Racial Differences in Serum Cotinine Levels of Smokers

Abstract

Abstract. The purpose of this study was to estimate black/white differences in cotinine levels for current smokers of both sexes, and to explore the potential contribution of mentholated cigarettes to these differences. Sera from 255 current smokers sampled from Southern Community Cohort Study participants (65 black men, 65 black women, 63 white men, 62 white women) were analyzed for cotinine, and linear regression was used to model the effect of race on cotinine level, adjusting for the number of cigarettes smoked within the last 24 hours, use of menthol vs. non-menthol cigarettes, exposure to environmental tobacco smoke, and age. Black smokers smoked fewer cigarettes than white smokers, yet had crude mean cotinine levels nearly as high or higher than white smokers. After multivariate adjustment, cotinine levels were an average of 50 ng/ml higher among black than white women (p = 0.008) and non-significantly 12 ng/ml higher among black than white men (p = 0.52). We observed no increase in cotinine levels associated with menthol cigarette use. We conclude that differences in cotinine levels among smokers suggest racial variation in exposure to and/or metabolism of tobacco smoke constituents, but our findings do not support a role for menthol preference in this disparity.

Comparison of Serum Cotinine Concentration within and across Smokers of Menthol and Nonmenthol Cigarette Brands among Non-Hispanic Black and Non-Hispanic White U.S. Adult Smokers, 2001–2006

“…Also, on an average, the specific menthol brand and subbrands black smokers smoked had a higher FTC nicotine levels than the nonmenthol brands (the preferred type of cigarette smoked by whites) smoked by white smokers. At least 2 previous studies have found higher cotinine concentrations among smokers of mentholated cigarettes (20,21), whereas others did not (22)(23)(24)(25)(26)(27). In a recent study a Model 1: cpd þ continuous nicotine þ sex þ continuous weight.…”

Disparities Between Blacks and Whites in Tobacco and Lung Cancer Treatment

“…However, despite later initiation, black adults smoke at rates similar to whites (black men, 23.9%; black women, 19.2%; white men, 24.5%; white women, 19.8%) [23]. This is of particular concern because evidence suggests that racial differences in nicotine exposure (nicotine intake per cigarette is 30.0% greater) and metabolism of tobacco (slower clearance of nicotine) place black smokers, compared with white smokers, at a higher risk for tobacco-related diseases [24,25]. Blacks also have a lower rate of successful quitting [4,26].…”

Smoking, Menthol Cigarettes, and Peripheral Artery Disease in U.S. Adults

“…Some studies have shown that menthol cigarette use is associated with increased biomarkers of intake of tobacco smoke constituents (Clark, Gautam, & Gerson, 1996;Williams et al, 2007), whereas other studies have found no differences in levels of tobacco biomarkers by cigarette type (Ahijevych, Gillespie, Demirci, & Jagadeesh, 1996;Benowitz, Herrera, & Jacob, III, 2004;Heck, 2009;Muscat et al, 2009;Mustonen et al, 2005;Signorello, Cai, Tarone, McLaughlin, & Blot, 2009;Tobacco Products Scientific Advisory Committee [TPSAC], 2011;Wang et al, 2010). In a study of 161 Black and White smokers, menthol cigarettes were associated with higher cotinine levels and carbon monoxide concentrations after adjusting for race, cigarettes per day, and mean amount of cigarettes smoked (cigarettes smoked per day × average length [in millimeters] of each cigarette smoked; Clark et al, 1996).…”