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Cancer Epidemiol Biomarkers Prev. 2019 May;28(5):943-953. doi: 10.1158/1055-9965.EPI-18-0539. Epub 2019 Feb 7.

Biomarkers of Exposure among U.S. Adult Cigar Smokers: Population Assessment of Tobacco and Health (PATH) Study Wave 1 (2013-2014).

Author information

1
Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland. Cindy.Chang@fda.hhs.gov.
2
Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland.
3
National Institute on Drug Abuse, National Institutes of Health, Bethedsa, Maryland.
4
U.S. Centers for Disease Control and Prevention, Atlanta, Georgia.
5
Roswell Park Comprehensive Cancer Center, Buffalo, New York.
6
Westat, Rockville, Maryland.
7
Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.

Abstract

BACKGROUND:

Given the diverse cigar market and limited data on biomarker patterns by cigar type, we compared biomarkers of nicotine and tobacco toxicants among cigar smokers and other groups.

METHODS:

Using Wave 1 urinary biomarker data from 5,604 adults in the Population Assessment of Tobacco and Health (PATH) Study, we compared geometric mean concentrations among cigar-only smokers (all cigars and separately for traditional, cigarillo, and filtered cigars), cigarette-only smokers, dual cigar/cigarette smokers, and never users of tobacco. We calculated geometric mean ratios comparing groups with never users adjusting for sex, age, race/ethnicity, education and creatinine.

RESULTS:

Some day cigar-only smokers had lower biomarker concentrations than every day cigar-only smokers, but higher than never users. Every day cigar-only smokers (n = 61) had lower TNE-2 (cotinine+trans-3'-hydroxycotinine) compared to every day cigarette-only (n = 2217; P < 0.0001) and dual cigar/cigarette smokers (n = 601; P < 0.0001). Several biomarkers, including NNAL (NNK metabolite) and CYMA (metabolite of acrylonitrile), were comparable in these groups. In exploratory analyses, every day filtered cigar-only (n = 7) smokers had higher biomarker concentrations compared with every day traditional cigar-only smokers (n = 12) and cigarillo-only smokers (n = 24). Every day smokers of each cigar type were similar to exclusive cigarette smokers. For some biomarkers, particularly for every day filtered cigar-only smokers, concentrations were higher.

CONCLUSIONS:

For some biomarkers, every day cigar-only smokers were comparable with every day cigarette-only smokers. Exploratory analyses suggest that biomarkers vary by cigar type with every day filtered cigar-only smokers having the highest concentrations.

IMPACT:

High exposure to harmful constituents among cigar smokers is a continuing health issue.

PMID:
30733305
PMCID:
PMC6500461
[Available on 2020-05-01]
DOI:
10.1158/1055-9965.EPI-18-0539

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