Nicotine was not included in previous efforts to identify the most important toxicants of tobacco smoke. A health risk assessment of nicotine for smokers of cigarettes was conducted using the margin of exposure (MOE) approach and results were compared to literature MOEs of various other tobacco toxicants. The MOE is defined as ratio between toxicological threshold (benchmark dose) and estimated human intake. Dose-response modelling of human and animal data was used to derive the benchmark dose. The MOE was calculated using probabilistic Monte Carlo simulations for daily cigarette smokers. Benchmark dose values ranged from 0.004 mg/kg bodyweight for symptoms of intoxication in children to 3 mg/kg bodyweight for mortality in animals; MOEs ranged from below 1 up to 7.6 indicating a considerable consumer risk. The dimension of the MOEs is similar to those of other tobacco toxicants with high concerns relating to adverse health effects such as acrolein or formaldehyde. Owing to the lack of toxicological data in particular relating to cancer, long term animal testing studies for nicotine are urgently necessary. There is immediate need of action concerning the risk of nicotine also with regard to electronic cigarettes and smokeless tobacco.

Introducción: El consumo de sustancias psicoactivas en la adolescencia y adultez temprana se ve sujeto a una naturaleza dinámica compleja. Objetivo: Evaluar los factores de riesgo para el consumo de SPA en jóvenes peruanos que participaron en la cohorte mayor de “Niños del Milenio” en dos periodos durante el 2009 al 2016. Materiales y métodos: Realizamos un estudio observacional, analítico, tipo cohorte basado en la revisión secundaria de la cohorte mayor de “Niños del Milenio” en Perú. Nuestra población incluyó aquellos registros con datos completos de la 1era a la 5ta ronda analizados en dos periodos de seguimiento. Se excluyeron aquellos registros que reportaron el consumo alguna SPA al inicio de cada periodo. Se obtuvo una potencia mayor al 80%. Realizamos un Modelo Lineal Generalizado familia Poisson con función de enlace log ajustado por clústeres que permitió calcular el riesgo relativo. El análisis se efectuó en Stata versión 14.0. Los valores p <0.05 fueron considerados estadísticamente significativos. Resultados: La incidencia de consumo de alguna SPA fue de 67.31% y 60.20% en el primer y segundo periodo, respectivamente. En el Periodo 1, ser hombre, tener amigos consumidores de alcohol o tabaco y pertenecer a una familia monoparental incrementó el riesgo de consumir alguna SPA. En el Periodo 2, ser hombre incrementó el riesgo de consumir alguna SPA mientras no encontrarse estudiando lo redujo. Conclusión: La incidencia de consumo de SPA fue 67.31% y 60.20% en cada periodo. Factores sociodemográficos y psicosociales incrementaron el riesgo de consumo. / Introduction: Psychoactive substance use onset in adolescence and youth is driven by a complex dynamic nature. Objective: We aim to evaluate risk factors related to PAS use in Peruvian youth enrolled in the older cohort of “Young Lives” Study in two periods through 2009 to 2016. Materials and Methods: We conducted a cohort type study based on secondary analysis of the older cohort of “Young Lives” Study in Peru. Our population included those subjects with complete data from all phases (1st to 5th). This data was analyzed in two follow-up periods. Those who declared the consumption of any PAS were excluded at baseline of each period. We obtained a power greater than 80%. We perform a Generalized Linear Model, Poisson family with log link adjusted by clusters from which we calculated crude and adjusted relative risk. The analysis was performed using Stata version 14.0. P-values <0.05 were considered statistically significant. Results: The incidence of PAS use was 67.31% and 60.20% in the first and second period, respectively. On Period 1, being male, having alcohol and tobacco consuming friends and belonging to a single-parent family increased the risk of consuming PAS. On Period 2, being male increased the risk of consuming any PAS and not being enrolled in school decreased it. Conclusion: PAS incidence was 67.31% and 60.20% in each period. Various sociodemographic and psychosocial factors increased the risk of consumption. / Tesis