Black Light Smokers: How Nicotine Intake and Carcinogen Exposure Differ Across Various Biobehavioral Factors

• Published in: Journal of the National Medical Association Vol. 111; no. 5; pp. 509 - 520
• Main Authors: St.Helen, Gideon, Benowitz, Neal L., Ahluwalia, Jasjit S., Tyndale, Rachel F., Addo, Newton, Gregorich, Steven E., Pérez-Stable, Eliseo J., Cox, Lisa Sanderson
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2019; Elsevier Limited
• Subjects: Age; Biomarkers; Black smokers; Carcinogen exposure; Cigarettes; Correlates of exposure; Disease; Gender; Light; Light smokers; Lung cancer; Metabolism; Metabolites; Minority & ethnic groups; Nicotine; Smoking; Studies; Tobacco; 3-HC; COT; NNK; TNE; Black smokers; FTCD; Correlates of exposure; NNAL; TFC; NMR; CPD; Carcinogen exposure; Light smokers; NHANES; Nicotine
• ISSN: 0027-9684; 1943-4693
• DOI: 10.1016/j.jnma.2019.04.004

The study objective was to identify biobehavioral variables associated with greater intake of nicotine and a tobacco carcinogen among Black light smokers who smoke 1 to 10 cigarettes per day (CPD). We analyzed baseline data collected from 426 Black light smokers enrolled in Kick It at Swope III (KIS III), a smoking cessation trial for Black smokers. We examined differences in concentrations of tobacco biomarkers, including urinary total nicotine equivalents (TNE) and total 4-(methylnitrosamino)-1-(3)pyridyl-1-butanonol (NNAL; a human carcinogen), across gender, age, plasma nicotine metabolite ratio (NMR), CPD, and measures of tobacco dependence, including time to first cigarette (TFC), using ANOVA. Tobacco biomarker levels were significantly higher among those who smoked more CPD (6–10 vs 1–5 CPD) and those with greater reported physical dependence on tobacco. Concurrently, those who smoked 1–5 CPD smoked each cigarette more intensely than those who smoked 6–10 CPD. While we found no gender differences overall, among those who smoked 1–5 CPD, women had higher NNAL levels compared to men. The rate of nicotine metabolism, measured by the nicotine metabolite ratio, was not significantly related to TNE or NNAL levels. Among Black Light smokers, higher cigarette consumption and greater physical dependence—but not rate of nicotine metabolism, menthol use, or socioeconomic status—were associated with greater toxicant exposure and thus a likely increased risk of tobacco-related diseases. The lack of data on light smokers, and specifically on Blacks, make this observation important given the disproportionate burden of lung cancer in this population.