Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Carcinogenesis. 2020 Oct 15;41(10):1454-1459. doi: 10.1093/carcin/bgaa015.
This study aims to compare serum cotinine levels in e-cigarette and combustible cigarette smokers, in an attempt to quantify the potential chronic nicotine addiction risk that e-cigarettes pose. We analyzed 428 participants in 2015-2016 NHANES: 379 (87.03%) smoked combustible cigarettes alone and 49 (12.97%) smoked e-cigarettes. Serum cotinine levels were measured by isotope-dilution high-performance liquid chromatography/atmospheric pressure chemical ionization tandem mass spectrometric method with a detection limit of 0.015 ng/ml. Electronic cigarette smokers were younger than combustible cigarette smokers (mean age 36.79 versus 42.69 years, P = 0.03), more likely to be male (64.93% versus 48.32%, P = 0.09) and significantly less likely to live with other smokers (50.17% versus 90.07%, P < 0.01). Serum cotinine levels increased linearly with self-reported days of smoking in both electronic cigarette and combustible cigarette smokers, after accounting for living with a smoker. The analysis of the subgroup who reported daily use show non-statistically significantly higher serum cotinine levels in electronic cigarette smokers versus combustible cigarette smokers (β adj = 52.50, P = 0.10). This analysis of recent US data demonstrates that electronic cigarettes expose users to nicotine levels proportionate to, and potentially higher than combustible cigarettes, and thus pose a serious risk of chronic nicotine addiction. This could be particularly relevant in otherwise tobacco naive individuals; future risk of tobacco-related dependence, addiction and relapse, as well as of tobacco-related cancers in these subjects needs to be investigated.
本研究旨在比较电子烟和可燃香烟吸烟者的血清可替宁水平，试图量化电子烟带来的潜在慢性尼古丁成瘾风险。我们分析了 2015-2016 年 NHANES 的 428 名参与者：379 名（87.03%）单独吸食可燃香烟，49 名（12.97%）吸食电子烟。血清可替宁水平采用同位素稀释高效液相色谱/大气压化学电离串联质谱法测定，检测限为 0.015ng/ml。电子烟吸烟者比可燃香烟吸烟者年轻（平均年龄 36.79 岁比 42.69 岁，P = 0.03），男性比例更高（64.93%比 48.32%，P = 0.09），与其他吸烟者同住的比例明显更低（50.17%比 90.07%，P < 0.01）。在考虑与吸烟者同住的情况下，电子烟和可燃香烟吸烟者的血清可替宁水平均随自我报告的吸烟天数呈线性增加。在报告每日使用的亚组分析中，电子烟吸烟者的血清可替宁水平明显高于可燃香烟吸烟者（β调整= 52.50，P = 0.10）。这项对美国近期数据的分析表明，电子烟使使用者接触到的尼古丁水平与可燃香烟相当，甚至可能更高，因此存在严重的慢性尼古丁成瘾风险。这在原本不吸烟的人群中可能尤其相关；这些人群未来发生与烟草相关的依赖、成瘾和复发的风险，以及与烟草相关的癌症风险，需要进一步研究。
