Biomarkers of exposure among U.S. Adult cigar smokers: Population Assessment of Tobacco and Health (PATH) study Wave 1 (2013-2014)

Cindy M. Chang, Brian L. Rostron, Joanne T. Chang, Catherine G. Corey, Heather L. Kimmel, Connie S. Sosnoff, Maciej L. Goniewicz, Kathryn C. Edwards, Dorothy K. Hatsukami, Yuesong Wang, Arseima Y. Del Valle-Pinero, Maocheng Yang, Mark J. Travers, Stephen Arnstein, Kristie Taylor, Kevin Conway, Bridget K. Ambrose, Nicolette Borek, Andrew Hyland, Lanqing WangBenjamin C. Blount, Dana M. Van Bemmel

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


BACKGROUND: Given the diverse cigar market and limited data on biomarker patterns by cigar type, we compared biomarkers of nicotine and tobacco toxicants among cigar smokers and other groups.

METHODS: Using Wave 1 urinary biomarker data from 5,604 adults in the Population Assessment of Tobacco and Health (PATH) Study, we compared geometric mean concentrations among cigar-only smokers (all cigars and separately for traditional, cigarillo, and filtered cigars), cigarette-only smokers, dual cigar/cigarette smokers, and never users of tobacco. We calculated geometric mean ratios comparing groups with never users adjusting for sex, age, race/ethnicity, education and creatinine.

RESULTS: Some day cigar-only smokers had lower biomarker concentrations than every day cigar-only smokers, but higher than never users. Every day cigar-only smokers ( n = 61) had lower TNE-2 (cotinine+trans-3'-hydroxycotinine) compared to every day cigarette-only ( n = 2217; P < 0.0001) and dual cigar/cigarette smokers ( n = 601; P < 0.0001). Several biomarkers, including NNAL (NNK metabolite) and CYMA (metabolite of acrylonitrile), were comparable in these groups. In exploratory analyses, every day filtered cigar-only ( n = 7) smokers had higher biomarker concentrations compared with every day traditional cigar-only smokers ( n = 12) and cigarillo-only smokers ( n = 24). Every day smokers of each cigar type were similar to exclusive cigarette smokers. For some biomarkers, particularly for every day filtered cigar-only smokers, concentrations were higher.

CONCLUSIONS: For some biomarkers, every day cigar-only smokers were comparable with every day cigarette-only smokers. Exploratory analyses suggest that biomarkers vary by cigar type with every day filtered cigar-only smokers having the highest concentrations.

IMPACT: High exposure to harmful constituents among cigar smokers is a continuing health issue.

Original languageEnglish (US)
Pages (from-to)943-953
Number of pages11
JournalCancer Epidemiology Biomarkers and Prevention
Issue number5
StatePublished - May 2019

Bibliographical note

Funding Information:
M.L. Goniewicz is a consultant/advisory board member for Johnson & Johnson and receives grant support from Pfizer. This article was prepared while K. Conway was employed at the National Institute on Drug Abuse, NIH. No potential conflicts of interest were disclosed by the other authors.

Funding Information:
We thank Charlie Lawrence, Antonia M. Calafat, Stephen S. Hecht, Heather D'Angelo, and Deborah J. Neveleff for their contributions to this article. This project is supported with Federal funds from the National Institute on Drug Abuse, NIHealth, and the Center for Tobacco Products, Food and Drug Administration, Department of Health and Human Services, under a contract to Westat (contract no. HHSN271201100027C and HHSN271201600001C) and through an interagency agreement between the Center for Tobacco Products, FDA, and the Centers for Disease Control and Prevention.

Publisher Copyright:
©2019 American Association for Cancer Research.

PubMed: MeSH publication types

  • Journal Article


Dive into the research topics of 'Biomarkers of exposure among U.S. Adult cigar smokers: Population Assessment of Tobacco and Health (PATH) study Wave 1 (2013-2014)'. Together they form a unique fingerprint.

Cite this