Comparison of serum benzo(a)pyrene diol epoxide - Protein adducts level between kretek cigarette smokers and nonsmokers and the related factors

Background: Benzopyrene is a carcinogenic agent found in cigarette smoke. Benzo(a)pyrene diol epoxide (BPDE) is one of the benzopyrene metabolites. In this study, we investigated the level of serum BPDE in kretek cigarette smokers compared to non-smokers. Methods: A cross-sectional study which involved 32 "healthy" kretek cigarette smokers and 32 "healthy" nonsmokers were conducted. We collected the blood sample and the serum BPDE level was assayed using enzyme-linked immunosorbent assay kit. The BPDE serum level in kretek cigarette smokers was compared to the level in nonsmokers. Results: A total of 32 kretek smokers and 32 controls underwent an examination of the BPDE-protein adducts level. In the kretek smokers group, 59.4% were aged over 45 years and 56.3% have a high educational background, while in the control group, 87.5% were aged under 45 years and 75% have high educational backgrounds. The level of BPDE-protein adducts in the kretek smokers subject was 12.15 (8.87-33.55) ng/ml and the levels in the control group were 11.4 (3.87-13.27) ng/ml, P = 0.004. The factors which influence the levels BDPE-protein adducts in smokers cigarettes, as determined by multivariate analysis, were sucking pattern (P = 0.002) and the degree of addiction (P = 0.047). Conclusion: The serum BPDE-protein adducts level was higher in smokers compared to nonsmokers, and the sucking pattern and degree of addiction are the influencing factors.