arabia 2021 (Dahlawi et al., 2021) 37.4 26.71 267.14 49.15 4915.42 11.45 17.17 21.07 37.92
Saudi Arabia 2012 (Ashraf, 2012) 1.8 1.29 12.86 2.37 236.57 0.55 0.83 1.01 1.83
Spain 2015 (Armendáriz et al., 2015) 0.8 0.57 5.71 1.05 105.14 0.24 0.37 0.45 0.81
Tanzania 2024 (Ntarisa, 2024) 0.53 0.38 3.79 0.70 69.66 0.16 0.24 0.30 0.54
Turkey 2013 (Pelit et al., 2013) 0.3 0.21 2.14 0.39 39.43 0.091 0.14 0.17 0.30
Turkey 2012 (Duran et al., 2012) 1.1 0.79 7.86 1.45 144.57 0.34 0.51 0.62 1.12
Turkey 2012 (KADIOĞLU et al., 2012) 2.0 1.43 14.29 2.63 262.86 0.61 0.92 1.13 2.03
Turkey 2001 (Barlas et al., 2001) 1.7 1.21 12.14 2.23 223.43 0.52 0.78 0.96 1.72
U.S 2013 (Caruso et al., 2013) 0.9 0.64 6.43 1.18 118.29 0.28 0.41 0.51 0.91
UK 2005 (Nnorom et al., 2005) 1.3 0.93 9.29 1.71 170.86 0.40 0.60 0.73 1.31
U.S 2005 (Nnorom et al., 2005) 1.6 1.14 11.43 2.10 210.29 0.49 0.73 0.90 1.62
Average 2.91 2.08 20.80 3.83 382.85 0.89 1.33 1.64 2.95
Table 4 Estimation of non-carcinogenic and carcinogenic health risks for Pb.
Manufactures country Year Reference Mean concentrations (mg/kg) Non-carcinogenic health risk Carcinogenic health risk
Ingestion Inhalation Ingestion Inhalation
ADD ( × 10 - 6 mg/kg-day) HQ × 10 - 6 ADD (mg/m3-day) HQ LADD ( × 10 - 6 mg/kg-day) Cancer risk × 10 - 6 LADD (mg/m3-day)
Benin 2012 (Agbandji et al., 2013) 2.0 1.43 396.83 4.83 137.34 0.61 0.03 2.07
Brazil 2011 (Viana et al., 2011) 0.3 0.21 59.52 0.73 20.60 0.09 0.004 0.31
Bulgaria 2023 (Peeva et al., 2023) 1.6 1.14 317.46 3.87 109.87 0.49 0.02 1.66
China 2017 (Ren et al., 2016) 0.2 0.14 39.68 0.48 13.74 0.06 0.003 0.21
China 2014 (O’Connor et al., 2014) 2.5 1.79 496.03 6.04 171.67 0.77 0.03 2.59
Ethiopia 2016 (Engida, 2017) 6.2 4.43 1230.16 14.99 425.75 1.90 0.08 6.42
France 2012 (Agbandji et al., 2013) 4.4 3.14 873.02 10.64 302.14 1.35 0.06 4.56
Ghana 2014 (Sebiawu et al., 2014) 5.8 4.14 1150.79 14.02 398.78 1.78 0.07 6.01
Hungary 2002 (Csalári and Szántai, 2002) 0.5 0.36 99.21 1.21 34.33 0.15 0.01 0.52
India 2009 (Dhaware et al., 2009) 7.4 5.29 1468.26 17.89 508.15 2.27 0.10 7.67
India 2019 (Özcan et al., 2019) 3.5 2.50 694.44 8.46 240.34 1.07 0.05 3.63
India 2010 (Verma et al., 2010) 1.9 1.36 376.98 4.59 130.47 0.58 0.02 1.97
Iran 2016 (Ziarati et al., 2016) 34.4 24.57 6825.40 83.15 2362.21 10.53 0.44 35.64
Iran 2012 (Pourkhabbaz and Pourkhabbaz, 2012) 2.1 1.50 416.67 5.08 144.20 0.64 0.03 2.18
Iran 2015 (Pashapour et al., 2015) 22.3 15.93 4424.61 53.90 1531.31 6.83 0.29 23.10
Iraq 2021 (Haleem and Amin, 2021) 4.6 3.29 912.70 11.12 315.88 1.41 0.06 4.77
Iraq 2019 (Haleem et al., 2020) 4.6 3.29 912.70 11.12 315.88 1.41 0.06 4.77
Iraq 2014 (Karbon et al., 2015) 5.9 4.21 1170.64 14.26 405.15 1.81 0.08 6.11
Iraq 2015 (Al-Jeboori et al., 2015) 0.2 0.14 39.68 0.48 13.74 0.06 0.003 0.21
Ireland 2015 (Afridi et al., 2015) 0.4 0.29 79.37 0.97 27.47 0.12 0.005 0.41
Japan 2021 (Dinh et al., 2021) 1.6 1.14 317.46 3.87 109.87 0.49 0.02 1.66
Jordan 2005 (Massadeh et al., 2005) 2.7 1.93 535.71 6.53 185.41 0.83 0.03 2.80
Jordan 2003 (Jaradat et al., 2003) 0.3 0.21 59.52 0.73 20.60 0.09 0.004 0.31
Jordan 2004 (Massadeh et al., 2003) 2.7 1.93 535.71 6.53 185.41 0.83 0.03 2.80
Kenya 2015 (Omari et al., 2015) 6.8 4.86 1349.21 16.44 466.95 2.08 0.09 7.04
Kenya 2020 (Peter et al., 2020) 0.2 0.14 39.68 0.48 13.73 0.06 0.003 0.21
Malaysia 2017 (Ismail et al., 2017) 0.6 0.43 119.05 1.45 41.20 0.18 0.008 0.62
Malaysia 2019 (Janaydeh et al., 2019) 3.1 2.21 615.08 7.49 212.87 0.95 0.04 3.21
Nigeria 2013 (Eneji et al., 2013) 0.04 0.03 7.94 0.097 2.75 0.012 0.0005 0.04
Nigeria 2013 (IWUOHA et al., 2013) 22.8 16.29 4523.81 55.11 1565.65 6.98 0.29 23.62
Nigeria 2011 (Anhwange and Yiase, 2011) 2.0 1.43 396.83 4.83 137.34 0.61 0.03 2.07
Nigeria 2011 (Yebpella et al., 2010) 10.1 7.21 2003.97 24.41 693.55 3.09 0.13 10.46
Pakistan 2008 (Ajab et al., 2008) 14.4 10.28 2857.14 34.81 988.83 4.41 0.19 14.92
Pakistan 2019 (Haleem et al., 2020) 1.0 0.71 198.41 2.42 68.67 0.31 0.01 1.04
Pakistan 2008 (Ren et al., 2016) 0.3 0.21 59.52 0.73 20.60 0.09 0.004 0.31
Pakistan 2024 (Hussain et al., 2024) 2.08 1.49 412.70 5.03 142.83 0.64 0.03 2.15
Palestina 2015 (Abu-Obaid et al., 2015) 3.1 2.21 615.08 7.49 212.87 0.95 0.04 3.21
Philippines 2013 (Solidum, 2013) 1.0 0.71 198.41 2.42 68.67 0.31 0.01 1.04
Portugal 2014 (Pinto et al., 2017) 0.5 0.36 99.21 1.21 34.33 0.15 0.01 0.52
Poland 2008 (Galażyn-Sidorczuk et al., 2008) 0.8 0.57 158.73 1.93 54.94 0.24 0.01 0.83
Romanian 2014 (AGOROAEI et al., 2014) 4.2 3.00 833.33 10.15 288.41 1.29 0.05 4.35
Roumania 2018 (Strungaru et al., 2018) 0.4 0.29 79.37 0.97 27.47 0.12 0.01 0.41
Saudi Arabia 2021 (Dahlawi et al., 2021) 312.8 223.43 62063.52 756.08 21479.59 95.76 4.02 324.03
Saudi Arabia 2011 (Ashraf, 2012) 2.5 1.79 496.03 6.04 171.67 0.77 0.03 2.59
Serbia 2012 (Lazarević et al., 2012) 0.9 0.64 178.57 2.18 61.80 0.28 0.01 0.93
Spain 2015 (Armendáriz et al., 2015) 0.6 0.43 119.05 1.45 41.20 0.18 0.008 0.62
