Two essential aspects of NNK- and NNN-induced cancer. Metabolic activated NNK and NNN induce DNA adducts, which can be eliminated by functional DNA repair networks. Unresolved DNA adducts further cause mutations in oncogenes and tumor suppressor genes, which consists of the first step of NNK and NNN specific carcinogenesis. Binding of NNK and NNN to nAChRs promote tumor growth by enhancing and deregulating cell proliferation, cell survival and cell migration as well as cell invasion, which is the second step of NNK- and NNN-induced cancer. The combination of these two aspects of the biological reactions of NNK and NNN provide the condition for tumor development in smokers. NNK: 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone, NNN: N'-nitrosonornicotine.
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