Associations between biomarkers of nicotine/tobacco exposure and respiratory symptoms among adults who exclusively smoke cigarettes in the U.S.: Findings from the PATH Study Waves 1–4 (2013–2017)

Kathryn C. Edwards; Jenny E. Ozga; Carolyn Reyes-Guzman; Danielle Smith; Dorothy Hatsukami; Joy L. Hart; Asti Jackson; Maciej Goniewicz; Cassandra A. Stanton

doi:10.1016/j.abrep.2023.100487

Associations between biomarkers of nicotine/tobacco exposure and respiratory symptoms among adults who exclusively smoke cigarettes in the U.S. Findings from the PATH Study Waves 1–4 (2013–2017)

Kathryn C. Edwards, Jenny E. Ozga, Carolyn Reyes-Guzman, Danielle Smith, Dorothy Hatsukami, Joy L. Hart, Asti Jackson, Maciej Goniewicz, Cassandra A. Stanton

Psychiatry & Behavioral Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

Significance: Determining if tobacco-related biomarkers of exposure (BOE) are associated with respiratory symptoms is an important public health tool that can be used to evaluate the potential harm of different tobacco products. Methods: Adult data from people who exclusively smoked cigarettes (N = 2,438) in Waves 1–4 (2013–2017) of the Population Assessment of Tobacco and Health Study were stacked to examine associations between baseline and follow-up within wave pairs (W1-W2, W2-W3, W3-W4). Weighted generalized estimating equation models were used to evaluate associations between biomarkers of nicotine, tobacco-specific nitrosamines, acrolein, acrylonitrile, cadmium, and lead at baseline/follow-up and respiratory symptom(s) (wheezing/whistling in the chest, wheezing during exercise, and/or dry cough in the past 12 months) at follow-up. Results: Higher acrolein metabolite (CEMA) levels at follow-up were associated with increased odds of respiratory symptoms at follow-up for people who exclusively smoked cigarettes (aOR = 1.34; 95% CI = 1.06, 1.70), including when limited to those without a diagnosed respiratory disease (aOR = 1.46; 95% CI = 1.12, 1.90) and those who smoked daily (aOR = 1.40; 95% CI = 1.06, 1.84). Higher cadmium levels at baseline (while controlling for follow-up levels) were associated with reduced odds of respiratory symptoms at follow-up (aOR = 0.80; 95% CI = 0.65, 0.98) among people who exclusively smoked cigarettes without a respiratory disease. There were no significant associations between baseline/follow-up BOE and follow-up respiratory symptoms for people who smoked cigarettes non-daily. Conclusions: This research supports measuring biomarkers of acrolein, such as CEMA, as a potential intermediate measurement for increased respiratory symptom development. Measuring these biomarkers could help alleviate the clinical burden of respiratory disease.

Original language	English (US)
Article number	100487
Journal	Addictive Behaviors Reports
Volume	17
DOIs	https://doi.org/10.1016/j.abrep.2023.100487
State	Published - Jun 2023

Bibliographical note

Funding Information:
This study is a cross-institution collaborative project from the Health Effects Special Interest Group supported, in part, by the Center for Coordination of Analytics, Science, Enhancement and Logistics (CASEL) in Tobacco Regulatory Science U54DA046060-01 (National Institute of Drug Abuse (NIDA) and the Food and Drug Administration’s Center for Tobacco Products (FDA CTP). Individual authors were supported, in part, as follows: JLH-National Heart, Lung, and Blood Institute (NHLBI) and FDA CTP (U54HL120163) and National Institute of Environmental Health Sciences (NIEHS) (P42 ES023716); CRG- NCI (HHSN261201700004I). The content of this presentation/paper is solely the responsibility of the authors and does not necessarily represent the official views of the co-authors’ institutions, the NIH, or the FDA.

Publisher Copyright:
© 2023 The Author(s)

Keywords

Biomarkers
Cigarette
Nicotine
Public health

PubMed: MeSH publication types

Journal Article

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.abrep.2023.100487

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Cite this

Edwards, K. C., Ozga, J. E., Reyes-Guzman, C., Smith, D., Hatsukami, D., Hart, J. L., Jackson, A., Goniewicz, M., & Stanton, C. A. (2023). Associations between biomarkers of nicotine/tobacco exposure and respiratory symptoms among adults who exclusively smoke cigarettes in the U.S. Findings from the PATH Study Waves 1–4 (2013–2017). Addictive Behaviors Reports, 17, Article 100487. https://doi.org/10.1016/j.abrep.2023.100487

Associations between biomarkers of nicotine/tobacco exposure and respiratory symptoms among adults who exclusively smoke cigarettes in the U.S. Findings from the PATH Study Waves 1–4 (2013–2017). / Edwards, Kathryn C.; Ozga, Jenny E.; Reyes-Guzman, Carolyn et al.
In: Addictive Behaviors Reports, Vol. 17, 100487, 06.2023.

