Nicotine metabolite ratio predicts smoking topography and carcinogen biomarker level

Andrew A. Strasser, Neal L. Benowitz, Angela G. Pinto, Kathy Z. Tang, Stephen S. Hecht, Steve G. Carmella, Rachel F. Tyndale, Caryn E. Lerman

Research output: Contribution to journalArticlepeer-review

74 Scopus citations


Background: Variability in smoking behavior is partly attributable to heritable individual differences in nicotine clearance rates. This can be assessed as the ratio of the metabolites cotinine and 3′-hydroxycotinine (referred to as the nicotine metabolism ratio; NMR). We hypothesized that faster NMR would be associated with greater cigarette puff volume and higher levels of total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), a carcinogen biomarker. Methods: Current smokers (n = 109) smoked one of their preferred brand cigarettes through a smoking topography device and provided specimens for NMR and total NNAL assays. Results: Faster nicotine metabolizers (third and fourth quartiles versus first quartile) based on the NMR exhibited significantly greater total puff volume and total NNAL; the total puff volume by daily cigarette consumption interaction was a significant predictor of total NNAL level. Conclusion: A heritable biomarker of nicotine clearance predicts total cigarette puff volume and total NNAL. Impact: If validated, the NMR could contribute to smoking risk assessment in epidemiologic studies and potentially in clinical practice.

Original languageEnglish (US)
Pages (from-to)234-238
Number of pages5
JournalCancer Epidemiology Biomarkers and Prevention
Issue number2
StatePublished - Feb 2011

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