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The human health risks of cadmium (Cd), lead (Pb), and nickel (Ni) in fifty regular and slim cigarette brands available in the Serbian market were evaluated. Distributions on per-cigarette basis concentrations of these metals, as determined by graphite furnace atomic absorption spectrometry, were used as inputs in the probabilistic risk assessment. The contents of these metals in cigarettes varied significantly. Larger quantities of the studied metals were observed in regular cigarettes than in slim cigarettes, but the concentration levels per cigarette tobacco mass were higher in slim cigarettes. The metal concentrations in counterfeit cigarettes were marginally higher than those in authentic brands. Based on the mean concentrations, Pb was the most abundant toxic metal, followed by Ni and Cd. The calculated values of the cumulative hazard index (HI) and incremental lifetime cancer risk (ILCR) indicated a low noncarcinogenic risk and low but not negligible carcinogenic risk from Cd, Pb, and Ni. The mean HI and ILCR values obtained using probabilistic and deterministic approaches were similar. A Monte Carlo simulation was employed to minimize the uncertainty of health risk estimation. The sensitivity analysis revealed that the most influential factor was cigarette mass followed by Cd content.

Monte Carlo simulation of health risk from cadmium, lead, and nickel in cigarettes