Research output: Contribution to journal › Article › peer-review

Edwards, KC, Ozga, JE, Reyes-Guzman, C, Smith, D, Hatsukami, D, Hart, JL, Jackson, A, Goniewicz, M & Stanton, CA 2023, 'Associations between biomarkers of nicotine/tobacco exposure and respiratory symptoms among adults who exclusively smoke cigarettes in the U.S. Findings from the PATH Study Waves 1–4 (2013–2017)', Addictive Behaviors Reports, vol. 17, 100487. https://doi.org/10.1016/j.abrep.2023.100487

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title = "Associations between biomarkers of nicotine/tobacco exposure and respiratory symptoms among adults who exclusively smoke cigarettes in the U.S.: Findings from the PATH Study Waves 1–4 (2013–2017)",

abstract = "Significance: Determining if tobacco-related biomarkers of exposure (BOE) are associated with respiratory symptoms is an important public health tool that can be used to evaluate the potential harm of different tobacco products. Methods: Adult data from people who exclusively smoked cigarettes (N = 2,438) in Waves 1–4 (2013–2017) of the Population Assessment of Tobacco and Health Study were stacked to examine associations between baseline and follow-up within wave pairs (W1-W2, W2-W3, W3-W4). Weighted generalized estimating equation models were used to evaluate associations between biomarkers of nicotine, tobacco-specific nitrosamines, acrolein, acrylonitrile, cadmium, and lead at baseline/follow-up and respiratory symptom(s) (wheezing/whistling in the chest, wheezing during exercise, and/or dry cough in the past 12 months) at follow-up. Results: Higher acrolein metabolite (CEMA) levels at follow-up were associated with increased odds of respiratory symptoms at follow-up for people who exclusively smoked cigarettes (aOR = 1.34; 95% CI = 1.06, 1.70), including when limited to those without a diagnosed respiratory disease (aOR = 1.46; 95% CI = 1.12, 1.90) and those who smoked daily (aOR = 1.40; 95% CI = 1.06, 1.84). Higher cadmium levels at baseline (while controlling for follow-up levels) were associated with reduced odds of respiratory symptoms at follow-up (aOR = 0.80; 95% CI = 0.65, 0.98) among people who exclusively smoked cigarettes without a respiratory disease. There were no significant associations between baseline/follow-up BOE and follow-up respiratory symptoms for people who smoked cigarettes non-daily. Conclusions: This research supports measuring biomarkers of acrolein, such as CEMA, as a potential intermediate measurement for increased respiratory symptom development. Measuring these biomarkers could help alleviate the clinical burden of respiratory disease.",

keywords = "Biomarkers, Cigarette, Nicotine, Public health",

author = "Edwards, {Kathryn C.} and Ozga, {Jenny E.} and Carolyn Reyes-Guzman and Danielle Smith and Dorothy Hatsukami and Hart, {Joy L.} and Asti Jackson and Maciej Goniewicz and Stanton, {Cassandra A.}",

note = "Funding Information: This study is a cross-institution collaborative project from the Health Effects Special Interest Group supported, in part, by the Center for Coordination of Analytics, Science, Enhancement and Logistics (CASEL) in Tobacco Regulatory Science U54DA046060-01 (National Institute of Drug Abuse (NIDA) and the Food and Drug Administration{\textquoteright}s Center for Tobacco Products (FDA CTP). Individual authors were supported, in part, as follows: JLH-National Heart, Lung, and Blood Institute (NHLBI) and FDA CTP (U54HL120163) and National Institute of Environmental Health Sciences (NIEHS) (P42 ES023716); CRG- NCI (HHSN261201700004I). The content of this presentation/paper is solely the responsibility of the authors and does not necessarily represent the official views of the co-authors{\textquoteright} institutions, the NIH, or the FDA. Publisher Copyright: {\textcopyright} 2023 The Author(s)",

year = "2023",

month = jun,

doi = "10.1016/j.abrep.2023.100487",

language = "English (US)",

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T2 - Findings from the PATH Study Waves 1–4 (2013–2017)

AU - Edwards, Kathryn C.

AU - Ozga, Jenny E.

AU - Reyes-Guzman, Carolyn

AU - Smith, Danielle

AU - Hatsukami, Dorothy

AU - Hart, Joy L.

AU - Jackson, Asti

AU - Goniewicz, Maciej

AU - Stanton, Cassandra A.

