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Comparison of Nicotine Dependence and Biomarker Levels among Traditional Cigarette, Heat-Not-Burn Cigarette, and Liquid E-Cigarette Users: Results from the Think Study

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  • Guillaume Rudasingwa

    (Integrated Research Center of Risk Assessment, Soonchunhyang University, Soonchunhyang-Ro 22, Asan 31538, Korea)

  • Yeonjin Kim

    (Department of ICT Environmental Health System, Graduate School, Soonchunhyang University, Soonchunhyang-Ro 22, Asan 31538, Korea)

  • Cheolmin Lee

    (Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul 06236, Korea)

  • Jeomkyu Lee

    (Division of Respiratory and Allergy Disease Research, Department of Chronic Disease Convergence Research, National Institute of Health (NIH), Korea Disease Control and Prevention Agency (KDCA), Osong 28159, Korea)

  • Seunghyun Kim

    (Division of Respiratory and Allergy Disease Research, Department of Chronic Disease Convergence Research, National Institute of Health (NIH), Korea Disease Control and Prevention Agency (KDCA), Osong 28159, Korea)

  • Sungroul Kim

    (Integrated Research Center of Risk Assessment, Soonchunhyang University, Soonchunhyang-Ro 22, Asan 31538, Korea
    Department of ICT Environmental Health System, Graduate School, Soonchunhyang University, Soonchunhyang-Ro 22, Asan 31538, Korea)

Abstract

This study aimed to compare Korean smokers’ smoking-related biomarker levels by tobacco product type, including heat-not-burn cigarettes (HNBC), liquid e-cigarettes (EC), and traditional cigarettes (TC). Nicotine dependence levels were evaluated in Korean adult study participants including TC-, EC-, HNBC-only users and nonsmokers ( n = 1586) from March 2019 to July 2019 in Seoul and Cheonan/Asan South Korea using the Fagerström Test Score. Additionally, urine samples ( n = 832) were collected for the measurement of urinary nicotine, cotinine, OH-cotinine, NNAL(4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol), CYMA(N-acetyl-S-(2-cyanoehtyl)-L-cysteine), or CEMA (2-cyanoethylmercapturic acid) using LC–MS/MS. The median(interquartile range) nicotine dependence level was not different among the three types of smokers, being 3.0 (2.0–5.0) for TC- ( n = 726), 3.0 (1.0–4.0) for EC- ( n = 316), and 3.0 (2.0–4.0) for HNBC- ( n = 377) only users. HNBC-only users presented similar biomarker levels compared to TC-only users, except for NNAL (HNBC: 14.5 (4.0–58.8) pg/mL, TC: 32.0 (4.0–69.6) pg/mL; p = 0.0106) and CEMA (HNBC: 60.4 (10.0–232.0) ng/mL, TC: 166.1 (25.3–532.1) ng/mL; p = 0.0007). TC and HNBC users showed increased urinary cotinine levels as early as the time after the first smoke of the day. EC users’ biomarker levels were possibly lower than TC or HNBC users’ but higher than those of non-smokers.

Suggested Citation

  • Guillaume Rudasingwa & Yeonjin Kim & Cheolmin Lee & Jeomkyu Lee & Seunghyun Kim & Sungroul Kim, 2021. "Comparison of Nicotine Dependence and Biomarker Levels among Traditional Cigarette, Heat-Not-Burn Cigarette, and Liquid E-Cigarette Users: Results from the Think Study," IJERPH, MDPI, vol. 18(9), pages 1-12, April.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:9:p:4777-:d:546576
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    1. repec:cdl:ctcres:qt2f65f2j5 is not listed on IDEAS
    2. Tolstrup, J.S. & Hvidtfeldt, U.A. & Flachs, E.M. & Spiegelman, D. & Heitmann, B.L. & Bälter, K. & Goldbourt, U. & Hallmans, G. & Knekt, P. & Liu, S. & Pereira, M. & Stevens, J. & Virtamo, J. & Feskani, 2014. "Smoking and risk of coronary heart disease in younger, middle-aged, and older adults," American Journal of Public Health, American Public Health Association, vol. 104(1), pages 96-102.
    3. Tindle, H.A. & Shiffman, S., 2011. "Smoking cessation behavior among intermittent smokers versus daily smokers," American Journal of Public Health, American Public Health Association, vol. 101(7), pages 1-3.
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