Abstract
Cross-sectional survey data (N = 3264) from the National Health and Nutrition Examination Survey for 2013–2018 were used to investigate how serum hydroxycotinine concentrations vary among US adult smokers aged ≥ 20 years by smoker type. Those reporting using tobacco products during the last 5 days were classified as smokers. Smokers were classified as being cigarette only smokers, cigar only smokers, cigar and cigarette smokers, dual cigarette and e-cigarette smokers, e-cigarette only smokers, smokeless tobacco only users, and all other smokers. Regression models stratified by smoker type with log10 transformed values of serum hydroxycotinine as dependent variable were fitted to compute adjusted geometric means (AGM) for each type of smoker. The order in which various types of smokers were found to have AGMs for serum hydroxycotinine was cigarette and e-cigarette users (64.61 ng/mL), cigarette only smokers (53.17 ng/mL), smokeless tobacco only users (44.89 ng/mL), cigar and cigarette smokers (36.99 ng/mL), e-cigarette only users (32.52 ng/mL), smokers of miscellaneous tobacco products (20.32 ng/mL), and cigar smokers only (10.75 ng/mL). Compared to this as presented in a recent study, the order in which serum cotinine AGMs were: smokeless tobacco only users (272 ng/mL), cigarette only smokers (152.5 ng/mL), cigarette-e-cigarette or e-cigarette only users (146.3 ng/mL), smokers of miscellaneous tobacco products (105.5 ng/mL), cigar and cigarette smokers (92.5 ng/mL), cigar smokers only (65.1 ng/mL). Among cigarette only smokers, males had lower AGM than females (47.18 vs. 59.91 ng/mL, p < 0.01), but the reverse was true for smokeless tobacco only and miscellaneous smokers. In general, differences for hydroxycotinine levels did not exist among non-Hispanic white and non-Hispanic black smokers. Among US adults, cigarette only and dual cigarette-e-cigarette smokers had the highest, and cigar smokers had the lowest concentrations of serum hydroxycotinine.
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Data availability
All data used for analysis for this study are in public domain and available free of charge at www.cdc.gov/nchs/nhanes/index.htm
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The responsibility of executing every aspect of this study was borne by Ram B. Jain. This included conceptualizing and designing the study; generating study database; deciding the methods of statistical analysis; conducting the data analysis; generating, tabulating, and interpreting the study results; and ultimately, writing, reviewing, revising, and finalizing the study manuscript.
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Jain, R.B. Concentrations of serum hydroxycotinine for US adult smokers aged ≥ 20 years by type of smoker. Environ Sci Pollut Res 28, 43948–43955 (2021). https://doi.org/10.1007/s11356-021-13848-z
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DOI: https://doi.org/10.1007/s11356-021-13848-z