N1 - Funding Information: This study is a cross-institution collaborative project from the Health Effects Special Interest Group supported, in part, by the Center for Coordination of Analytics, Science, Enhancement and Logistics (CASEL) in Tobacco Regulatory Science U54DA046060-01 (National Institute of Drug Abuse (NIDA) and the Food and Drug Administration’s Center for Tobacco Products (FDA CTP). Individual authors were supported, in part, as follows: JLH-National Heart, Lung, and Blood Institute (NHLBI) and FDA CTP (U54HL120163) and National Institute of Environmental Health Sciences (NIEHS) (P42 ES023716); CRG- NCI (HHSN261201700004I). The content of this presentation/paper is solely the responsibility of the authors and does not necessarily represent the official views of the co-authors’ institutions, the NIH, or the FDA. Publisher Copyright: © 2023 The Author(s)

PY - 2023/6

Y1 - 2023/6

N2 - Significance: Determining if tobacco-related biomarkers of exposure (BOE) are associated with respiratory symptoms is an important public health tool that can be used to evaluate the potential harm of different tobacco products. Methods: Adult data from people who exclusively smoked cigarettes (N = 2,438) in Waves 1–4 (2013–2017) of the Population Assessment of Tobacco and Health Study were stacked to examine associations between baseline and follow-up within wave pairs (W1-W2, W2-W3, W3-W4). Weighted generalized estimating equation models were used to evaluate associations between biomarkers of nicotine, tobacco-specific nitrosamines, acrolein, acrylonitrile, cadmium, and lead at baseline/follow-up and respiratory symptom(s) (wheezing/whistling in the chest, wheezing during exercise, and/or dry cough in the past 12 months) at follow-up. Results: Higher acrolein metabolite (CEMA) levels at follow-up were associated with increased odds of respiratory symptoms at follow-up for people who exclusively smoked cigarettes (aOR = 1.34; 95% CI = 1.06, 1.70), including when limited to those without a diagnosed respiratory disease (aOR = 1.46; 95% CI = 1.12, 1.90) and those who smoked daily (aOR = 1.40; 95% CI = 1.06, 1.84). Higher cadmium levels at baseline (while controlling for follow-up levels) were associated with reduced odds of respiratory symptoms at follow-up (aOR = 0.80; 95% CI = 0.65, 0.98) among people who exclusively smoked cigarettes without a respiratory disease. There were no significant associations between baseline/follow-up BOE and follow-up respiratory symptoms for people who smoked cigarettes non-daily. Conclusions: This research supports measuring biomarkers of acrolein, such as CEMA, as a potential intermediate measurement for increased respiratory symptom development. Measuring these biomarkers could help alleviate the clinical burden of respiratory disease.

AB - Significance: Determining if tobacco-related biomarkers of exposure (BOE) are associated with respiratory symptoms is an important public health tool that can be used to evaluate the potential harm of different tobacco products. Methods: Adult data from people who exclusively smoked cigarettes (N = 2,438) in Waves 1–4 (2013–2017) of the Population Assessment of Tobacco and Health Study were stacked to examine associations between baseline and follow-up within wave pairs (W1-W2, W2-W3, W3-W4). Weighted generalized estimating equation models were used to evaluate associations between biomarkers of nicotine, tobacco-specific nitrosamines, acrolein, acrylonitrile, cadmium, and lead at baseline/follow-up and respiratory symptom(s) (wheezing/whistling in the chest, wheezing during exercise, and/or dry cough in the past 12 months) at follow-up. Results: Higher acrolein metabolite (CEMA) levels at follow-up were associated with increased odds of respiratory symptoms at follow-up for people who exclusively smoked cigarettes (aOR = 1.34; 95% CI = 1.06, 1.70), including when limited to those without a diagnosed respiratory disease (aOR = 1.46; 95% CI = 1.12, 1.90) and those who smoked daily (aOR = 1.40; 95% CI = 1.06, 1.84). Higher cadmium levels at baseline (while controlling for follow-up levels) were associated with reduced odds of respiratory symptoms at follow-up (aOR = 0.80; 95% CI = 0.65, 0.98) among people who exclusively smoked cigarettes without a respiratory disease. There were no significant associations between baseline/follow-up BOE and follow-up respiratory symptoms for people who smoked cigarettes non-daily. Conclusions: This research supports measuring biomarkers of acrolein, such as CEMA, as a potential intermediate measurement for increased respiratory symptom development. Measuring these biomarkers could help alleviate the clinical burden of respiratory disease.

KW - Biomarkers

KW - Cigarette

KW - Nicotine

KW - Public health

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