Turkey 2012 (Duran et al., 2012) 3.7 2.64 734.13 8.94 254.07 1.13 0.05 3.83
Turkey 2001 (Barlas et al., 2001) 1.0 0.71 198.41 2.41714 68.67 0.31 0.01 1.04
U.S 2013 (Caruso et al., 2013) 0.4 0.29 79.37 0.97 27.47 0.12 0.005 0.41
Average 10.48 7.48 2078.96 25.33 719.5 3.21 0.14 10.85
Table 5 Estimation of non-carcinogenic and carcinogenic health risks for Cr.
Manufactures country Year Reference Mean concentrations (mg/kg) Non-carcinogenic health risk Carcinogenic health risk
Ingestion Inhalation Ingestion Inhalation
ADD ( × 10 - 6 mg/kg-day) HQ × 10 - 6 ADD (mg/m3-day) HQ × 10 3 LADD ( × 10 - 6 mg/kg-day) Cancer risk × 10 - 6 LADD (mg/m3-day) Cancer risk
Brazil 2011 (Viana et al., 2011) 1.4 1.00 333.33 0.84 8.36 0.43 0.21 0.36 0.03
Brazil 2020 (Lisboa et al., 2020) 0.6 0.43 142.86 0.36 3.58 0.18 0.09 0.15 0.012
China 2017 (Ren et al., 2016) 0.1 0.07 23.81 0.06 0.60 0.03 0.02 0.03 0.002
China 2014 (O’Connor et al., 2014) 0.6 0.43 142.86 0.36 3.58 0.18 0.09 0.15 0.01
Ghana 2014 (Sebiawu et al., 2014) 4.3 3.07 1023.81 2.57 25.68 1.32 0.66 1.10 0.09
Hungary 2009 (Hamidatou et al., 2009) 8.4 6.00 2000.00 5.02 50.16 2.57 1.29 2.15 0.18
India 2019 (Özcan et al., 2019) 1.4 1.00 333.33 0.84 8.36 0.43 0.21 0.36 0.03
India 2010 (Verma et al., 2010) 4.1 2.93 976.20 2.45 24.48 1.26 0.63 1.05 0.09
Iraq 2021 (Haleem and Amin, 2021) 3.3 2.36 785.72 1.97 19.71 1.01 0.51 0.84 0.07
Iraq 2020 (Haleem et al., 2020) 3.3 2.36 785.72 1.97 19.71 1.01 0.51 0.84 0.07
Iraq 2014 (Karbon et al., 2015) 3.8 2.71 904.76 2.27 22.69 1.16 0.58 0.97 0.08
Kenya 2015 (Peter et al., 2020) 2.8 2.00 666.67 1.67 16.72 0.86 0.43 0.72 0.06
Malaysia 2017 (Ismail et al., 2017) 22.1 15.79 5261.92 13.20 131.97 6.77 3.38 5.66 0.48
Nigeria 2013 (Eneji et al., 2013) 0.12 0.09 28.57 0.07 0.72 0.04 0.02 0.03 0.002
Nigeria 2009 (Asubiojo et al., 2009) N.A 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Nigeria 2013 (IWUOHA et al., 2013) 21.6 15.423 5142.86 12.90 128.98 6.61 3.31 5.53 0.46
Nigeria 2011 (Anhwange and Yiase, 2011) 2.2 1.57 523.81 1.31 13.14 0.67 0.34 0.56 0.05
Nigeria 2018 (Azeez et al., 2019) 6.4 4.57 1523.81 3.82 38.22 1.96 0.98 1.64 0.14
Pakistan 2024 (Hussain et al., 2024) 11.2 8.0 2666.67 6.69 66.88 3.43 1.71 2.87 0.24
Romanian 2014 (AGOROAEI et al., 2014) 3.8 2.71 904.76 2.27 22.69 1.16 0.58 0.97 0.08
Romania 2018 (Strungaru et al., 2018) 1.2 0.86 285.71 0.72 7.17 0.37 0.18 0.31 0.03
Saudi Arabia 2021 (Dahlawi et al., 2021) 1.8 1.29 428.57 1.07 10.75 0.55 0.28 0.46 0.04
Spain 2015 (Armendáriz et al., 2015) 1.4 1.00 333.33 0.84 8.36 0.43 0.21 0.36 0.03
Tanzania 2024 (Ntarisa, 2024) 1.82 1.3 433.33 1.09 10.87 0.56 0.28 0.47 0.04
Turkey 2012 (Duran et al., 2012) 5.0 3.57 1190.48 2.99 29.86 1.53 0.77 1.28 0.11
Turkey 2001 (Barlas et al., 2001) 1.6 1.14 380.92 0.96 9.55 0.49 0.24 0.41 0.03
U.S 2013 (Caruso et al., 2013) 2.4 1.71 571.43 1.43 14.33 0.73 0.37 0.61 0.05
Average 4.49 3.21 1069.05 2.68 26.81 1.37 0.69 1.15 0.097
Table 6 Estimation of non-carcinogenic and carcinogenic health risks for As.
Manufactures country Year Reference Mean concentrations (mg/kg) Non-carcinogenic health risk Carcinogenic health risk
Ingestion Inhalation Ingestion Inhalation
ADD ( × 10 - 6 mg/kg-day) HQ × 10 - 3 ADD (mg/m3-day) HQ × 10 3 LADD ( × 10 - 6 mg/kg-day) Cancer risk × 10 - 6 LADD (mg/m3-day) Cancer risk × 10 - 3
Benin 2012 (Agbandji et al., 2013) 37.1 26.50 88.33 32.33 2155.33 11.36 17.04 13.86 59.58
Brazil 2011 (Viana et al., 2011) 0.09 0.06 0.21 0.08 5.23 0.03 0.04 0.03 0.15
China 2014 (O’Connor et al., 2014) 0.8 0.57 1.90 0.70 46.48 0.24 0.37 0.30 1.29
France 2012 (Agbandji et al., 2013) 50 35.71 119.05 43.57 2904.76 15.31 22.96 18.67 80.30
Hungary 2009 (Hamidatou et al., 2009) 3.9 2.79 9.29 3.40 226.57 1.19 1.79 1.46 6.26
India 2009 (Dhaware et al., 2009) 0.5 0.36 1.19 0.44 29.05 0.15 0.23 0.19 0.80
Ireland 2015 (Afridi et al., 2015) 0.2 0.14 0.48 0.17 11.62 0.06 0.09 0.07 0.32
Malaysia 2017 (Ismail et al., 2017) 0.03 0.02 0.07 0.03 1.74 0.01 0.014 0.01 0.048
Mexico 2008 (Martínez et al., 2008) 0.6 0.43 1.43 0.52 34.86 0.18 0.28 0.22 0.96
Serbia 2012 (Lazarević et al., 2012) 0.2 0.14 0.48 0.17 11.62 0.06 0.09 0.07 0.32
Turkey 2001 (Barlas et al., 2001) 0.9 0.64 2.142 0.78 52.29 0.28 0.41 0.34 1.45
U.S 2013 (Caruso et al., 2013) 0.2 0.14 0.48 0.17 11.62 0.06 0.09 0.07 0.32
Average 7.9 5.6 18.75 6.9 457.60 2.41 3.62 2.94 12.6
Table 7 Estimation of non-carcinogenic and carcinogenic health risks for Hg.
Manufactures country Year Reference Mean concentrations (mg/kg) Non-carcinogenic health risk
Ingestion Inhalation
ADD ( × 10 - 6 mg/kg-day) HQ × 10 - 3 ADD (mg/m3-day) HQ × 10 3
Ireland 2015 (Afridi et al., 2015) 4.4 3.14 31.43 10.33 34.45
Japan 2021 (Dinh et al., 2021) 12.3 8.79 87.86 28.89 96.29
Malaysia 2017 (Ismail et al., 2017) 0.2 0.14 1.43 0.47 1.57
Pakistan 2019 (Haleem et al., 2020) 0.1 0.07 0.71 0.23 0.78
Turkey 2001 (Barlas et al., 2001) 0.3 0.21 2.14 0.70 2.35
Average 3.5 2.47 24.71 8.13 27.09

