Cotinine and Tobacco-Specific Carcinogen Exposure Among Nondaily Smokers in a Multiethnic Sample

UMMS Affiliation

Department of Medicine, Division of Preventive and Behavioral Medicine

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Document Type



Behavioral Disciplines and Activities | Behavior and Behavior Mechanisms | Chemicals and Drugs | Community Health and Preventive Medicine | Preventive Medicine | Substance Abuse and Addiction


BACKGROUND: Nondaily smoking has increased among current U.S. smokers in the past decade and is practiced by a significant percentage of smokers. Although research in nondaily smoking has grown, little is known about levels of exposure to tobacco toxicants among nondaily smokers and their variation across ethnic groups.

METHODS: We examined urinary levels of cotinine and a tobacco-specific nitrosamine (NNAL) in community participants. Associations between the biomarker data and smoking characteristics were evaluated using Spearman's correlation analysis.

RESULTS: Participants were 28 Blacks, 4 Latinos, and 25 Whites who smoked at least 1 cigarette on 4-24 days in the past 30 days. Participants averaged 3.3 (SD = 2.1) cigarettes per day (cpd) on days smoked, smoked an average of 13.0 (SD = 5.4) days in the past month, and smoked nondaily for 10.5 (SD = 10.5) years. Median levels of creatinine-normalized cotinine and NNAL were 490.9ng/mg and 140.7 pg/mg, respectively. NNAL and cotinine were highly correlated, r = .84; NNAL and cotinine were modestly correlated with cpd, r = .39 and r = .34 (all p values

CONCLUSIONS: Our findings demonstrate that nondaily smokers are, on average, exposed to significant levels of nicotine and carcinogenic nitrosamines, with exposures of 40%-50% of those seen in daily smokers. This level of exposure suggests a significant health risk. Nicotine and carcinogen exposure is most closely related to number of cigarettes smoked per day but not to number of days per month of smoking.

DOI of Published Version



Khariwala SS, Scheuermann TS, Berg CJ, Hayes RB, Nollen NL, Thomas JL, Guo H, Ahluwalia JS, Benowitz NL. Cotinine and Tobacco-Specific Carcinogen Exposure Among Nondaily Smokers in a Multiethnic Sample. Nicotine Tob Res. 2014 May;16(5):600-5. doi: 10.1093/ntr/ntt194. Link to article on publisher's site

Journal/Book/Conference Title

Nicotine and tobacco research : official journal of the Society for Research on Nicotine and Tobacco

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Link to Article in PubMed

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