Five-Day Changes in Biomarkers of Exposure Among Adult Smokers After Completely Switching From Combustible Cigarettes to a Nicotine-Salt Pod System. Issue 8 (5th November 2019)

• Record Type: Journal Article
• Authors: Jay, Joanna; Pfaunmiller, Erika L; Huang, Norman J; Cohen, Gal; Graff, Donald W
• Is Part Of: Nicotine & tobacco research. Volume 22:Issue 8(2020)
• Page Start: 1285
• Page End: 1293
• Publication Date: 2019-11-05
• Subjects: Nicotine -- Periodicals; Tobacco -- Research -- Periodicals; Tobacco habit -- Periodicals; Nicotine -- Periodicals; Tobacco -- Periodicals; Smoking -- Periodicals; 613.85
• DOI: 10.1093/ntr/ntz206
• Languages: English
• ISSNs: 1462-2203

Abstract

Abstract: Introduction: This study examined changes in biomarkers of exposure (BoE) after 5 days of nicotine-salt pod system (NSPS) use, compared with continuation of usual-cigarette smoking and cigarette abstinence, among adult combustible cigarette smokers. Aims and Methods: A randomized, open-label, parallel-cohort, confinement study of healthy adult smokers, naive to NSPS use, was conducted. Participants ( N = 90) were randomized to six cohorts ( n = 15 each): exclusive ad libitum use of NSPS (four flavors: Virginia Tobacco, Mint, Mango, Creme), continuation of usual-brand cigarette smoking, or cigarette abstinence. Total nicotine equivalents and BoE (NNN, NNAL, 3-HPMA, MHBMA, S-PMA, HMPMA, CEMA, 1-OHP, and COHb) were measured. Results: Eight non-nicotine BoEs, measured in urine, were reduced by an aggregate of 85.0% in the pooled NSPS cohort; increased by 14.4% in the cigarette cohort ( p < .001 for pooled NSPS vs. cigarette); and reduced by 85.3% in the abstinence cohort ( p > .05; 99.6% relative reduction between pooled NSPS vs. abstinence). Similar changes in individual BoEs were also observed ( p < .001 for each BoE between pooled NSPS vs. cigarettes; and abstinence vs. pooled NSPS; p > .05 for each BoE between pooled NSPS vs. abstinence). Blood COHb decreased by 71.8% in the pooled NSPS cohort and 69.1% in the abstinence cohort ( p > .05) and increased by 13.3% in the cigarette cohort ( p < .001). Mean total urine nicotine equivalents increased in the pooled NSPS and cigarette cohorts by 9% and 26%, respectively, and did not significantly differ ( p > .05). Conclusion: Complete switching from cigarettes to NSPS produced significant reductions in key non-nicotine BoEs associated with cigarette smoking. Implications: The results of this study concorded with evidence that complete switching from combustible cigarettes to tobacco and nontobacco-flavored vapor products may reduce exposure to key carcinogens and other toxicants known to be associated with tobacco-related diseases. Future research is needed to assess the long-term health effects of NSPS use. These results should not be interpreted to mean that the use of NSPS is without any risk, particularly for nonusers of tobacco products.