Abstract
Objective
It is unclear why Black smokers in the United States have elevated risk of some tobacco-related diseases compared to White smokers. One possible causal mechanism is differential intake of tobacco toxicants, but results across studies are inconsistent. Thus, we examined racial differences in biomarkers of toxic volatile organic compounds (VOCs) present in tobacco smoke.
Method
We analyzed baseline data collected from 182 Black and 184 White adult smokers who participated in a randomized clinical trial in 2013–2014 at 10 sites across the United States. We examined differences in urinary levels of ten VOC metabolites, total nicotine equivalents (TNE), and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), controlling for covariates such as cigarettes per day (CPD), as well as differences in VOCs per TNE to assess the extent to which tobacco exposure, and not metabolic factors, accounted for racial differences.
Results
Concentration of metabolites of acrolein, acrylonitrile, ethylene oxide, and methylating agents were significantly higher in Blacks compared to Whites when controlled for covariates. Other than the metabolite of methylating agents, VOCs per TNE did not differ between Blacks and Whites. Concentrations of TNE/CPD and VOCs/CPD were significantly higher in Blacks. Menthol did not contribute to racial differences in VOC levels.
Conclusions
For a given level of CPD, Black smokers likely take in higher levels of acrolein, acrylonitrile, and ethylene oxide than White smokers. Our findings are consistent with Blacks taking in more nicotine and toxicants per cigarette smoked, which may explain their elevated disease risk relative to other racial groups.
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Acknowledgements
We thank Lisa Yu, Kristina Bello, and Lawrence Chan for lab analyses, and all members of the Center for the Evaluation of Nicotine in Cigarettes for data collection. This work was supported by grant U54 DA031659 (ECD/DKH) from the National Institute on Drug Abuse and the Food and Drug Administration Center for Tobacco Products; grants DA02277 (NLB), DA012393 (Reese Jones, not a co-author), and R25DA035163 (James Sorensen, not a co-author) from the National Institute on Drug Abuse; grant P30AG15272 (EJP-S) from the National Institute on Aging; grant S10RR026437 from the National Center for Research Resources; grant 22FT-0067 (GStH) from the California Tobacco Related Disease Research Program and a Resource Allocation Program (RAP) grant from the University of California, San Francisco (GStH). The contents and views in this manuscript are those of the authors and should not be construed to represent the views of the National Institutes of Health, the Food and Drug Administration, or any of the sponsoring organizations or agencies of the US government.
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NLB is a consultant to Pfizer and Achieve Life Sciences, companies that market or are developing smoking cessation medications, and has served as a paid expert witness in litigation against tobacco companies. The other authors declare that they have no conflict of interest.
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St.Helen, G., Benowitz, N.L., Ko, J. et al. Differences in exposure to toxic and/or carcinogenic volatile organic compounds between Black and White cigarette smokers. J Expo Sci Environ Epidemiol 31, 211–223 (2021). https://doi.org/10.1038/s41370-019-0159-9
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DOI: https://doi.org/10.1038/s41370-019-0159-9