Table 8 shows the average arithmetic mean concentration, Mean. ADD Ing , ADD Inh , LADD Ing , LADD Inh , HQ Ing , HQ Inh , Risk Ing , and Risk Inh . The mean LADD for carcinogenic human health risks through ingestion were 0.89, 3.21, 1.37 and 2.41 × 10 - 6  mg/kg-day for Cd, Pb, Cr and As, respectively. The mean LADD values for inhalation were 1.64, 10.85, 1.15, and 2.94 mg/m3-kg for Cd, Pb, Cr and As, respectively. The mean risk for ingestion was 1.34, 0.14, 0.69 and 3.62 × 10 - 6 for Cd, Pb, Cr and As, respectively. The mean risk for inhalation was 2.95, 96.50 and 12.6 × 10 - 3 for Cd, Cr and As, respectively. A risk within the range of 1 × 10 - 6 to 1 × 10 - 4 is considered acceptable(Benson et al., 2017; Ismail et al., 2017; Ntarisa, 2024). Therefore, the ingestion risk for all metals is acceptable as it falls within the permissible range, while the inhalation risk for all metals is unacceptable since all values exceed the accepted limit of 1 × 10 - 6 to 1 × 10 - 4 . Fig. 1 shows some effects of toxic heavy metals present in tobacco cigarettes. From the figure, lung cancer is the main contributor to cancer due to tobacco cigarettes smoking from contaminated heavy metals such as Cd, Hg, Pb, Cr As, etc.

