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

J Natl Med Assoc. 2019 Oct;111(5):509-520. doi: 10.1016/j.jnma.2019.04.004. Epub 2019 May 11.

Abstract

Objective: 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).

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Black smokers; Carcinogen exposure; Correlates of exposure; Light smokers; Nicotine.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Biomarkers / blood
  • Biomarkers / urine
  • Black or African American*
  • Carcinogens / metabolism
  • Cotinine / analogs & derivatives*
  • Cotinine / blood*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nicotine / metabolism*
  • Nitrosamines / urine*
  • Sex Factors
  • Smoking* / blood
  • Smoking* / urine
  • Tobacco Products / statistics & numerical data
  • Tobacco Use Disorder / blood
  • Tobacco Use Disorder / urine
  • Young Adult

Substances

  • Biomarkers
  • Carcinogens
  • Nitrosamines
  • hydroxycotinine
  • Nicotine
  • 4-(methylnitrosamino)-1-(3-pyridyl)-1-butan-1-ol
  • Cotinine