Correlates of the nicotine metabolite ratio in Alaska Native people who smoke cigarettes

Exp Clin Psychopharmacol. 2022 Jun;30(3):359-364. doi: 10.1037/pha0000461. Epub 2021 Apr 15.


Research on nicotine metabolism has primarily focused on white adults. This study examined associations between nicotine metabolism, tobacco use, and demographic characteristics among Alaska Native adults who smoke cigarettes. Participants (N = 244) were Alaska Native adults who smoked and who provided a plasma sample at baseline (70.1%) or follow-up (29.9%) of a randomized controlled trial of a cardiovascular risk behavior intervention. At baseline, participants self-reported age, sex, Alaska Native heritage, cigarettes per day, time to first cigarette upon wakening, menthol use, perceived difficulty staying quit, tobacco withdrawal symptoms, and past-month tobacco product use, binge drinking, and cannabis use. At 3-, 6-, 12-, and 18-month follow-ups, participants self-reported 7-day point prevalence abstinence from smoking. Height and weight were measured to calculate body mass index (BMI). Participants' nicotine metabolite ratio (NMR), calculated as the ratio of plasma cotinine and trans-3' hydroxycotinine, was log-transformed. The sample (52.0% male, age M = 47.0 years [SD = 13.8], 60.3% of Inupiaq heritage) averaged 12.5 cigarettes per day (SD = 10.5); 64.0% smoked within 30 min of wakening. NMR was not significantly associated with age, sex, Alaska Native heritage, BMI, cigarettes per day, time to first cigarette upon wakening, menthol use, perceived difficulty staying quit, past-month dual tobacco product use, withdrawal symptoms, past-month binge drinking, past-month cannabis use, or abstinence from smoking (all p-values > .050). Characteristics that relate to NMR in Alaska Native adults may differ from those typically identified among white adults. Specifically, results may suggest that Alaska Native adults with slower nicotine metabolism do not titrate their nicotine intake when smoking. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Alaskan Natives*
  • Binge Drinking*
  • Cigarette Smoking*
  • Electronic Nicotine Delivery Systems*
  • Female
  • Humans
  • Male
  • Menthol
  • Middle Aged
  • Nicotine / metabolism
  • Smoking Cessation* / methods
  • Substance Withdrawal Syndrome*
  • Tobacco Products*
  • Tobacco Use Disorder*


  • Menthol
  • Nicotine