Table 8 Average arithmetic mean concentration, Mean ADD Ing , ADD Inh , LADD Ing , LADD Inh , HQ Ing , HQ Inh , Risk Ing , and.. Risk Inh
Toxic heavy metal Average arithmetic Mean concentrations (mg/kg) Non-carcinogenic health risk Carcinogenic health risk
Ingestion Inhalation Ingestion Inhalation
Mean ADD ( × 10 - 6 mg/kg-day) Mean HQ × 10 - 3 Mean ADD (mg/m3-day) Mean HQ × 10 3 Mean LADD ( × 10 - 6 mg/kg-day) Mean Cancer risk × 10 - 6 Mean LADD (mg/m3-day) Mean Cancer risk × 10 - 3
Cd 2.91 2.08 20.80 3.83 382.85 0.89 1.34 1.64 2.95
Pb 10.48 7.48 2.08 25.33 0.72 3.21 0.14 10.85 *
Cr 4.49 3.21 1.07 2.68 26.81 1.37 0.69 1.15 96.50
As 7.9 5.6 18.75 6.9 457.60 2.41 3.62 2.94 12.6
Hg 3.5 2.47 24.71 8.13 27.09 * * * *
* = Not found in the literature.
Tobacco cigarette brand, type of metals, inhalation process, and how it affects human health.
Fig. 1
Tobacco cigarette brand, type of metals, inhalation process, and how it affects human health.

