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Its mechanism of action and discovery are described below: Identified nitrosamine impurities with carcinogenic (cancer-causing) potential include: Sources of nitrosamine impurities include: 6, 24, 25, 26 Nitrosamines can be grouped by cancer risk, as follows: Human studies demonstrating increased cancer risk posed by nitrosamine include the following: Research suggests NDMA and NDEA may increase risk of liver cancer, as follows: FDA regulatory limits on nitrosamine contaminants led to the following recalls: The FDA set safety limits on N-nitroso-varenicline found in Chantix, as follows: 6 Higher Limits and Risk : Agency scientists determined that higher intake levels, up to 185 ng/day (92.5 ppm), pose a slightly increased cancer risk compared to the 37 ng/day limit

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These alterations can lead to an array of health issues, including: Hormone Affected Potential Consequences Cortisol Increased stress responses Estrogen Irregular periods, fertility issues Progesterone Early onset of menopause, painful sex Prolactin Depression, difficulty in getting pregnant Thyroid hormones Altered metabolism and energy levels Gonadotropins Irregular menstrual cycles The hormonal imbalances caused by smoking may result in irregular menstrual cycles, reduced fertility in women, and in some cases, an early onset of menopause, which can lead to symptoms like hot flashes and mood swings

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