Population estimates for biomarkers of exposure to cigarette smoke in adult U.S. cigarette smokers

Nicotine Tob Res. 2009 Oct;11(10):1216-25. doi: 10.1093/ntr/ntp126. Epub 2009 Aug 21.


Introduction: There are about 4,800 different chemical constituents in cigarette smoke. Therefore, the total systemic exposure evaluation of the population of smokers to cigarette smoke is challenging. Measurement of biomarkers as surrogates of cigarette smoke constituents is a realistic approach to assess exposure.

Objective: To estimate cigarette smoke exposure of the U.S. smoker population.

Methods: Stratified, cross-sectional, multicenter design (39 sites in 31 states); 3,585 adult cigarette smokers and 1,077 nonsmokers. Biomarkers were determined from 24-hr urine collections or blood samples. Population estimates were generated by weighting sample data with weights from a large U.S. probability sample (Behavioral Risk Factor Surveillance System).

Results: The adult smoker population estimates for tobacco-specific biomarkers were nicotine equivalents 13.3 mg/24 hr (SE 0.14), serum cotinine 184 ng/ml (1.8), and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol 439 ng/24 hr (5.5). The population estimates for smokers and nonsmokers for nontobacco-specific biomarkers were 1-hydroxypyrene 317 (6.8) and 110 (7.1) ng/24 hr, 4-aminobiphenyl Hb adducts 43.1 (1.04) and 11.4 (1.5) pg/g Hb, carboxyhemoglobin 5.26(0.04) in percent of hemoglobin saturation and 1.45(0.02), 3-hydroxypropylmercapturic acid 2,030 (24) and 458 (17) microg/24 hr, monohydroxy-butenyl-mercapturic acid 3.61 (0.1) and 0.30 (0.02) microg/24 hr, and dihydroxy-butyl-mercapturic acid 556 (4.9) and 391 (5.5) microg/24 hr. On average, young adult smokers had lower exposure than older smokers; female smokers had lower exposure than males, and Black smokers had lower exposure than Whites.

Discussion: This study estimated the population exposure to cigarette smoke constituents in adult U.S. smokers and identified significant differences between subpopulations. The data may serve as a reference for monitoring the impact of changes in cigarette consumption and the introduction of potentially reduced exposure cigarettes.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / analysis*
  • Biomarkers / blood
  • Biomarkers / urine
  • Chromatography, Gas
  • Chromatography, Liquid
  • Cross-Sectional Studies
  • Demography
  • Environmental Exposure*
  • Female
  • Humans
  • Immunoassay
  • Male
  • Smoking / blood*
  • Smoking / urine*
  • Tandem Mass Spectrometry
  • Tobacco*
  • United States


  • Biomarkers