4

4 Conclusion

The current study reviewed articles that offered a thorough examination of the human health risk assessment associated with toxic metals found in various brands of tobacco cigarettes. The study analysed 76 articles from various continents to ascertain human risk assessment of toxic metals Cd, Pb, Cr, As, and Hg in cigarette brands manufactured worldwide. The targeted articles were those published in English from 2000 to September 2024. The result shows that HQ < 1 for all toxic metal ingestion. It signifies no health risk. However, if HQ > 1 for all metal inhalation, it signifies considerable health risks. The reviewed studies show risk ingestion for all metals is acceptable since it falls within the range of 1 × 10 - 6 to 1 × 10 - 4 . Sadly, the risk of inhalation for all metal is unacceptable since all are out of the range of 1 × 10 - 6 to 1 × 10 - 4 . The data produced in this review will establish baseline risk values for toxic heavy metals in various cigarette brands worldwide.

CRediT authorship contribution statement

Anastazia Tarimo Felix: Writing – review & editing, Writing – original draft, Visualization, Software, Resources, Methodology, Investigation, Formal analysis, Data curation, Conceptualization. Amos Vincent Ntarisa: Writing – review & editing, Validation, Supervision, Resources, Project administration, Methodology, Funding acquisition, Conceptualization.

Funding

This research received no grant from any funding agency.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Appendix A

Supplementary data

Supplementary data to this article can be found online at https://doi.org/10.1016/j.jksus.2024.103484.

Appendix A

Supplementary data

The following are the Supplementary data to this article:

Supplementary Data 1


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