• 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 Wang, Benjamin C Blount, and Dana M van Bemmel.
• Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland. Cindy.Chang@fda.hhs.gov.
• Cancer Epidemiol. Biomarkers Prev. 2019 May 1; 28 (5): 943-953.

BackgroundGiven 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.MethodsUsing 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.ResultsSome 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.ConclusionsFor 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.ImpactHigh exposure to harmful constituents among cigar smokers is a continuing health issue.©2019 American Association for Cancer Research.

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