Cigarette rod length and its impact on serum cotinine and urinary total NNAL levels, NHANES 2007-2010.
BACKGROUND
Research suggests that smokers of slim, long, or ultralong cigarettes may have a perception of reduced harm from their own brand. This study compared serum cotinine and urinary total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanonol (NNAL) levels among smokers of regular-sized (68-72mm), king-sized (79-88mm), and long (94-101mm) or ultralong (110-121mm) cigarettes.


METHODS
Nationally representative data from the 2007-2008 and 2009-2010 National Health and Nutrition Examination Survey were analyzed for 3,699 current smokers aged ≥20 years. Biomarker levels were summarized using geometric means (GMs). Multivariate linear regression analyses were performed to assess the effect of cigarette rod length on log-transformed serum cotinine and creatinine-adjusted urinary total NNAL levels.


RESULTS
The GM of serum cotinine level was higher among smokers of long/ultralong cigarettes (263.15ng/ml) compared with smokers of regular-sized (173.13ng/ml) or king-sized (213.79ng/ml) cigarettes. Similarly, the GM of creatinine-adjusted NNAL levels was higher among smokers of long/ultralong cigarettes (0.48ng NNAL/mg of creatinine) compared with smokers of regular-sized (0.34ng NNAL/mg of creatinine) or king-sized (0.33ng NNAL/mg of creatinine) cigarettes. After adjusting for potential confounders, mean cotinine and NNAL levels were both significantly higher among smokers of long/ultralong cigarettes compared with levels observed in smokers of either regular-sized or king-sized cigarettes. However, no significant differences were observed between smokers of regular-sized and king-sized cigarettes in mean levels of cotinine or NNAL.


CONCLUSIONS
Significantly elevated tobacco biomarker levels were observed among smokers of long/ultralong cigarettes compared with smokers of regular-sized or king-sized cigarettes. This underscores the need to educate the public about the dangers of all tobacco products.
Department of Social and Behavioral Sciences, Center for Global Tobacco Control, Harvard School of Public Health, Boston, MA.
Israel T
IT
Agaku
Constantine I
CI
Vardavas
Gregory N
GN
Connolly
D000328:Adult; D015415:Biomarkers / Q000097:blood / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000097:blood*; D009602:Nitrosamines / Q000652:urine*; D011725:Pyridines / Q000652:urine*; D062789:Tobacco Products / Q000009:adverse effects*; D055815:Young Adult
D015415:Biomarkers; D009602:Nitrosamines; D011725:Pyridines; D009538:Nicotine; C099565:4-(methylnitrosamino)-1-(3-pyridyl)-1-butan-1-ol