Exposure to Nicotine and Toxicants among Dual Users of Tobacco Cigarettes and E-cigarettes: Populati
Friday, May 21, 2021
Posted by: Natalia Gromov
Danielle
M Smith, Carol Christensen, Dana van Bemmel, Nicolette Borek, Bridget Ambrose,
Gladys Erives, Raymond Niaura, Kathryn C Edwards, Cassandra A Stanton, Benjamin
C Blount, Lanqing Wang, Jun Feng, Jeffery M Jarrett, Cynthia D Ward, MS,
Dorothy Hatsukami, Stephen S Hecht, Heather L Kimmel, Mark Travers, Andrew
Hyland, Maciej L Goniewicz.
Exposure to Nicotine and
Toxicants among Dual Users of Tobacco Cigarettes and E-cigarettes: Population
Assessment of Tobacco and Health (PATH) Study, 2013–2014.
Nicotine & Tobacco Research, Volume 23, Issue 5, May 2021, Pages 790–797, https://doi.org/10.1093/ntr/ntaa252.
Introduction. Concurrent
use of tobacco cigarettes and e-cigarettes (“dual use”) is common among tobacco
users. Little is known about differences in demographics and toxicant exposure
among subsets of dual users.
Aims and Methods. We
analyzed data from adult dual users (current every/some day users of tobacco
cigarettes and e-cigarettes, n = 792) included in the PATH Study Wave 1
(2013–2014) and provided urine samples. Samples were analyzed for biomarkers of
exposure to nicotine and selected toxicants (tobacco-specific nitrosamine NNK
[NNAL], lead, cadmium, naphthalene [2-naphthol], pyrene [1-hydroxypyrene],
acrylonitrile [CYMA], acrolein [CEMA], and acrylamide [AAMA]). Subsets of dual
users were compared on demographic, behavioral, and biomarker measures to
exclusive cigarette smokers (n = 2411) and exclusive e-cigarette users (n =
247).
Results.
Most dual users were predominant cigarette smokers (70%), followed by daily
dual users (13%), non-daily concurrent dual users (10%), and predominant vapers
(7%). Dual users who smoked daily showed significantly higher biomarker
concentrations compared with those who did not smoke daily. Patterns of
e-cigarette use had little effect on toxicant exposure. Dual users with high
toxicant exposure were generally older, female, and smoked more cigarettes per
day. Dual users who had low levels of biomarkers of exposure were generally
younger, male, and smoked non-daily.
Conclusions.
In 2013–2014, most dual users smoked cigarettes daily and used e-cigarettes
occasionally. Cigarette smoking appears to be the primary driver of toxicant
exposure among dual users, with little-to-no effect of e-cigarette use on
biomarker levels. Results reinforce the need for dual users to stop smoking
tobacco cigarettes to reduce toxicant exposure.
Implications.
With considerable dual use of tobacco cigarettes and e-cigarettes in the United
States, it is important to understand differences in toxicant exposure among
subsets of dual users, and how these differences align with user demographics.
Findings suggest most dual users smoke daily and use e-cigarettes
intermittently. Low exposure to toxicants was most common among younger users,
males, and intermittent smokers; high exposure to toxicants was most common
among older users, females, and heavier cigarette smokers. Results underscore
the heterogeneity occurring within dual users, and the need to quit smoking
cigarettes completely in order to reduce toxicant exposure.
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