Tobacco Biomarkers by Latino Heritage and Race, US, 2007 to 2014 National Health and Nutrition Examination Survey.

BACKGROUND

Tobacco biomarkers reflect smoking intensity and are used to assess cessation status. No study has evaluated variation by Latino heritage.

METHODS

Data from the 2007 to 2014 National Health and Nutrition Examination Survey were used to evaluate geometric mean concentrations of serum cotinine and urinary total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), stratified by smoking status and race and ethnicity, and ROC curves estimated values to distinguish smokers from nonsmokers by race and ethnicity and Latino heritage.

RESULTS

The sample (n = 18,597) was 50.1% female, 16.6% Latino (58.6% Mexican, 10.4% Central American, 9.1% South American, 7.3% Puerto Rican, 3.5% Dominican, 2.7% Cuban, and 8.4% other Latinos, overall), 12.7% Black, and 70.7% White. Black nonsmokers and smokers had the highest cotinine concentrations (0.1 and 177.1 ng/mL), and among nonsmokers, Black individuals had the highest NNAL concentrations (1.4 pg/mL). Latino smokers had the lowest cotinine (32.7 ng/mL) and NNAL (63.9 pg/mL) concentrations. Among Latino smokers, Puerto Rican individuals had higher concentrations of cotinine (100.0 ng/mL) and NNAL (136.4 pg/mL). Cotinine levels defining smoking (Black: 9.1 ng/mL; Latino: 0.9 ng/mL; White: 3.8 ng/mL) and NNAL (Black: 24.1 pg/mL; Latino: 5.7 pg/mL; White: 15.5 pg/mL) varied. Puerto Rican adults (cotinine: 8.5 ng/mL; NNAL: 17.2 pg/mL) had higher levels than Central American (cotinine: 1.0 ng/mL, NNAL: 5.5 pg/mL) and Mexican (cotinine: 0.9 ng/mL, NNAL: 6.0 pg/mL) adults.

CONCLUSIONS

Cotinine and NNAL concentrations that define smoking differed by race and ethnicity and by heritage among Latinos, showing meaningful differences.

IMPACT

Cessation interventions with biomarker validation need to consider Latino heritage.