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. 2021 May 31;21(1):1025.
doi: 10.1186/s12889-021-11052-9.

Characterizing nicotine exposure among a community sample of non-daily smokers in the United States

Andréa L Hobkirk  1   2 , Vishal Midya  3 , Nicolle M Krebs  4 , Sophia I Allen  4 , Lisa Reinhart  4 , Dongxiao Sun  5 , Andrea L Stennett  6 , Joshua E Muscat  4
Affiliations

Characterizing nicotine exposure among a community sample of non-daily smokers in the United States

Andréa L Hobkirk et al. BMC Public Health. .

Abstract

Background: Over one-quarter of all smokers in the United States identify as non-daily smokers and this number is projected to rise. Unlike daily smokers who typically maintain consistent levels of nicotine exposure with regular smoking, non-daily smokers have variable patterns of smoking that likely result in high intraindividual variability in nicotine intake. The current study aimed to characterize the weekly intraindividual variability in cotinine and identify smoking-related predictors in nondaily smokers.

Methods: An ecological momentary assessment of 60 non-daily smokers ages 24-57 years was conducted over a consecutive 7-day at-home protocol to log each smoking session, assessments of mood and social activity during smoking, and collection of daily saliva samples in a convenience sample from Pennsylvania, USA. Hierarchical linear regression analyses were conducted to determine the effects of smoking characteristics on total cotinine exposure measured by pharmacokinetic area under the curve and the range, maximum, and minimum cotinine values during the week controlling for demographic variables.

Results: The mean daily cotinine level was 119.2 ng/ml (SD = 168.9) with individual values that ranged from nondetectable to 949.6 ng/ml. Menthol predicted increased total cotinine levels (P < 0.05). Shorter time to the first cigarette of the day predicted significantly higher minimum (P < 0.05), maximum (P < 0.05), and total cotinine values (P < 0.05) after controlling for covariates. Negative emotions and social interactions with others were also significantly associated with higher cotinine metrics. There was no significant effect of the nicotine metabolite ratio.

Conclusions: Our findings highlight the variability in nicotine exposure across days among non-daily smokers and point to the role of smoking context in nicotine exposure. The findings suggest the need to develop better assessment methods to determine health and dependence risk and personalized cessation interventions for this heterogeneous and growing group of smokers.

Keywords: Cotinine; Nicotine dependence; Nicotine exposure; Non-daily smokers; Smoking behavior.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Display of the intraindividual variability of daily salivary cotinine values for each participant in the sample. For display purposes, the sample was grouped into tertiles based on each participant’s mean cotinine value. Each line represents the daily salivary cotinine (ng/ml) values for a single participant
Fig. 2
Fig. 2
Five cotinine values derived from saliva samples collected every 3–4 h during a single day for six randomly selected participants
See this image and copyright information in PMC

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