Concentrations of Cotinine and 4-(Methylnitrosamino)-1-(3-Pyridyl)-1-Butanol (NNAL) in U.S. Non-Daily Cigarette Smokers

Abstract

Background: Accumulating evidence suggests that non-daily smokers have higher disease and mortality risks than never smokers. Yet, the accuracy of self-reported non-daily cigarette smoking is poorly understood. Methods: We examined the concordance between self-reported non-daily smoking and serum cotinine in 18,835 adult participants (20 years or older) of the 2007 to 2014 National Health and Nutrition Examination Surveys, in comparison with daily smokers and nonsmokers. We also analyzed concentrations of the urinary biomarker 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) by smoking status. Results: In the study sample, 77.8% (14,660) reported currently not smoking (nonsmokers), 18.3% (3,446) smoked every day (daily smokers), and 3.9% (729) smoked on some days of the past month (non-daily smokers). Just 2.1% of nonsmokers had cotinine concentrations in the active smoking range (>10 ng/mL), compared with 70.4% of non-daily and 98.8% of daily smokers. Non-daily smokers reported smoking a median of 24 cigarettes per month [interquartile range (IQR) = 9–60] and had substantially higher concentrations of NNAL (median = 72.5; IQR = 14.8–211.0 pg/mL) than nonsmokers (median = 0.4; IQR = 0.4–2.1 pg/mL), although lower than daily smokers (median = 294.0; IQR = 148.0–542.0 pg/mL). Among non-daily smokers, concentrations of cotinine and NNAL were positively correlated with days and cigarettes smoked per month (P < 0.001). Conclusions: We observed excellent concordance between self-reported non-daily cigarette smoking and concentrations of serum cotinine. Impact: These results provide evidence for the validity of self-reported non-daily smoking and indicate that non-daily smokers are exposed to substantial concentrations of carcinogenic nitrosamines regardless of the low number of cigarettes they smoke per month.

Short-term smoking increases the risk of insulin resistance

“…We defined “short-term smoking pattern” based on half-life values (i.e. 18–24 h, 40 days for cotinine and NNAL) 23 , 38 . A "Continuous smoker" was defined as a participant who met both smoking criteria for 18–24 h and 40 days.…”

Comparative Study on the Chronic Vascular Responses Induced by Regular Versus Occasional Waterpipe Smoke Inhalation in Mice

“…Moreover, we have demonstrated earlier that LDH is increased following short-and long-term exposure to WPS [42,62,63]. High levels of LDH in the plasma are usually associated with cell damage caused by smoking [31].…”

“…Accumulating evidences suggest that light and non-daily cigarette smoking are associated with increased morbidity including a similar risk of cardiovascular diseases as heavier smokers, different types of cancer, respiratory diseases and reproductive health problems [27][28][29][30][31]. Hence, as far as we are aware, there is a scarcity of data on the vascular and systemic effects of occasional WPS and in order to address that, we aimed to investigate the mechanisms underlying the effects of six months exposure to either Occ-WPS (30 minutes/ day, 1 day/week) or Reg-WPS (30 minutes/day, 5 days/week) on thrombogenicity, platelet aggregation, endothelial integrity, inflammation, and oxidative stress.…”

Switching away from smoking at 12 months among adult JUUL users varying in recent history of quit attempts made with and without smoking cessation medication

“…Importantly, research on nondaily smokers suggests that they are a relevant target for behavior change in the interest of prevention. Nondaily smokers have substantial exposure to smoking‐related toxicants 68 and incur significant increases in risk of premature mortality 50 . Although nondaily smokers are less dependent than daily smokers, they nevertheless demonstrated considerable dependence in the population‐representative PATH study 46 .…”