261729 Racial differences in the relationship between nicotine dependence and nicotine and carcinogen exposure

Monday, October 29, 2012

Gideon St.Helen, PhD , Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA
Delia Dempsey, MD , Department of Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics, University of California, San Francisco, San Francisco, CA
Margaret Wilson , Department of Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics, University of California, San Francisco, San Francisco, CA
Peyton Jacob III, PhD , Department of Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics, University of California, San Francisco, San Francisco, CA
Neal L. Benowitz, MD , Department of Medicine, Division of Clinical Pharmacology and Experimental Therapeutics, Medical Service, University of California, San Francisco, San Francisco, CA
Introduction: Black smokers are reported to smoke cigarettes differently, have greater nicotine dependence, and have higher risk for lung cancer than non-Hispanic White smokers. We investigated the relationship between nicotine dependence and biomarkers of nicotine and tobacco carcinogens in Black and White smokers.

Methods: We measured urine nicotine equivalents, 4-(methylnitrosamino)-1-(3)pyridyl-1-butanol (NNAL), and polycyclic aromatic hydrocarbon (PAH) metabolites in 204 Black and White smokers. We used time to first cigarette after waking (TFC) and Fagerström Test for Nicotine Dependence (FTND) to measure tobacco dependence.

Results: Respective average TFC and FTND for Black and White smokers were not significantly different (all p-values>0.05). Urine nicotine equivalents, NNAL, and total PAH metabolites remained flat with increasing FTND in Black smokers but increased in White smokers (Race x FTND interaction, all p-values <0.005). FTND was not significantly correlated with urine nicotine equivalents, NNAL, and PAHs in Black smokers with low nicotine dependence (TFC>15 min) or high dependence (TFC≤15 min) (median TFC=15 minutes). In contrast, there was moderately strong correlation between FTND and nicotine equivalents, NNAL, and PAH among White smokers of low nicotine dependence and poor or non-significant correlations among White smokers with high dependence.

Conclusion: Our data indicate a poor relationship between nicotine dependence measures and tobacco exposure biomarkers and carcinogens among Black compared to White smokers. The relationship between nicotine dependence measures and tobacco biomarkers in Black smokers regardless of level of dependency resembled highly nicotine dependent White smokers.

Learning Areas:
Chronic disease management and prevention
Diversity and culture
Environmental health sciences
Epidemiology
Public health or related research

Learning Objectives:
Evaluate racial differences in the relationship between nicotine dependence and biomarkers of nicotine and tobacco carcinogens

Keywords: Smoking, Smoking Cessation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I performed the statistical analysis and wrote the first draft of the paper. I have also been the first author of two papers from an NIH funded study on outdoor secondhand smoke that are currently under revision.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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