REVIEW Tobacco Smoke Carcinogens and Lung Cancer

The complexity of tobacco smoke leads to some confusion about the mechanisms by which it causes lung cancer. Among the multiple components of tobacco smoke, 20 car-cinogens convincingly cause lung tumors in laboratory ani-mals or humans and are, therefore, likely to be involved in lung cancer induction. Of these, polycyclic aromatic hydro-carbons and the tobacco-specific nitrosamine 4-(methylni-trosamino)-1-(3-pyridyl)-1-butanone are likely to play major roles. This review focuses on carcinogens in tobacco smoke as a means of simplifying and clarifying the relevant infor-mation that provides a mechanistic framework linking nico-tine addiction with lung cancer through exposure to such compounds. Included is a discussion of the mechanisms by which tobacco smoke carcinogens interact with DNA and cause genetic changes—mechanisms that are reasonably wel