Changes in Biomarkers of Tobacco Exposure among Cigarette Smokers Transitioning to ENDS Use: The Population Assessment of Tobacco and Health Study, 2013-2015.

Hoda T Hammad,Yuesong Wang,Lanqing Wang,Cindy M Chang,Andrew Hyland,Dana M Van Bemmel,Lisa M Faulcon,Carol H Christensen,Wilson M Compton,Nicolette Borek,Brian L Rostron,Antònia M Calafat ,Raymond Niaura ,Stephen S Hecht,Kathryn C Edwards,Maciej Ł Goniewicz ,Heather L Kimmel,Benjamin C Blount,Deepak Bhandari,Gabriella M Anic,Colm Everard ,Binnian Wei,Dorothy K Hatsukami,Arseima Y Del Valle-Pinero,Bridget K Ambrose,Gladys Erives

doi:10.3390/ijerph19031462

Abstract

Limited data are available for how biomarkers of tobacco exposure (BOE) change when cigarette smokers transition to using electronic nicotine delivery systems (ENDS). Using biomarker data from Waves 1 (2013–2014) and 2 (2014–2015) of the PATH Study, we examined how mean BOE concentrations, including metabolites of nicotine, tobacco-specific nitrosamines (TSNA), polycyclic aromatic hydrocarbons (PAH), and volatile organic compounds (VOC) and metals, changed when 2475 adult smokers transitioned to using ENDS or quit tobacco products. Exclusive smokers who transitioned to dual use had a significant decrease in NNAL (4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol), but not nicotine metabolites, most PAHs, metals, or VOCs. Exclusive smokers who became dual users had significant reductions in total nicotine equivalents, NNAL, and 2CyEMA (acrylonitrile metabolite), but only in those who reduced cigarettes per day (CPD) by >=50%. Smokers who transitioned to exclusive ENDS use had significant reductions in most TSNAs, PAHs, and VOCs; however, nicotine metabolites did not decrease in dual users who became exclusive ENDS users. Smokers who quit tobacco use had significant decreases in nicotine metabolites, all TSNAs, most PAHs, and most VOCs. Cigarette smokers who became dual users did not experience significant reductions in most BOEs. Reductions were impacted by changes in CPD. However, transitioning from smoking to no tobacco or exclusive ENDS use was associated with reduced exposure to most BOEs measured. Future analyses could incorporate additional waves of PATH data and examine changes in biomarker exposure by ENDS device type and CPD.

Highlights

Biomarkers of tobacco exposure (BOE) are used to characterize human exposure to harmful and potentially harmful constituents (HPHC) resulting from tobacco product use
The study was conducted by the Center for Tobacco Products (CTP), Food and Drug Administration (FDA) and the National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH) under a contract with Westat [18]
Similar demographic characteristics were observed for dual users who became exclusive electronic nicotine delivery systems (ENDS) users or stopped all tobacco use, these groups had a higher proportion of participants who had at least some college education

Summary

Introduction

Biomarkers of tobacco exposure (BOE) are used to characterize human exposure to harmful and potentially harmful constituents (HPHC) resulting from tobacco product use. E-cigarette aerosol contains many of the HPHCs found in combusted tobacco products including carbonyl compounds, VOC, and TSNA, at lower levels than in cigarette smoke [2]. Several cross-sectional studies have compared biomarkers of exposure (BOE) to tobacco product toxicants between cigarette smokers and ENDS users [3,4,5,6,7,8,9,10,11]. Those studies observed significantly lower levels of various TSNA, VOC, and some PAH in ENDS-only users compared to exclusive cigarette smokers.

Methods

Results

Discussion

Conclusion